Delayed Childbearing: Should Women Freeze Their Eggs?

Isabel Platt, Celeste Chen, Anna E. Mazzuco PhD and Varuna Srinivasan, National Center for Health Research

Many women today are deciding to have children later in life. But women in their late 30’s and early 40’s are less likely to become pregnant because their fertility decreases as they age. According to the latest research by the Centers for Disease Control and Prevention, about 1 in 10 women have difficulty becoming pregnant, and for women aged 40-44, about half have trouble becoming pregnant. [1] [2] One possible option is for women to freeze their eggs while they are young. These women would use those frozen eggs to try to become pregnant at a later age, when they have a father and/or sperm donor in mind. Egg freezing, or “oocyte cryopreservation,” is no longer an experimental procedure, but is it safe and effective? [3] At what age, and for what purposes, should women decide to freeze their eggs?

InVitro Fertilizaton (IVF)

When a woman wants to have a child using her frozen eggs, her eggs will be thawed, fertilized and implanted into her uterus using in vitro fertilization (IVF).

IVF is a form of “assisted reproductive technology” that has been around since the late 1970s. Most women who do IVF receive injections to ensure that many eggs are available for extraction at one time. While there are some risks to the mother from stimulating increased egg production, most women unable to get pregnant without IVF feel that the benefits far outweigh the possible harms. And babies born using IVF, once called “test tube babies,” are usually just as healthy as other babies (see “Risks” later in this article).

Thirty years ago, IVF involved extracting a woman’s eggs, fertilizing them immediately in the laboratory, and then implanting them in her uterus. Extra fertilized eggs (embryos) were frozen in case the woman decided to use them later on. Therefore, while women have been freezing their embryos for years, the practice of freezing unfertilized eggs is relatively new.

What Is the Success Rate Of IVF?

In general, the younger a woman is, the more likely that IVF will successfully result in a successful pregnancy. In a study conducted between 2000-2005 involving more than 6,000 women, with an average age of 36, researchers found that about 1 in 4 were able to have a child after one round of IVF using fresh eggs. After three rounds of IVF, the success rate reached 45% to 53%; after six cycles, the success rate was between 50% and 70%.[4]

How does this compare to women trying to get pregnant the old-fashioned way—without a technological assist? Under natural conditions, about 75% of women at age 30 will successfully get pregnant within one year. At age 35, the success rate drops to 66%; women at age 40 have a 44% chance of getting pregnant over a 12 month period.[5]

How Much Does IVF and Egg-Freezing Cost?

IVF can be very expensive. If a woman freezes her eggs, she will have to pay for both the egg freezing and the IVF cycle(s) when she wants to become pregnant! The average cost of one IVF cycle (the removal, fertilization, and implantation of a fertilized egg) is about $12,400.[6] Depending on the technology, the clinic, and the state, it can cost as much as $19,000 for a single cycle of egg freezing.[7] However, these costs are dropping, and fertility clinics are now offering payment plans for as low as $4000-7000, which includes birth control pills, hormone injections and freezing process. Some fertility clinics are offering financial incentives to attract young professional women below the age of 30. [7]

Only 15 states have laws that require insurance companies to cover at least part of the costs associated with infertility diagnoses and treatments, which may include IVF. These states are Arkansas, California, Connecticut, Hawaii, Illinois, Louisiana, Maryland, Massachusetts, Montana, New Jersey, New York, Ohio, Rhode Island, Texas and West Virginia. [1][8] However, the laws in each state vary greatly in terms of which costs are covered. Egg freezing can become a great financial investment which may not always pay off!

What Is Involved In Freezing Eggs?

Removing and freezing eggs takes about two weeks and requires several visits to the doctor. The removal process is the same as in standard IVF with fresh eggs. First, the quantity and quality of the eggs are tested to make sure enough eggs will respond well to hormones.[9] If the tests go well, the woman is given follicle stimulating hormone (FSH) injections every day for 8-12 days, and she is seen by her doctor every few days.[10]

These eggs are then taken out of the woman’s body using a needle, with the help of anesthesia to avoid pain. [11] On average,20-30 eggs are removed and then evaluated for their health. [9] Healthy eggs are frozen and stored in liquid nitrogen for up to ten years.[12]

The good part about egg freezing is that it allows a woman to decide when in the next ten years to use her eggs to have a baby. The bad part is that the chances of a woman’s frozen eggs being successfully fertilized, implanted and the pregnancy carried to term are much lower than undergoing IVF using fresh eggs or frozen embryos (eggs that were fertilized with sperm before being frozen).  Unfertilized eggs seem to be more fragile than fertilized eggs, and so they may not survive the freezing process as well.  The success rate of IVF with fresh eggs versus frozen embryos doesn’t seem to be significantly different, suggesting that embryos are hardier and can withstand freezing better.

Of the three egg options available to women who need or want to use assisted reproductive technology—fresh eggs, frozen eggs, or frozen embryos– frozen eggs are the least reliable, although success rates will likely improve with newer freezing technologies.

How Likely Is a Woman to Have a Baby Using Frozen Eggs?

When a woman decides to have a child using her frozen eggs, 6 to 8[9] eggs will be thawed and fertilized through IVF with sperm from a sperm bank or from a husband, partner, or friend. The fertilized eggs will then be implanted in her uterus.[13] In the U.S., several embryos (fertilized eggs) are usually implanted to improve the chance of pregnancy.[9] In other countries, doctors recommend “elective single-embryo transfer” instead, where only one embryo is selected to be implanted into the uterus. This is increasingly recommended by doctors in the U.S. because it prevents potential complications associated with carrying more than one child at a time. [14]

In theory, frozen eggs can be used by women at any age. The American Society for Reproductive Medicine (ASRM) says that if a woman freezes her eggs at age 30, these eggs will still be capable of fertilization even ten years later at age 40. The problem that egg freezing doesn’t solve is this: as a woman gets older, the chances of a fertilized egg being successfully implanted in her uterus drop.[15]

Fertility clinics around the country report varying rates of live birth success based on the number of eggs implanted and age of the woman, but it’s important to remember that fertility clinics don’t always reveal the number of IVF rounds that were needed or even if a pregnancy resulted in a successful birth. In April 2017, a new tool was developed to help predict the likelihood of live births based on the age and number of frozen eggs. [16]

Another study from 2018 funded by the China’s National Key Research and Development Program and their National Natural Science Foundation found that live birth rates do not differ between frozen and fresh eggs in ovulatory women. They were also able to find that the main adverse side effect, ovarian hyper stimulation syndrome was less likely for frozen egg transplants than with fresh eggs.[17]

What is clear from all the information is that given current freezing technologies, using frozen eggs for fertilization and IVF is NOT as effective as doing IVF with fresh eggs or frozen embryos.


Although egg freezing is increasingly common, like all medical procedures it comes with some risks. After the eggs are removed, the woman is likely to experience abdominal discomfort similar to relatively severe menstrual cramps. [18] The needle used for egg retrieval may cause bleeding or infection of the ovaries. [18] An additional risk is that the weeks of fertility drug injections could cause mild ovarian hyper stimulation syndrome, which affects up to a third of women undergoing IVF. When this occurs, women may experience abdominal pain, nausea, and vomiting after egg retrieval for one to two weeks. Three to eight percent of women undergoing IVF may experience severe ovarian hyper stimulation syndrome with more intense pain and bloating, which in some cases may be life-threatening. Women with polycystic ovaries and women under 30 are more at risk for this syndrome.[19]  A study of Dutch women in 2011 found that women who had IVF treatments were more likely to develop a highly curable form of ovarian cancer, called borderline ovarian cancer. But this is a correlation that might not be caused by IVF. It is possible that women undergoing IVF may be more likely to have other health habits or traits that increase their risk of ovarian cancer. [20]

Egg freezing and IVF have not been shown to put the child at a significant risk for developmental disorders. Most studies have concluded that the risks of autism, mental retardation, and other birth defects are only slightly higher for children conceived through IVF using fresh or frozen eggs as they are for a natural pregnancy.

Couples that have children through IVF sometimes have genetic conditions or medical problems other than infertility that increase the chances of their children being born with a defect of some kind. [21] A 2014 study found a 30% increase in birth defects in children conceived through assisted reproductive technologies, including IVF. While this seems high, it’s important to remember that couples having trouble getting pregnant are more likely to have children with birth defects even if they don’t use IVF or other technologies to enable them to have children. In fact, about 20% of couples with infertility problems who conceive naturally give birth to children with some kind of birth defect. [19]

The most important risk to be aware of is false hope. Until 2012, egg freezing was considered an “experimental” procedure by the American Society for Reproductive Medicine (ASRM). While those experts no longer consider egg freezing experimental, they warn that, “Marketing this technology for the purpose of deferring childbearing may give women false hope and encourage women to delay childbearing.”[21]It’s worth remembering that no matter how young a woman is when she freezes her eggs, her chances of becoming pregnant and successfully carrying a baby to term decreases as she gets older.

Why do Women Freeze Their Eggs?

Women choose to freeze their eggs for both medical and personal reasons. ASRM considers egg freezing a “valid technique” for women who want to have children after completing necessary medical treatment that could affect a woman’s eggs or harm her fetus. For instance, women with ovarian cancer or another ovarian disease may need to take medication or undergo radiation that could cause infertility. Some women may need to have their ovaries removed, and women who take tamoxifen to treat or prevent breast cancer may also stop ovulating. Radiating or removing the ovaries makes eggs infertile, but if women freeze their eggs prior to treatment, they may still potentially become pregnant through IVF, even though the chances are quite low. [21]

In 2013, celebrities such as Sofia Vergara and Jennifer Love Hewitt publicly announced that they had frozen their eggs to ensure that they will be able to have children in their 40s. At around $15,000, the procedure is much more affordable for celebrities than for the average woman. Like other medical decisions by celebrities, egg freezing should not be taken casually.

Kaitlyn Bristowe, a celebrity who was on the TV show The Bachelorette is very influential on social media, has been sharing her egg freezing experiences with her fans.[7]  As part of this fad, egg freezing boutique clinics have lowered their prices and are now offering egg freezing parties in an effort to entice young customers. For women below the age of 30, egg freezing may seem like a form of insurance for future fertility. [7]   However, it is far from a guarantee.  Keep in mind that egg freezing was intended for older women with serious conditions affecting their fertility, but is now being marketed as a safe procedure for all women, despite the lack of research on the long-term risks or benefit. The success rate of fertilization in women who froze their eggs in their 20s is not yet known. [7]

Bottom Line

Egg freezing potentially enables women to have children at a later age than would otherwise be possible and/or to wait until they have a partner to father them.  If a woman’s body responds well to the hormones that stimulate egg production and the eggs are frozen before a woman reaches her late 30s, there is a chance that some eggs will be successfully fertilized and implanted through IVF, which is a relatively safe.[11] For now, however, undergoing IVF using frozen eggs is far less likely to end in a successful pregnancy than using fresh eggs or frozen embryos (fertilized eggs). Until freezing technologies improve, trying to create a family with frozen eggs may end up being an expensive pipe dream for many women. If you are considering freezing your eggs, be sure to talk to your doctor about whether this procedure is right for you.

All articles on our website have been approved by Dr. Diana Zuckerman and other senior staff.


[1]  FastStats. Accessed August 30, 2018.

[2] NSFG – Listing I – Key Statistics from the National Survey of Family Growth. Accessed August 30, 2018.

[3] Reshef E. Fertility Experts Issue New Report on Egg Freezing; ASRM Lifts “Experimental” Label from Technique – Eli Reshef, MD. Accessed August 30, 2018.

[4] Cumulative Live-Birth Rates after In Vitro Fertilization | NEJM. New England Journal of Medicine. Accessed August 30, 2018.

[5] Henri Leridon; Can assisted reproduction technology compensate for the natural decline in fertility with age? A model assessment, Human Reproduction, Volume 19, Issue 7, 1 July 2004, Pages 1548–1553,

[6]  Q06: Is In Vitro Fertilization Expensive?” ASRM Frequently Asked Questions About Infertility. American Society for Reproductive Medicine.

[7] Ferla R. These Companies Really, Really, Really Want to Freeze Your Eggs. Published 2018. Accessed August 30, 2018.

[8] Basco D, Campo-Engelstein L, Rodriguez S. Insuring Against Infertility: Expanding State Infertility Mandates to Include Fertility Preservation Technology for Cancer Patients. The Journal of law, medicine & ethics : a journal of the American Society of Law, Medicine & Ethics. 2010;38(4):832-839. doi:10.1111/j.1748-720X.2010.00536.x.

[9] Mayo Clinic. Egg freezing. December 30, 2017. Accessed August 31, 2018.

[10] Fertility Texas. What are the Steps of the IVF Process?. Accessed August 31, 2018.

[11] .  NYU Langone. Egg Freezing & Embryo Banking. Accessed August 30, 2018.

[12] Embryo Freezing (Embryo Cryopreservation) | Fertility Preservation. Published 2018. Accessed August 30, 2018.

[13]  Egg freezing | Human Fertilisation and Embryology Authority. Published 2018. Accessed August 30, 2018.

[14] Magli, M. Cristina, M.Sc.|Lappi, Michela, B.Sc.|Ferraretti, Anna P., M.D.|Capoti, Alessandra, B.Sc.|Ruberti, Alessandra, B.Sc.|Gianaroli, Luca, M.D. Impact of oocyte cryopreservation on embryo development. Fertility and Sterility. 2010;93(2):510-5

[15]  Donnez J, Dolmans M. Fertility preservation in women. The New England journal of medicine. 2017;377(17):1657-1665. doi: 10.1056/NEJMra1614676.

[16] R.H. Goldman, C. Racowsky, L.V. Farland, S. Munné, L. Ribustello, J.H. Fox; Predicting the likelihood of live birth for elective oocyte cryopreservation: a counseling tool for physicians and patients, Human Reproduction, Volume 32, Issue 4, 1 April 2017, Pages 853–859,

[17] Shi Y, Sun Y, Hao C, et al. Transfer of fresh versus frozen embryos in ovulatory women. N Engl J Med. 2018;378(2):126-136. doi: 10.1056/NEJMoa1705334.

[18]  Institute Of Medicine And National Research. Assessing the Medical Risks of Human Oocyte Donation for Stem Cell Research: Workshop Report. National Academies of Science, engineering and medicine. 2007:Chapter 3

[19] College of Obstetricians and Gynecologists. The Management of Ovarian Hyperstimulation Syndrome. 2016.

[20] Institute Of Medicine And National Research. Assessing the Medical Risks of Human Oocyte Donation for Stem Cell Research: Workshop Report. National Academies of Science, engineering and medicine. 2007:Chapter 3

[21] Simpson JL, Birth defects and assisted reproductive technologies, Seminars in Fetal & Neonatal Medicine (2014),