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Fertility, family planning, & egg freezing
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Egg freezing is the fastest-growing fertility treatment in the UK, with the procedure rising by 64 per cent in just two years during the pandemic.
It was once perceived to be a treatment exclusive to the rich and famous, including Khloe and Kourtney Kardashian, Paris Hilton, Chrissy Teigen, Emma Roberts, and Sofía Vergara – who have all been vocal about their decision to freeze their eggs. But now, with the saturation of social media and the procedure becoming more widespread, there has been an increase in women wanting to learn more.
With recent advances in science and further research into fertility, people are becoming more aware of fertility decline and the biological certainty that eggs change with age.
Society has evolved since the 1970s and experienced a massive shift, with more women and people with ovaries knuckling down on careers and leading busy lifestyles. More interestingly, a study revealed that the top influence for 70 per cent of women who wanted to freeze their eggs was, in fact, not having yet found a partner they wanted to have children with.
Dr Vivienne Hall, Amilis consultant and fertility medicine specialist, has witnessed the increase firsthand.
She noted a stark difference in 2014 when the vitrification process was introduced, which saw an increase in pregnancy rates from freezing and gave clinics the confidence to recommend it as a successful procedure.
Dr Hall also backs the belief that social media has influenced the rise, as more women have opened up about their experiences online. Some have gone as far as to throw parties for their frozen eggs, while others have committed their life savings to the cause.
In 2022, the Human Fertilisation and Embryology Authority (HFEA) changed the law to extend the length of time of freezing eggs from 10 to 55 years.
"There was a glitch in the HFEA legislation that stated that eggs could only be frozen for 10 years," Dr Hall explained. "This made women worry about reaching an expiry date before they were ready to try for a pregnancy. This was a total mistake as men could freeze their sperm for 55 years. This was rectified in 2022 and women can now also freeze for up to 55 years."
Dr Hall has seen people from as young as 23 to the age of 42, and the average age of people visiting Amilis is 36.
"In the clinic, I am seeing more younger women coming in and doing it if they have the means - particularly those in their mid to late 20s," she explained. "It is true that the younger you do it, the higher your chances are of freezing eggs that are by definition 'normal.'"
The cost is dependent on a variety of factors including the clinic, location and medications required, though it typically totals around £5,000 to £7,000 in the UK. This includes the screening, initial consultation, medications and ongoing tests, anaesthetist fees, HFEA fee and freezing. You will then pay an annual storage fee of around £350 to £400.
The egg-freezing process is typically broken down into four phases, as per Dr Hall:
Tests and monitoring
Blood tests to assess hormone levels like oestrogen, Anti-Müllerian Hormone (AMH) and Follicle-Stimulating Hormone (FSH) which helps stimulate follicle growth. You'll also undergo an ultrasound to measure your antral follicle count which can be an indicator of your remaining egg reserve. Results will help you decide how successful it could be, the chances of having a baby from freezing your eggs and how many cycles you may need to do.
Ovarian stimulation
This is the part people have probably heard about the most. You'll be prescribed medications to stimulate the ovaries to develop multiple mature eggs at once (usually it's just one per month) to help increase the number of eggs available for freezing. These medications are typically injectable fertility drugs and will be monitored and adjusted by your doctor throughout the process. You may also be asked to take a few tablets before your period starts to 'prime' and help ensure that eggs grow uniformly to help you get more mature eggs.
You'll be on the medications for 11 to 14 days to stimulate your ovaries to produce eggs.
HCG trigger shot
Once the ultrasound shows the follicles have reached a good size (indicating that they probably contain mature eggs) you'll be prescribed a trigger shot. This trigger shot contains a surge of Human Chorionic Gonadotropin (hCG) or similar which is a hormone that mimics the body's natural ovulation signal. This is done at precisely 36 hours before egg retrieval.
Egg retrieval
This is an ultrasound-guided surgical procedure to retrieve the mature eggs directly from the ovaries.
Gynaecologists use a transvaginal ultrasound-guided needle. The doctor guides the thin needle through the vagina and punctures the follicles to aspirate the eggs using the ultrasound image as a guide. Your eggs are then tested with viable mature eggs transferred to the freezer and stored. You'll likely feel out of sorts for the first few days after the retrieval with some spotting, but most people are back to work the following day.
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When the person is ready to take the next step, they will undergo a treatment to thicken the lining of the uterus over the course of a cycle, Dr Hall explained. This is generally done naturally or stimulated with prescribed medications.
"You'll be monitored to determine when your lining has reached the desired thickness. From there your eggs are taken out of the freezer, thawed and fertilised with your partner or donor sperm. This has to be done with a procedure known as the ICSI technique," she continued.
The next day will determine whether fertilisation has occurred before embryos are cultured in the lab for five days and then transferred to the uterus using a simple technique similar to a smear test.
Dr Hall highlighted that there is an additional cost to this step, ranging from £1,500 to £2,000.
Dr Hall acknowledges that there's still work to be done in terms of awareness and affordability. Recently, Amils launched one of the most affordable AMH tests on the market which can really aid in stripping back on some of the cost.
"Sadly, at the moment it's still totally on the person to pay to freeze eggs for social reasons. NHS spends on fertility treatment for women in their late 30s and 40s. Hopefully, this will change as in the long term it's beneficial for all women to freeze their eggs," she said.
"We don't have a crystal ball to know what your future may hold – you may never need to use your frozen eggs - but if you can, it's worth providing yourself with the option."
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