The Discouraging Truth About Egg Freezing And IVF Success Rates
Actress Rebel Wilson’s “year of health” and weight loss transformation was motivated by her desire to have a baby. But at age 40 and single, she felt her only option was to freeze her eggs for a future IVF treatment.
Maybe you aren’t in your early forties and looking to start your fertility journey, like Rebel Wilson. Maybe you’re fresh out of college, and you want to explore the world and pursue your career first, and have kids later. Or maybe you’re in your thirties and want to have kids, but you haven’t met Mr. Right yet.
Conventional medicine (and societal pressure) suggests that freezing your eggs now and doing IVF later is the best option for women in your shoes. Heck, even Google and Facebook will cover the costs of freezing the eggs of their female employees.
But is this really the best way – for our bodies or our bank accounts? What if we could, I don’t know, find a way to preserve our natural fertility so we could conceive naturally later down the road, without risking our money or our bodies?
We’ll be looking at how to preserve our natural fertility in part two of this series, but first, let’s dig into the financial and emotional costs of going the egg-freezing and IVF route.
The Financial Cost of Freezing Your Eggs and IVF
A single egg-freezing cycle takes four to six weeks, but the financial investment is much more. After collecting data from 4,000 patients, Fertility IQ cites the average cost of medical treatment as $11,000 and medication as $5,000, plus storing your eggs at $500 a year.
Additionally, most women undergo an average of 2.1 egg-freezing cycles, which doubles the cost. This means your total could be upwards of $30,000 just to harvest and store your eggs – without factoring in future rounds of IVF to use the eggs.
Using your frozen eggs in IVF isn’t any less expensive. According to The New York Times, “the average IVF cycle can cost anywhere from $12,000 to $17,000 (not including medication). With medication, the cost can rise to closer to $25,000. There are add-ons, including genetic testing of the embryos and surgical procedures (such as sperm extraction or laparoscopy), which can increase the cost of IVF by thousands of dollars.”
The average total cost of one cycle of IVF is about $25,000.
Furthermore, most couples will need more than one round of IVF to get pregnant and stay pregnant. But predicting how many cycles it will take is difficult. Some studies suggest it will take most women three rounds, while others suggest six.
Couples will likely be shouldering the burden of these procedures alone as “only 15 states require insurance plans to cover infertility, and two – California and Texas – require insurers to offer coverage. Though typically, only a small fraction of the cost, such as that of medications, is covered.”
The Emotional Cost
The process of freezing your eggs is lengthy and tends to be filled with medication and doctor's appointments. We already know the treatment cycle lasts four to six weeks. The process begins with ultrasounds and blood work to look for any potential issues, and can usually take three to five visits to the IVF clinic. Depending on your cycle, test results, and medical history, the doctor will decide if you need to suppress your menstrual cycle, which could involve taking the pill or doing an injection daily for up to two weeks. Side effects include hot flashes, night sweats, headaches, and mood swings.
The next step is taking a customized cocktail of fertility hormone drugs designed to increase the number of eggs your body produces. This cocktail is delivered in a daily injection in the stomach or thigh for 10-12 days. During this time, you’re monitored with ultrasounds and blood tests. The injections can cause mood changes and PMS-like feelings. They also bring the risk of developing Ovarian Hyperstimulation Syndrome, which is when the ovaries swell and leak fluid into the body.
Jean Hannah Edelstein described her personal IVF experience for The Guardian: "The hormones are making me moody. They are also making me doughy. My jeans no longer fit comfortably and when I get home from the office in the evening I lie on the sofa and watch 'Sex and the City' until 9:30 pm, when [my partner] E draws the drugs into the syringes and injects me again...I feel like a pallid, slow version of my former self. I can’t exercise, in case my swollen ovaries twist. I don’t want to see friends or go out to dinner or walk the dog."
I feel like a pallid, slow version of my former self.
"I go to an additional appointment to the doctor, a standard procedure to check my uterus for obstructions that could make it hard for me to get pregnant. Take some ibuprofen afterwards, the doctor advises, and I do, and I go to my office and am overcome an hour later by cramping so excruciating I assume this must be what it feels like to go into labor."
Once your eggs have developed sufficiently, you will be sedated, either with local or general anesthesia, and your eggs will be collected with a needle inserted through the vagina and into each ovary. The procedure usually takes about 20 minutes.
Following the procedure, you might experience cramping, vaginal bleeding, and pelvic discomfort. At this point, you can either freeze your eggs, or have them fertilized and freeze the embryos. You can also move right into IVF with your fertilized eggs.
Unless, like in Edelstein’s case, not enough eggs survive the process to be used: “Five days later we have the results. Eleven eggs were retrieved. But only two of them survive until the fifth day, which is how long they have to grow before they can be biopsied for the genetic testing, which is the whole reason we’re doing IVF in the first place..."
"Two embryos is not enough. I feel despondent. I thought that we were halfway through the process, but now we’re back at the beginning. In the days since the retrieval, the effects of the withdrawal from the hormones are worse than the ones I had from the injections: I’m doughier than ever, exhausted, depressed.”
If harvesting enough eggs was successful and you’re moving to IVF, an egg or two will be selected a few days after being harvested. You will be given progesterone to prepare the lining of your uterus. The embryo transfer procedure is done without anesthesia and takes about 15 minutes. It involves inserting a speculum and a small plastic tube through the vagina. You’ll then need to wait about two weeks before taking a pregnancy test.
IVF’s Discouraging Success Rate
Ok, let’s say you’ve spent the money and survived the emotional rollercoaster of both freezing your eggs and IVF. What are your chances of seeing those two pink lines?
According to a 2015 study, if you’re younger than 40, your chance of getting pregnant with your harvested eggs in your first IVF attempt is 32%. If you’re 40-42 years old, the chance drops to 12%. If you’re older than 42, your chance is less than 4%.
The CDC reported similar numbers in 2018: an average of 38% of IVF cycles result in a live birth in women under 35. The success rate declines as women age:
32% among women ages 35 to 37
23% among women ages 38 to 40
14% among women ages 41 to 42
7% among women 43 and 44
3% after age 44
So the older you are when undergoing IVF, the more likely it is that you will need multiple attempts to get pregnant.
The older you are when undergoing IVF, the more likely you will need multiple attempts to get pregnant.
If IVF Success Rates Are So Low, Why Do Doctors Push It?
When I first started looking into why I wasn’t getting pregnant almost 10 years ago, I went to my local, regular Ob/Gyn. Here I was, a seemingly healthy 24 year old, who couldn’t get pregnant. Unfortunately, my doctor didn’t seem to understand the basics of female reproduction. He was dismissive of my fertility awareness method charts. He did blood work to check my reproductive hormones on only one day of my cycle, and then prescribed the ovulation medication Clomid for three months. When that didn’t do anything (other than make me moody, give me hot flashes, and dry up my cervical mucus), he ordered a test to see if my fallopian tubes were blocked. When that came back clear, he gave up and referred me – at age 24, with no obvious health issues – to IVF.
Whether it was from pure ignorance of female fertility or what to do next, professional laziness, or his clearly friendly relationship with the IVF clinic that motivated his recommendation, I don’t know. (Many IVF clinics pay a kickback to the referring Ob/Gyn.) But I do know that IVF wouldn’t have solved my fertility problems.
Egg freezing and IVF are presented as the one-size-fits-all solution to solving infertility when it just doesn’t have the success rate to deserve that kind of reputation. It’s expensive, it’s risky, and it doesn’t solve the underlying cause of the infertility in the first place.
Could preserving your natural fertility serve you better instead? Find out in Part 2 of this series here. Read Part 3 on the health benefits of living with your natural cycle of estrogen and progesterone here.
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