Seven common egg freezing questions, answered by fertility experts
After being diagnosed with polycystic ovary syndrome (PCOS) and endometriosis, actor Florence Pugh decided to undergo egg freezing treatment last year. Speaking on the She MD podcast this week, Pugh explained how her conditions can make it difficult to conceive children, and what triggered the move to have the procedure in the first place.
It began when she had a "sudden feeling" to go get checked out. "I’d had a few weird dreams; I think my body was telling me," she said.
She then met with Dr Thaïs Aliabadi, who also appeared on the podcast with the Little Women star. During that consultation, the doctor gave the diagnosis and asked whether Pugh had ever had an egg count – to which she responded no: "I’m so young."
"It was just so bizarre because my family are baby-making machines," she said. "My mum had babies into her 40s. My gran had babies throughout… And then, of course, I learned completely different information, at age 27, that I need to get my eggs out and do it quickly, which was just a bit of a mind-boggling realisation and one that I’m really lucky and glad that I found out when I did because I’ve been wanting kids since I was a child."
PCOS affects between 8-13% of women of reproductive age, but worryingly, up to 70% of women go undiagnosed. A further 10% of women and girls of reproductive age suffer with endometriosis – that’s around 190 million.
While egg freezing is becoming increasingly popular, it is also a serious procedure and one that isn’t cheap. So, why do it? "Egg freezing," says Marija Skujina, CEO and founder of Plan Your Baby. "offers a chance to postpone a childbirth for many reasons – either due to illness or for a social reason. In the medical world, we often hear that egg freezing is like insurance; you want to have it, but you hope you’ll never need it."
At what age should women start the egg freezing process?
A woman is most fertile in her twenties and up to her early thirties. Skujina explains that after 35, the ovarian reserve – something we are born with and that ages along with us – begins to diminish more rapidly. "The sooner someone knows they might want to consider the option of egg freezing, the better," she advises. "Typically, the mid-twenties is an excellent time to start thinking about it."
How does egg freezing work, exactly?
It begins with a detailed ovarian assessment, says Skujina. This evaluates the ovarian reserve, and allow the clinician to create the most suitable treatment plan.
This is followed by a stimulation protocol, similar to the process used in IVF cycles. "Stimulation typically involves daily injections and close monitoring of hormone levels through blood tests, along with ultrasound scans to track the growth of ovarian follicles," Skujina outlines. "This ensures adequate follicle development, allowing adjustments to the treatment as needed."
Next up comes a "trigger shot", says Skujina. This is administered to prepare the body for egg collection.
The eggs are retrieved 36-38 hours later. This takes around 15-30 minutes. "During this process, the eggs are collected and assessed," says Skujina. "Only eggs at the appropriate maturation stage can be frozen for later use. The more eggs frozen, the higher the chances of success in the future."
The whole process lasts 9-14 days. During the stimulation there will be blood assessments and ultrasound scan assessments to ensure the egg retrieval will take place on the right day.
How expensive is egg freezing?
Roughly £5,000-£7,000, but this can depend on the company you use. In some cases, the NHS may fund egg freezing, but it is rare. This is usually only the case if you are under the age of 42 and undergoing a medical treatment that may impact your fertility.
Dr Misra-Sharp also highlights schemes such as Access Fertility, which offers IVF refunds and money-back offers for multiple cycles, in certain clinics and if patients are eligible. She also highlights organisations like Fertility Network UK, which provide resources, support and occasional funding opportunities, and suggests looking at employer benefits, as some companies offer fertility preservation as part of their benefits packages.
At what age are women likely going to get the best results?
This, Skujina says, isn't quite so clear cut. Just as every woman is different, every case is different. For example, those who, like Pugh, have PCOS and/or endometriosis can have a lower egg quality – which also diminishes with age.
In an otherwise healthy female patient, she says, the best results are typically achieved between the ages of 25 and 32. "It’s important to clarify that when discussing egg freezing, 'best results' refer to achieving a good number of retrieved oocytes – not pregnancy rates or live births. Those outcomes depend on additional factors, including sperm quality, uterine health, and more," she adds.
Is it painful?
"The procedure is not painful, and it is also performed under a very short and mild sedation/general anaesthesia if required (very rarely). After the procedure, the woman may have some discomfort, like pre-menstrual or ovulation cramps," Skujina says.
"Usually the painkillers are administered by the doctor/nurse to reduce the discomfort and pain. Again, the level of discomfort varies based on the number of eggs retrieved, technique and experience of the clinician."
Are there any side effects people should consider before they have treatment?
According to Skujina: "The biggest issue that might come up with egg freezing is the same that comes up in IVF cycles. The risk of OHSS (Ovarian Hyper Stimulation Syndrome) is real, but less and less common in recent years, because we have so many ways to control it and reduce the risks for the patient."
Dr Misra-Sharp also highlights the following potential side effects:
Emotional impact: The psychological toll of undergoing treatment and uncertainty about future outcomes.
Egg loss during thawing: Not all frozen eggs survive the thawing process, which can be emotionally challenging.
Future financial burden: Additional costs for storage and future IVF cycles may arise.
Overstimulation risks: Mild ovarian torsion, where an ovary temporarily twists, is rare but possible.
Bloating, breast tenderness, and mood changes during the stimulation phase.
Spotting or cramping after the retrieval procedure.
Can hereditary conditions come into play?
"As always and in anything, yes," says Skujina. "Heredity impacts our health and fertility is no exception. There are genetic disorders that may decrease fertility or impair it completely. There are women’s health specific issues like PCOS and endometriosis that may impact ovarian reserve and egg quality. All these are taken into account when we talk to a patient, and the stimulation treatments we provide are tailored to each patient, so we make sure we can obtain the best outcome."
Read more about fertility:
Why British mums are not surprised by plummeting fertility rates (Yahoo Life UK, 5-min read)
I went through 29 rounds of IVF to get the family I wanted (Yahoo Life UK, 4-min read)
"I was told I had period pain - it was endometriosis, two uteruses and cervixes" (SWNS)
