It was good to feel like I was taking charge of my own fertility – I’ve always described it as a very expensive insurance policy.” Thirty-nine-year-old Hannah* is talking about the two rounds of elective egg freezing she underwent in her early thirties. Back then, she says, “it was almost a slightly shameful thing”, but the process is now the fastest-growing fertility treatment in the UK. Millennials are hitting traditional life milestones such as home ownership and marriage later than their parents, but women’s biological clocks haven’t changed of course – making the idea of buying more time to have children an appealing one.
Until just over 10 years ago, egg freezing was the preserve of women undergoing treatments such as chemotherapy or facing premature infertility. But in 2012, the American Society of Reproductive Medicine decided that it was no longer an “experimental” procedure. Since then, it has become a potential option for women who aren’t ready to have children yet (often because they haven’t found the right partner) and want to put their fertility on ice. And, according to the Human Fertilisation and Embryology Authority (HFEA), the number of egg-freezing cycles increased from 2,576 in 2019 to 4,215 in 2021, a dramatic rise of 64 per cent.
But it is not a magic bullet – far from it. Egg freezing can be emotionally, physically and financially demanding, raising hopes with no guarantee of success. Earlier this month, Guy’s Hospital in London apologised after the frozen eggs and embryos of more than 100 women were potentially damaged due to faulty freezing solution; incidents like this are extremely rare, but worrying nonetheless.
Still, the idea of a potential “security blanket” for fertility is an appealing one; “insurance policy” is a phrase that crops up again and again in conversations about egg freezing, and for many women who undergo the process, it is a way of regaining a sense of control over their future. Hannah says she had been “happy to live in blissful ignorance” about her fertility until a comment from her sister changed her perspective. “She said to me: ‘Wouldn’t you want to know that you’ve done everything you possibly can to have a child, everything that’s within your power at the moment?’” Amy, 39, had a similar thought process before eventually deciding to freeze her eggs last year, having spent her thirties focusing on her career in the beauty industry. “My mum said to me: ‘It’s basically putting an insurance policy on yourself. If you use it, you’ll be so delighted that you did it. And if you don’t use it, I genuinely don’t think you’ll regret spending the money.’ I thought, she’s right, I’m just going to do it.”
Money is indeed a major factor in whether or not women can even consider egg freezing. It is a very expensive process, and it’s not a one-and-done situation when it comes to payment, either. The HFEA says that the average cost for one cycle is £3,350, but you’ll have to pay for medication and pre-retrieval tests too, plus storage tends to cost between £125 and £350 each year. And if you want to thaw the eggs and transfer them to the womb further down the line, this costs around £2,500 on average. “I really feel for anybody going through it right now,” Hannah says. “Because even a few years ago, it was a lot of money. But now it must be more expensive and even tougher in the current financial climate.”
Meanwhile, 31-year-old Katy is preparing to freeze her eggs later this year. “I’m in that period where a lot of my friends are getting married, quite a few are pregnant or have already had children,” she says. “There’s been a massive shift in the makeup of my friendship group, whereas there’s not been a lot of change in terms of my dating life.” Egg freezing had always seemed quite abstract to her: it was the subject of throwaway comments, rather than an actual possibility. But after realising that becoming a mother “was something I knew I really wanted out of life”, she started to look into the process properly. “I thought, ‘I need to take control of this, to secure my ability to have a baby either with a partner or on my own. It’s something I need to take a bit more seriously.’”
At first, Katy explains, she felt like opting for egg freezing “was quite a sad decision”. But once she had the initial tests and talked through her results with the consultant earlier this year, “that sadness around it turned into… empowerment is probably too strong a word, but I’m pleased I’m doing this. I’m in a position where I’m privileged enough that I can afford to do this. That’s awesome, and hopefully I don’t have to use them, but I’ll kick myself if I don’t do it.”
An egg-freezing cycle typically takes about two weeks and begins at the start of a woman’s menstrual period. Patients must inject themselves with a follicle-stimulating hormone for about 10 days; around 36 hours before the retrieval, they’ll take a “trigger” injection to release the mature eggs. Daily hormone injections in the lead-up can be gruelling. “The first time I did that, I just remember crying for nearly two hours with the needle poised above my belly,” Hannah says. It was an emotional time for Amy, too. “I was crying for no reason, and I’m not a crier at all,” she recalls. “It really knocked me for six […] and I’m single, so I was going through it on my own.”
It’s a horrible irony of the freezing process: most of the women opting for it are single, so they must embark on a draining prep process alone (and potentially end up feeling more isolated as a result). “Don’t get me wrong, I’ve got phenomenally supportive family and friends, but they don’t live with me, they’re not there when you’re doing injections or you feel sick or whatever,” Amy adds. “So that adds weight to it as well. You can feel very alone when you’re going through it, and you think ‘why am I doing this?’” And what if you’re trying to juggle dating too? “It was not the easiest time,” Hannah recalls. “I was dating somebody during the first round who was a bit younger than me, and I didn’t tell him about it until I had a big wobble and burst into tears. And the relationship ended pretty much at that point.”
Then there’s the procedure itself, which takes about half an hour or less, usually under deep sedation rather than general anaesthetic. A needle is passed through the vaginal wall and into the ovary, then fluid is gently drawn out of each follicle and checked for eggs, which can then be frozen. Over the past decade or so, vitrification – a speedy freezing method involving liquid nitrogen – has become more widespread, and the survival rate for frozen eggs has increased as a result (although age is the most important factor – the HFEA recommends freezing eggs before you reach 35).
The emotional tumult doesn’t necessarily end here. However old you are, it’s near impossible to make firm guarantees about how many eggs will be collected (the HFEA says that most patients under 38 end up with seven to 14 eggs, but this isn’t always possible). So if the doctors only manage to retrieve a few, the disappointment can be heartbreaking – and patients might end up having to question whether they can afford to embark on this expensive journey again.
Amy had good results in her initial fertility check-up, and went into the process feeling “quite nonchalant”, she says. “And then when I did my first cycle, I didn’t get a particularly great number of eggs. I felt like someone had died. It took me about three days to get over. I didn’t realise how devastated I was – and I still don’t know if that’s because I really want a kid or whether that was me being really competitive with myself. I just felt really disappointed and let down. My body just didn’t respond to the medication the way they would have thought based on my initial tests”.
She eventually underwent two further cycles, which increased her number of available eggs – and she’s glad she did it, because it has bought her time to think about whether she definitely wants children. “It’s given me the freedom and the ability to take a step back and go, ‘do I actually want kids?’” she says. “If you’re in a panic and you’re anxious, you cannot make that level of decision. Don’t get me wrong, there is still an element of me that goes, ‘do I want to have children? Am I going to use the eggs?’ But I think I would be unable to even ask myself the question and have a semi-logical conversation with myself about [it] if I hadn’t frozen my eggs.”
If a woman does eventually decide to use her frozen eggs, whether that’s using sperm from a partner or a donor, first they must be thawed. Clinicians then create embryos through a process called intracytoplasmic sperm injection (ICSI), which are later transferred to the womb. It’s hard to find statistics about the success rate, because so few women have actually returned for the next part of the process (that might be because they’re still not ready, or because they’ve ended up conceiving naturally).
Rebecca* froze her eggs nearly seven years ago, but has decided not to use them. She and her husband had always been pretty sure that parenthood wasn’t for them, but in her mid-thirties, she found herself “getting really emotional and worried that we weren’t making the right decision […] so we did it as a hedge, so if we changed our mind somewhere down the line, we would be able to [have children]”. The process “changed my mentality completely,” she says. “I don’t think I’ve ever been emotional about it again. Over time, it’s reinforced that we have done the right thing, because there’s never been any need or want to revisit… we’re quite happy as we are.” Like Amy, she says that no longer feeling rushed “took all the pressure off the decision […] It became, ‘I can do this when I’m ready and when I want to’, and it’s turned out that that’s never”.
It’s given me the freedom and the ability to take a step back and go, ‘do I actually want kids?’
The question of whether or not to become a mother is always a deeply personal one. It’s crucial to recognise that freezing eggs might not guarantee parenthood further down the line. But for some, it can be a (pricey) way of buying peace of mind, even if it’s not a panacea. “I thought, ‘I’m actually never going to regret having this option,’” Amy says. “Even if I don’t use [the eggs], I’m never going to regret investing in myself.”
*Names have been changed for anonymity
Retrieval: Clinicians use a probe to inspect extracted eggs
