Oocyte cryopreservation, a fancy term for egg freezing, is a relatively new technology that allows a woman to retrieve and freeze her eggs in order to delay pregnancy. Many women are turning to this procedure for a variety of reasons: they don't feel ready for pregnancy just yet, they aren't in a committed relationship, or they've been diagnosed with cancer, and the chemotherapy would impact their fertility. The good news is that having PCOS doesn't mean that you should freeze your eggs, although you might consider doing so for one of the reasons listed above.
How Does the Procedure Work?
Oocyte cryopreservation is very similar to the initial stages of IVF: you’ll take two different types of medication for a period of approximately a week and a half to two weeks. The first medication suppresses your body’s natural hormone production so that you don't ovulate prematurely, and the second stimulates the ovaries to produce multiple eggs instead of the usual one.
While you're on the medication, you'll be instructed to return to the office for monitoring visits — blood tests and ultrasounds — to assess your response to the medication. Every doctor and clinic has its own protocol: some physicians will have you visit every day, while others will only have you come in a few times during the entire cycle. Be sure to follow his instructions exactly.
Once the doctor feels that the eggs are sufficiently developed, he will instruct you to take a final trigger injection of human chorionic gonadotropin, or hCG, to cause the eggs to mature. A minor surgery, the egg retrieval is performed approximately 35 ½ hours later. It takes about a half hour to an hour, and you'll likely be asleep during the procedure. The doctor will insert an ultrasound probe into your vagina so he can visualize your ovaries. He’ll then insert a needle into the ovary to aspirate the fluid inside each of the ovarian follicles.
The fluid will be given to the embryologist, who will examine it under the microscope to look for the egg. The healthy eggs will then be isolated and frozen using specialized techniques. When you're ready, the eggs will be thawed and fertilized, and the resulting embryos transferred into your uterus to hopefully create a pregnancy. Sometimes multiple cycles are required to get enough healthy eggs to use.
Are There Risks?
Yes. There is a risk of developing Ovarian Hyperstimulation Syndrome, or OHSS. This syndrome occurs most frequently right after the egg retrieval and can be quite serious, particularly for women with PCOS.
As the fluid-filled egg follicles begin to grow within the ovary, it enlarges. Sometimes, the hormones and chemicals produced by the empty egg follicles (after the egg retrieval) can cause fluid elsewhere in the body to shift into the abdominal cavity or the lungs. Women with PCOS are at a greater risk for developing OHSS due to the already large number of follicles on the ovary, and the tendency for women with PCOS to over-respond to the hormones.
In addition, there's a risk that the eggs may not survive the freezing or thawing processes. Most clinics won't refund the money you paid for the cycle, so there's a potential to lose a lot of funds.
Is it Covered By Insurance?
In most cases, no, egg freezing is not covered by your health insurance. Since a single cycle can cost up to $10,000 or even more, this is not a decision to be taken lightly. In addition, storage fees for those eggs can range from a few hundred dollars a year to a few thousand.
How Long Are They Good For?
Assuming they are of good quality, frozen eggs should last for several years. You will need a number of eggs to ensure that you have enough healthy eggs that will survive the freezing and thawing processes, fertilization and embryo development.
How Do I Pick a Doctor?
You should find someone who is close to your home to make travel to and from the clinic as easy as possible, since you will be there quite frequently. The office should have hours that are convenient so that you don’t have to take a lot of time off work to see the doctor. Make sure to ask about their experience with egg freezing, including how many cycles they perform, and their success rates.
Do your research before selecting your doctor. If you only have one practice close to you and you're not comfortable with their level of experience, consider traveling to a distant clinic. They should be willing to work with you to minimize the number of appointments and amount of travel that you will need to do. This is not that unusual: most clinics are used to working with out-of-town patients, and have procedures in place to make it easier for you. The bottom line is that you should feel comfortable with whichever center you select.