How to decide if freezing your eggs is right for you — and where to get started

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Trying to decide if you want to have kids — and if so, when — is a deeply personal decision. It can also be a stressful decision, especially when your biological clock is ticking and you want to prioritize other things in your life— like your career, waiting on the right partner or wanting the option to decide to have kids later.

You might even be asking yourself: Should I freeze my eggs?

Egg freezing has become more mainstream since 2012 when the procedure was no longer deemed "experimental" — there are more clinics these days, and sometimes the procedure is covered by insurance depending on where you live and a host of other factors. But even with expanded access, it's still a huge, complex undertaking. And even if you have the privilege to freeze your eggs, you probably have a ton of questions: Does it hurt? How likely is it to work? How much does it cost?

So here at Life Kit, we've talked to experts on how to make the best, most informed decision for yourself when it comes to fertility preservation. Here's what they have to say.

Clarify why you want to freeze your eggs — and when

The first question to ask yourself is: How important is it for me to have a biological connection to my children? If your answer is 'not important,' then freezing your eggs may not be for you.

To help yourself distill your feelings, sit down and make a pros and cons list. You can also ask yourself the following questions: What is my goal for freezing my eggs? Do I want to have a family? How many kids do I want? Would I be open to being a single parent?

Another question to ask yourself: Am I at the right age to do this?

"It is absolutely true that fertility starts to decline in your 30s," says Dr. Amanda Adeleye, an assistant professor and reproductive endocrinologist at the University of Chicago.

Dr. Adeleye says that 35 to 37 years old is often a good age for egg freezing. Though she hesitates to give a blanket recommendation because the decision is so dependent on personal circumstances.

Seek support

Marginalized communities, like people of color and trans people, may not seek fertility treatments because the option might not be presented to them by family or doctors, says Angela Bethea-Walsh a licensed psychologist who specializes in fertility psychotherapy.

Trystan Reese is a trans fertility advocate and runs Trans Fertility Co., a website dedicated to fertility research and support. He says while there's limited data, we do know that less than 5 percent of the trans community do any fertility preservation.

If you're in a marginalized community and you're considering fertility treatments, it's advised to seek support networks. "I always advise people to go on Facebook or other social media platforms that feel safe for you and search for groups and join groups," says Reese.

Think about the money

Just because egg freezing is becoming more accessible, doesn't mean it's affordable. Without insurance, egg freezing can range from $10,000 to $20,000, which includes medication, doctor visits and the actual surgical procedure to remove the eggs. It doesn't, however, include the yearly storage fee for your frozen eggs, which can be up to $800 a year. And, of course, you should factor in the cost of in vitro fertilization if you decide to use your eggs down the road. (But that's a topic for another Life Kit.)

Currently, only 19 states require insurance companies to supply coverage for infertility treatments. And that depends on your insurance company's policies. Some won't cover egg freezing unless it's deemed medically necessary. So make sure you double-check your plan if you live in those states.

There are grants that you can apply to get financial assistance, but there aren't many. So our experts say don't rely on them.

You can take out a personal loan or save money over time, if you can plan accordingly. One savings tip is to put your money into a high-yield savings account, which is a savings account that has a higher interest rate than a regular savings account.

Overall, we asked a lot of fertility experts about the best way to afford egg freezing, and unfortunately, no one had a great answer. We wish it was different, but that's the reality for now.

Choose the right doctor

Once you clarify your goals and figure out your financial situation, it's time to start looking for the right fertility clinic and doctor.

You can start by asking your personal doctor, like an OBGYN, who they recommend. Then go down the list of names.

Dr. Adeleye recommends using a clinic or doctor's office that feels safe, clean and responds in a timely manner. It's also important that you work with a provider you feel comfortable having a frank conversation with.

Reese agrees on finding a place that treats you respectfully. If you're trans or nonbinary, he advises finding an ally who is not trans and having them call clinics on your behalf. He says they should ask the following questions: "Have you had training on using gender-neutral pronouns? Have you had training on working with people who are pre-transition or post-transition?"

Find out where your fertility stands

Once you've decided on your clinic and doctor, the clinic will schedule an appointment to take a closer look at your fertility.

A typical check-up will start with an ultrasound of the ovaries so they can see how many follicles you have. Follicles are the small sacs that surround the eggs. After that, you'll have blood drawn.

Dr. Adeleye says this is because she needs to see the anti-Müllerian hormone (AMH), which is a hormone that is produced by the follicles. "The AMH level will help to guide me as to how my patient will respond to ovarian stimulation for egg banking," she says.

If the doctor then decides you are a good candidate for egg banking, they might want to start you right away. However, you don't have to if it's not medically urgent. Experts say it's important for you to be fully ready because the egg freezing cycle is a lot.

Prepare for the egg-freezing cycle

One typical egg-freezing cycle can range from 10 to 14 days. During that time you'll be attending doctor appointments almost daily to make sure your eggs are maturing correctly.

You'll also be giving yourself hormones by injecting shots into your abdomen area. Those hormones will help the follicles and eggs grow.

If you aren't comfortable injecting yourself, you can enlist a friend or loved one to help you. Two pieces of advice: Try numbing the area with ice beforehand. And take deep breaths before you inject yourself to relax the area.

Some doctors recommend that you take it easy during this period since your body is going through so many changes. This means no vigorous exercise and no penile-vaginal intercourse.

For people, who are taking any gender-affirming hormones like testosterone, it's recommended to take a break as you prepare for egg freezing. There's not much data on what gender-affirming hormones could do to fertility. One study showed that transgender men who used gender-affirming hormones and stopped a few months before fertility treatments yielded the same number of eggs as a cis woman patient.

But for some, getting off hormones can be hard and could trigger gender dysphoria. There can be physical and mental changes such as a change in voice and recurrence of menstruation, things that may make that person feel more feminine.

"Really the best option is to freeze your eggs before you transition," Reese says. "That way you don't have to go off your hormones later on." However, Reese assures people that it's possible to freeze your eggs if you have already transitioned — just make sure you have a good support system in place.

Get ready for the procedure

About 36 hours before the egg-removal procedure, you'll take something called a trigger shot. In that shot is medication that tells the eggs to release from the follicles so they're ready to be extracted.

The extraction is a same-day procedure and it goes by pretty quickly. There's no cutting and no stitches, but the doctor does use a needle to extract the eggs through the vaginal canal.

You'll probably be sore at the site of the egg removal and in the abdominal area, and you could bloat and have hormonal changes since you're no longer taking the hormonal shots. Asking for a couple of days off work after the procedure is a safe bet.

Also, if you don't have any help at home, it's recommended that you prepare before the procedure: clean your house, make your bed comfortable and have the necessities easily accessible so you can focus on resting.

One universal tip: have a heating pad on hand at all times. It's a lifesaver if you're feeling sore.

Prepare for the uncertainty of it all

Remember that one egg freezing cycle can take up to two weeks, plus some recovery time after the egg retrieval. So it's good to ask yourself: What is life going to look like during this process?

You may want to lean on your support system — Ask your friends to bring you meals, join you on a long walk, or just send you some lighthearted texts.

It's important to know that it's quality over quantity when it comes to your eggs. Research shows that most people will need 10 to 20 mature eggs to have a baby, but that doesn't mean you'll have 10 to 20 babies. It really depends on how healthy your eggs are in that cycle.

After everything you've gone through in the past few weeks, you'll still have to wait a day or two after your procedure to hear how many healthy eggs the doctor can freeze. That kind of uncertainty is stressful, so it's important to get good sleep, stay hydrated and try meditation to manage your stress.

Bethea-Walsh says stay in the present, follow the directions from the doctor and control what you can control. "Just remember, thoughts are not facts. Feelings are not facts."

Your body is going to be going through a lot of changes, but it's going to do what it's going to do. We are born with all the eggs we'll ever have, and that's out of your control.

Thank your body for doing such a hard task, and be gentle to yourself.

The audio portion of this story was produced by Audrey Nguyen.

We'd love to hear from you. If you have a good life hack, leave us a voicemail at 202-216-9823, or email us at LifeKit@npr.org. Your tip could appear in an upcoming episode.

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