Record numbers of women in the UK are now choosing to freeze their eggs, according to new data released by the Human Fertilisation and Embryology Authority (HFEA) earlier this week.

More than 4,200 patients froze their eggs in 2021, compared to 2,576 in 2019. It’s a dramatic rise of 64%, making egg and embryo freezing the UK’s fastest-growing fertility treatment.

For women who are not yet ready to start a family, the procedure can “take off some of the pressure of having to think about having children immediately while maybe juggling other things that you want to do in your life”, says Kayleigh Hartigan, the founder of Fertility Mapper, who has worked in the sector for around 18 years and advised on the government’s Women’s Health Strategy.

But, she says, women need to be aware of both the positive and negative aspects of freezing their eggs: “This is genuinely a medical procedure, and we should be prepared for the impact of that before starting.” 

If egg freezing is something you have been considering, or if you’re just keen to understand more about what it involves, here is what you should know. 

What is egg freezing?

Until 2012, egg freezing tended to be reserved for women facing premature infertility or undergoing medical treatments like chemotherapy. Since then, it has become more widely available to women (albeit at a cost – more on that later) as a means of attempting to preserve their fertility.

Everyone will have different reasons for opting for egg freezing: some women know they want to have children but haven’t found the right partner yet; others don’t feel like they are in the right emotional or financial situation for parenthood or want more time to build their careers. Sanya-Jeet Thandi, 30, froze her eggs earlier this year after her divorce. “I don’t want to go into dating with the pressure of thinking I want a family,” she tells Stylist. Egg freezing, she thought, would “take the pressure off my love life completely, and I can really focus on my career for the coming years”.

It’s crucial, however, to bear in mind that freezing your eggs is not a guarantee that you will have children in the future; indeed, Thandi says she has come to see it as “like an insurance policy” for her biology.

The process is similar to the first half of IVF treatment. After a preparation period to stimulate the ovaries, a fine needle attached to a probe is passed through the ovary. The fluid within each follicle is aspirated and then checked for an egg, which will then be frozen, usually through a technique known as vitrification.

The survival rate of eggs has increased since vitrification became more common in fertility treatments. “The age that you freeze your eggs impacts the likely success of the process,” Hartigan explains (the HFEA recommends undergoing freezing before 35). 

What are the costs?

Egg freezing is a very pricey process – and it’s not as simple as preparing for one up-front cost, either. Your first expenses will include all the initial tests and investigations, says Hartigan. Then there is the procedure itself. “Different clinics include different things in their package price,” she adds, explaining that some won’t include the cost of vitrification, so check and double-check the small print.

You’ll also have to pay for your eggs to be stored each year, which tends to cost between £125 and £350 annually, according to the HFEA. Overall, they estimate that the process of egg freezing and thawing costs an average of £7,000 to £8,000.

Finding a clinic

Before you embark on this process, it’s crucial to remember that although egg freezing is an increasingly common procedure, it’s still one that comparatively few people undergo. “The numbers are around just over 4,000 people [in 2021],” Hartigan notes. “It’s really important to know that while that number is significant, there were roughly 76,000 rounds of IVF [undertaken] in that same year. What that means is if you’re going to a fertility clinic, not all fertility clinics will have even carried out the egg-freezing procedure.” 

And once you have frozen your eggs, she adds: “If you plan to use them in the future, you obviously have to thaw them, [and] the actual number of eggs that have been thawed from fertility clinics is likely to be very low.”

Two key questions to ask at an initial consultation with a fertility clinic, Hartigan says, are: “How many rounds of egg freezing have you done, and have you ever thawed eggs and used them in a follow-up procedure?” Finding an experienced embryologist is just as important as an experienced consultant, too. “Eggs are single-celled, and embryos are a combination of cells, which means that eggs are very delicate,” she notes.

Also key is choosing a clinic where you feel well informed; it’s worth investigating whether they offer out-of-hours support or the chance to talk to an embryologist beforehand. Thandi says she phoned up various potentials before eventually opting for the clinic that made her feel most at ease. “I was really scared, if I’m honest, so if someone made me feel more comfortable, I was going to go with them,” she explains.

Thandi also found it useful to reach out to other people who had undergone the procedure before. If you don’t know anyone who has frozen their eggs, you might consider consulting clinic reviews or signing up to a free online community, like The IVF Network, which offers support and advice. 

Before the process

Before the egg freezing cycle begins, you’ll take an anti-Mullerian hormone (AMH) test, which helps to assess your ovarian reserve, and undergo an ultrasound scan “that looks at your uterus and your ovaries, and counts the follicles”, explains Rebecca Hay, a registered midwife and patient services manager at London fertility clinic The Evewell.

You’ll also have a consultation with a doctor about your medical history and how many children you might want to have, as that may impact the number of cycles that you need. A nurse will also talk you through your treatment plan and explain the consent forms. 

“We’re a very tightly regulated industry, so there’s a lot of consent forms that we want people to have the time to understand and digest,” Hay says. This paperwork will set out how long the eggs will be stored and details about how they might be used if something happens to you in the future. 

The freezing cycle

The cycle usually begins with your period. When you start to bleed, you get in touch with your clinic, then arrange to come in for a baseline scan, which is usually on day two or day three of your menstrual cycle, Hay explains. This is to check your uterine lining and to see whether there are any cysts on your ovaries that might impact the treatment. 

“Cysts can come and go from month to month – they’re not necessarily anything sinister, but you need to make sure that they’re not going to interfere when we start giving medication,” Hay adds.

Once your clinic has given you the go-ahead, you’ll have to inject yourself with a follicle-stimulating hormone, usually for 10 days. During this period, you’ll be visiting the clinic for regular scans every other day, so that the staff can track how the follicles are developing. Thandi stayed with her parents during this time. 

“My recommendation to any woman going through it would be: if you’ve got family that can support you and help you, do that,” she says. “Or if you can stay with a friend or have a friend come to stay with you, do that.”

The injections, Thandi adds, have “got to be taken like clockwork – you have to take them at the same time every day”. She started to feel pain “around the injection sites” (this will vary from patient to patient, and not everyone will experience this); she also recalls a day when her emotions were “just off the charts. I knew it was the hormones, but it didn’t make it any easier.”

Halfway through the cycle, another medication is introduced to stop you ovulating. “We’re trying to suppress that natural response because we want all of those eggs to be within the sac – we need to say where we’re collecting the eggs from,” Hay explains. “When we can see on the scans that those follicles are big enough that they’re likely to contain a mature egg, that’s when we plan for somebody to have that collection.” Thirty-six hours before your eggs are retrieved, you’ll take a ‘trigger injection’. 

In the run-up to her operation, Thandi continued to experience pain and had to visit her clinic every day for regular scans. She learned that she was at risk of ovarian hyper-stimulation syndrome (OHSS), and her procedure was brought forward by a day. OHSS can cause fluid to build up in the abdomen or ovaries, and according to the Royal College of Obstetricians and Gynaecologists, just over one in 100 women will develop moderate or severe OHSS during their fertility treatment. Research has found that it is more common in younger women, as well as women with polycystic ovary syndrome (PCOS), with high levels of oestrogen and with large numbers of follicles.

The process itself

Egg retrieval takes place under deep sedation, rather than a general anaesthetic, and the process tends to take from 20 to 30 minutes. The embryologist will count the eggs, and later that day, they should be able to contact you and let you know how many have been “matured” and therefore how many can be frozen, Hay says. 

In terms of downtime, she adds that “everybody is different” – some will feel mild pain, some will have very few side effects, and others will be affected for longer, like Thandi, who experienced pain for about a week after the operation.

Some women, especially if they are older, will need to undergo another cycle to retrieve more eggs, Hartigan notes. “You are really investing a lot of time and money and emotions into the process,” she says, cautioning against seeing egg freezing as a “one and done” thing. 

What happens further down the line?

When you are ready to continue your fertility treatment, the clinic will create embryos using sperm from a partner or a donor, through a technique called ICSI (intracytoplasmic sperm injection). Between five and seven days later, the embryo is transferred to the womb. IVF, of course, doesn’t guarantee a pregnancy, and can be extremely emotionally and physically demanding.

“I think the misconception out there is that egg freezing is a silver bullet,” Hays says. “Our standpoint is that it is for people that are not ready to have a baby right now, or whose [fertility test] results clinically are lower than they would like, and they want to preserve some options for the future.”

You can find more information and statistics about egg freezing at hfea.gov.uk

Images: Getty