Should You Freeze Your Eggs If You Have PCOS?

Many women are turning to egg freezing, also known as oocyte cryopreservation, as a means to preserve their eggs for future pregnancy. The reasons for this vary: not feeling ready for pregnancy just yet, not being in a committed relationship, or having been diagnosed with cancer and chemotherapy will impact fertility.

The good news is that having polycystic ovary syndrome (PCOS) doesn't mean that you have to freeze your eggs, although you might consider doing so for one of the reasons listed above.

How It Works

The process of retrieving your eggs is identical to the first phase of in-vitro fertilization (IVF): you'll give yourself daily hormone injections for approximately two weeks.

There are three different types of medications used in an egg freezing cycle. The first medication is a hormone (follicle-stimulating hormone, or FSH) or combination of hormones (FSH and luteinizing hormone, or LH) that gets your ovaries to produce more eggs. You will typically start this medication on the first or second day of your egg freezing cycle. The second medication is a gonadotropin-releasing hormone (GnRH), which prevents you from ovulating too early and releasing your eggs before your healthcare provider has a chance to retrieve them. GnRH is usually injected once a day, beginning mid-cycle.

While you're on these medications, your healthcare provider will perform regular hormone blood tests to monitor the effects of the treatments. You will also have at least one ultrasound to detect ovulation and to monitor egg development. Every healthcare provider and clinic has its own protocol: some healthcare providers 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 the instructions exactly.

Once the healthcare provider feels that the eggs are sufficiently developed, you'll take the final medication, will instruct you to take a final trigger injection of human chorionic gonadotropin, or hCG, which triggers ovulation. It is usually injected 36 hours before egg retrieval so that your body releases the eggs at just the right time.

When your eggs are ready, your healthcare provider will begin the egg retrieval process. The process takes about 10 to 20 minutes, and you'll likely be asleep during the procedure.

The healthcare provider 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.

Possible Risks

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 the potential to lose a lot of funds.

Is It Covered by Insurance?

In most cases, egg freezing is not covered by your health insurance. Since the egg retrieval procedure costs around $10,000 and hormone medication costs can range from $3,000 to $5,000, this is not a decision to be taken lightly.

In addition, storage fees for those eggs can range from a few hundred to a few thousand dollars a year.

How Long Are They Good For?

Assuming the eggs are of good quality, frozen eggs should last for several years. You will need a number of them to ensure that you have enough healthy eggs that will survive the freezing and thawing processes, fertilization and embryo development.

How to Pick a Healthcare Provider

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 healthcare provider. 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 healthcare provider. 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 the 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.