Egg Freezing Before Chemotherapy: What You Need to Know

Chemo can be very brutal on a person’s reproductive system. As a result, many cancer patients who desire to have children are encouraged to freeze their eggs prior to beginning their treatment. The good news is that with improved technologies and medical advances, many cancer patients can go on to live full lives after treatment. However, they may not be able to have children naturally, therefore their frozen eggs would be used in fertility treatments to build their families.  So let us talk about how chemo affects fertility, the process of freezing one’s eggs and if it is possible to become pregnant using these eggs. We shall also touch on the cost of egg freezing before chemotherapy,  and if insurance covers these costs. 

How Chemotherapy Affects Egg Quality

Chemotherapy tends to have a negative impact on egg quality because it is a treatment that targets rapidly multiplying cells. Different types of cancer are treated with different chemotherapy protocols. Depending on how aggressive the treatment and the duration, hormone production and ovaries could be negatively impacted, which in turn would affect the quantity and quality of eggs a person has.

There are patients who may experience early menopause following their treatment, while others may find that their fertility has also been restored. Even with restored fertility, there are no guarantees that a person can become pregnant naturally. Therefore having frozen eggs ahead of treatment, one can go on to build their families through assisted reproductive technologies (ART).

Egg Freezing: How the Process Works

The process of egg freezing is done in several phases, whereby a person’s ovaries are stimulated to develop multiple eggs which are retrieved when they are mature. Stimulating ovaries is done using hormones that are administered regularly. During this time, the development of the eggs and the hormonal levels in the body are monitored closely. 

Close monitoring ensures that any adverse effects are kept to a minimum. When the eggs reach the desired size, they are retrieved and analysed for any anomalies. The mature healthy eggs will be cryofrozen until they are required. It is also possible to fertilize the eggs and cryofreeze embryos instead. 

Cryopreservation is the preferred method for fertility preservation because ice crystals do not form on the eggs, which can cause damage during thawing. The reason for this is that the water content is drawn out of the cells and replaced with a preservation fluid. As well, the freezing is done rapidly, from 98.6 degrees to minus 384.80 fahrenheit. 

Success Rates of Pregnancy After Egg Freezing

Following chemotherapy, some people experience a return of their menstrual cycle. This is indicative that there is a restoration of hormonal function. However, fertility testing would be necessary to determine if the person can become pregnant and carry the pregnancy to term. There are cases where a person becomes completely infertile and may consider using the services of a surrogate. 

Younger patients are the ones more likely to experience a restoration of their fertility, while older women have fewer odds. However, radiation therapy if administered around the pelvic area, could also impact a person’s ability to become pregnant. That said, it is possible to become pregnant after egg freezing, for those whose uterus is healthy enough to carry a pregnancy after cancer treatment. 

The odds are promising, with a successful oocyte thaw standing at 82 percent,  a 67 percent fertilization rate and a 48 percent live birth rate. While it is possible to become pregnant at any age, regardless of the age one was when the eggs were retrieved, people who are 38 years old and below at the time of embryo transfer have higher success rates. 

How Long Can Eggs Be Frozen?

Theoretically, eggs can remain frozen for decades. However compared to sperm freezing, egg freezing is fairly new, therefore there is insufficient data regarding how long eggs can remain frozen and still be viable. There are cases where after 10 years people have had their eggs thawed and fertilized, leading to successful pregnancy and life births. However, further research is required in the area of long-term effects of cryopreservation. 

Cost and Insurance Coverage

The cost of cryopreservation varies from one location to another, and insurance covers equally vary. Overall, cryopreservation costs include medication, bloodwork, and ultrasounds during ovarian stimulation, egg retrieval procedure, the actual cryopreservation, and the cost of storing the eggs until they are required. 

By law, insurers in most States are required to cover the costs of fertility preservation. However, with the varied covers, one would need to speak directly with their insurance provider to know what is covered and what they may need to pay themselves. Many fertility clinics also offer finance options for egg freezing, and grants are available to cancer patients for their fertility preservation. 

FAQs

Is egg freezing painful?

Egg freezing is typically not a painful process, but a person may experience discomfort during ovarian stimulation and after the egg retrieval process.  

How much does egg freezing cost for cancer patients?

There are three main categories of costs for egg freezing:

• Ovarian stimulation: $3,000 - $5,000
• Egg retrieval and freezing: $5,000 - $7,000 
• Storage (annually): $300 - $600

As previously mentioned, there are grants, financial aid and discounted programs available for cancer patients with organizations such as Fertility Within Reach, and Livestrong Fertility. 

How soon should I freeze my eggs before chemo?

One should freeze their eggs as soon as possible. This will be determined by your oncologist and fertility specialist because the duration required for successful retrieval needs to be weighed against your optimal treatment window.