Egg Freezing Before Chemotherapy: What You Need to Know

In the rush of tests, consultations, and life-altering conversations after a cancer diagnosis, it’s easy for thoughts about future family planning to slip through the cracks. But for many, the desire to have biological children doesn’t disappear with the diagnosis, it only becomes more urgent. One vital yet often overlooked topic in this whirlwind? Fertility preservation. Specifically, egg freezing before chemotherapy.

Chemotherapy is undeniably a powerful tool in the fight against cancer. But like all powerful tools, it has a downside. It doesn’t discriminate between the cancerous cells it aims to destroy and the healthy ones it catches in the crossfire, including the precious, rapidly dividing cells within the ovaries. That collateral damage can seriously impact your future fertility.

How Chemotherapy Affects Egg Quality

Chemotherapy operates like a tactical strike force: it hunts down fast-growing cells and shuts them down. That’s brilliant when it’s targeting tumors. But the ovaries, with their rapidly dividing eggs (called oocytes), end up as unintended casualties. Among the most aggressive offenders? Alkylating agents. These are heavy-hitting chemo drugs that damage the DNA of cells, shutting down their ability to reproduce.

As a result, eggs exposed to these agents may be damaged or destroyed. Over time, this can significantly deplete your ovarian reserve. For some, the damage may be temporary. For others, it might result in permanent fertility loss.

Here are a few variables that determine how chemotherapy impacts your fertility:

• The type and dose of drugs used: Some chemotherapy drugs are more toxic to reproductive tissue than others. Alkylating agents, in particular, are known fertility wreckers.
• Your age during treatment: The younger you are, the more eggs you likely have, and the better your chances of bouncing back after chemo.
• Your fertility status pre-treatment: If your ovarian reserve was already low, chemotherapy may accelerate reproductive aging or even trigger early menopause.

In some women, chemotherapy leads to premature ovarian insufficiency (POI), which means the ovaries shut down before the age of 40. Others might go through menopause far earlier than expected. Given how unpredictable these outcomes can be, freezing your eggs before starting treatment offers a proactive way to preserve your fertility and any future family-building options.

Egg Freezing: How the Process Works

So, how exactly does egg freezing work? It's a fascinating blend of hormone science, precision timing, and modern technology.

Everything begins with hormonal stimulation. For about 10 to 14 days, you'll administer hormone injections daily. The goal here? To encourage your ovaries to produce a cluster of eggs in one cycle instead of the usual single monthly egg.

While this hormonal symphony plays out inside your body, you’ll be monitored closely. Blood tests track your estrogen levels, and ultrasounds measure the size and number of follicles maturing in your ovaries. Once your follicles are the right size, you'll get a final injection called a "trigger shot" to ready the eggs for retrieval.

About 36 hours after this trigger, it’s go time. You’ll head to a clinic, like RPMG, where a fertility specialist uses a thin needle, guided by ultrasound, to gently extract the eggs from your ovaries. This quick outpatient procedure usually takes 20 to 30 minutes and is done under light sedation, so you won’t feel a thing.

The final step is vitrification. This is the flash-freezing method that prevents damaging ice crystals from forming inside your eggs. Once frozen, the eggs are stored in tanks of liquid nitrogen, where they can safely remain for years. When you’re ready to have a child, those eggs can be thawed, fertilized with sperm, and implanted through IVF.

Success Rates of Pregnancy After Egg Freezing

So you’ve frozen your eggs. What are the odds that they’ll turn into a healthy baby later on?

Several factors influence the answer:

• Age at the time of freezing: The younger you are when you freeze your eggs, the healthier and more viable they’ll be.
• Number of eggs frozen: Think of each egg as a lottery ticket. More tickets result in better odds.
• Your overall reproductive health: If there are underlying fertility issues, even healthy eggs might not be enough.
• Egg survival after thawing: Fortunately, vitrification has drastically improved thaw success. Roughly 90% of eggs survive the thawing process.

Here are some helpful statistics:

• Of the eggs that survive thawing, a majority can be successfully fertilized.
• The live birth rate per frozen egg stands at about 5% to 12%.
• Freezing 10 to 15 eggs before the age of 35 gives you a 70% to 80% chance of having at least one child in the future.

While no procedure can promise a guaranteed baby, these numbers offer a hopeful glimpse into what’s possible.

How Long Can Eggs Be Frozen?

Here’s some good news: once frozen, eggs don’t go stale. Thanks to vitrification, they can stay preserved in liquid nitrogen for years, even decades, without significant degradation in quality.

There is no hard cutoff for how long eggs can remain frozen. In fact, successful pregnancies have occurred using eggs stored for over 10 years. The most critical factor isn’t how long the eggs have been in storage, but rather how old you were when they were harvested. Younger eggs are more robust and have higher chances of leading to a live birth.

That said, fertility clinics usually operate under certain storage policies, which may be guided by local regulations or medical best practices. Some may only store eggs for a set period unless you renew your agreement, while others might have transfer procedures in place if you decide to switch clinics.

Be sure to ask your clinic about:

• Annual storage fees
• Maximum storage duration
• Rules around transferring eggs to another facility

Cost and Insurance Coverage

Egg freezing isn’t cheap. But for many cancer patients, it’s an investment in future possibilities.

Here’s a breakdown of the average costs:

• Ovarian stimulation and medications: $3,000-$5,000
• Egg retrieval and freezing: $5,000-$7,000
• Annual storage fees: $300-$600

Total could be anywhere from $8,000 to $12,000 up front, with yearly costs for storage.

Insurance coverage is a mixed bag. Here’s what to know:

• If your fertility preservation is deemed medically necessary (like before chemo), some insurance plans will foot part of the bill.
• A few states require insurers to cover fertility preservation for cancer patients.
• Nonprofits like Livestrong Fertility and Fertility Within Reach offer grants, discounts, and support to help ease the financial burden.

So while the cost might look steep at first glance, you may have more financial wiggle room than expected.

Bottom Line

Egg freezing may not be the first thing you think of when faced with a cancer diagnosis. But it might become one of the most meaningful steps you take to ensure your future dreams of family remain within reach. Empower yourself with the facts, talk to a fertility specialist, and explore your options before treatment begins. Hope doesn’t have to wait until after recovery. It can start now.

FAQs

How does chemotherapy affect fertility?

Chemotherapy can harm reproductive tissues in both men and women. For women, it may damage or destroy eggs, disrupt hormone production, or lead to early menopause. In men, it can reduce or eliminate sperm production. The effects depend on the drug type, dosage, age, and pre-treatment fertility health.

Is egg freezing painful?

Most people tolerate egg freezing well. Hormone shots might cause bloating or mood changes. The egg retrieval process is done under sedation, so you won’t feel it. You may have some cramping or light bleeding afterward, but these symptoms typically resolve within a few days.

How much does egg freezing cost for cancer patients?

Egg freezing costs between $8,000 and $12,000, depending on the clinic and location. That includes hormone meds, retrieval, and freezing. Ongoing storage is an additional $300 to $600 annually. Some insurance plans and nonprofit organizations offer financial support for cancer patients.

What is the success rate of IVF with frozen eggs?

About 90% of eggs survive thawing. Of those, 75% to 80% fertilize successfully. The live birth rate per egg is between 5% and 12%, with higher success for eggs frozen before age 35. Freezing 10 to 15 eggs at a younger age can give you a 70% to 80% chance of future pregnancy.

How soon should I freeze my eggs before chemo?

Ideally, start the egg freezing process 2 to 4 weeks before chemotherapy. One cycle takes about 10 to 14 days. Some patients may need more than one round, so act quickly. The sooner you preserve your eggs, the better the chances of protecting your fertility.