Making Time Stand Still: When a Woman Should Consider Freezing Her Eggs

In the whirlwind of modern life, many women find themselves juggling careers, relationships, and personal goals, and putting family planning on the back burner despite the fact that their biological clock ticks on. With fertility declining steadily after the age of 30 and so many competing priorities, the decision of when to start a family becomes increasingly complex.

According to the World Health Organization, one in six people are affected by infertility in their lifetime, highlighting the importance of knowing when it’s the right time to take proactive steps to preserve fertility. 

The Readiness Age for Having Children is Pushing Older in America

In the United States, the age at which women are having children has gradually risen over the past few decades. According to data from the US Census Bureau, the average age of first-time mothers in the United States of women ages 20-24 declined by 43 percent, while those of women ages 35-39 increased by 67 percent between 1990 and 2019. This shifted the median age at which women gave birth in the United States from 27 to 30 during that period.

This change in the timing of childbirth reflects changing societal norms, increased access to education and career opportunities for women, and evolving perspectives on family planning and parenthood. Additionally, advancements in fertility treatment and reproductive technologies are providing women with more options for family planning, allowing them to extend their childbearing years if desired. 

The Biological Timeline

Between the ages of 20 and 40, a woman's reproductive abilities undergo significant changes. In their early 20s, fertility peaks, with the highest chance of conception and the lowest risk of pregnancy complications. As women approach their late 20s and early 30s, fertility begins to decline. By age 35, this decline accelerates, with a notable decrease in both egg quantity and quality.

Research published in the Journal of Human Reproductive Sciences highlights that by age 40, a woman's chances of conceiving naturally drop to around 5 percent per menstrual cycle, compared to about 20 percent in her early 30s. Additionally, the risk of miscarriage and chromosomal abnormalities increases significantly with age.

When to Consider Egg Freezing

Given these biological realities, many women decide to pursue egg freezing to save their younger eggs for later. The ideal time for women to seriously consider egg freezing is in their late 20s to early 30s. By taking proactive steps to preserve their fertility during this window, women can mitigate the effects of age-related decline and retain the option of future pregnancy using their younger, healthier eggs.

However, every woman's journey is unique, and personal circumstances such as career goals, relationship status, and health considerations must also be factored in. Therefore, it's essential to have open discussions with a fertility specialist to determine the best course of action based on individual factors.

Navigating the Egg Freezing Process: A Roadmap to Success

Embarking on the egg freezing journey can feel overwhelming, but it can be a transformative experience with the right guidance. Here's how it can be done effectively:

• Consultation with a Fertility Specialist: Begin by scheduling a consultation with a reputable fertility clinic or specialist. During this initial appointment, a fertility specialist will discuss medical history, conduct fertility tests, and discuss goals and concerns.

• Customized Treatment Plan: Based on the findings of the initial consultation, the fertility specialist will create a personalized treatment plan tailored to meet the patient’s needs. This may include ovarian reserve testing, hormone therapy, and the egg retrieval procedure.

• Egg Retrieval Procedure: The egg retrieval process typically involves several weeks of hormone injections to stimulate egg production, followed by a minor surgical procedure to collect the mature eggs from the ovaries. While the procedure is relatively low risk, it's essential to closely follow the doctor's instructions and prepare for potential side effects.

• Egg Freezing and Storage: After retrieval, the patient’s eggs are frozen using a process called vitrification, which preserves their quality for future use. The frozen eggs are then stored in a secure facility until they are ready to be used.

Pros and Cons: Weighing the Options

Like any medical procedure, egg freezing comes with its own set of pros and cons. 

Pros:

• Preserves fertility options for women who wish to delay childbearing.

• Allows women to use their younger, healthier eggs later in life.

• Provides peace of mind and a sense of control over reproductive choices.

Cons:

• Not guaranteed to result in a successful pregnancy.

• Requires a significant financial investment, including treatment costs and ongoing storage fees.

• Involves hormonal medication and a minor surgical procedure, which has potential risks and side effects.
  

Increased Attention on Egg Freezing and Assisted Reproductive Medicine in the Cultural Zeitgeist

While egg freezing has been around since the 1980s, for decades it was primarily used by cancer patients before undergoing treatment that might damage their fertility. The American Society for Reproductive Medicine lifted the treatment’s experimental label in 2012 which led to an expansion of those pursuing treatment.

In 2015 there were about 7,600 egg freezing cycles recorded nationwide, but by 2022, the number hit 29,803, a nearly 300% increase, and millions of women now share their IVF and egg freezing journeys on social media using hashtags like #ivfJourney #ivfwarrior and #infertility. While popular movies have long covered pregnancy as a theme (Juno, Knocked Up, Mama Mia, etc.), recently there has been a proliferation of multimedia looking at egg freezing, IVF, and other assisted reproductive technology.

The 2024 film "Scrambled," offered a personal look at a woman's journey into freezing her eggs – underscoring how prevalent the procedure has become in an era where family creation gets increasingly postponed, and the upcoming film “Joy,” on Netflix will tell the true story of the world’s first IVF baby.

The 2023 book “Motherhood on Ice: The Mating Gap and Why Women Freeze Their Eggs” drew on stories from more than 150 women who pursued fertility preservation technology and explored how many women delay childbearing because they face a lack of eligible, educated, and equal partners ready for marriage and parenthood. As more women pursue egg freezing, it is also becoming a more in-demand corporate benefit – in 2015 only 5% of large employers covered egg freezing; in 2023 the number jumped to 1 in 5.

Ultimately, deciding when a woman should freeze her eggs is deeply personal, influenced by a combination of biological, social, and emotional factors. By understanding the biological timeline of fertility, seeking guidance from fertility experts, weighing the pros and cons of egg freezing, and learning from the journey of others who’ve gone through the process, women in their late 20s to early 30s can decide whether they should take proactive and increasingly common steps to preserve their reproductive options and empower themselves on their journey to motherhood.

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Dr. Melanie Landay is a fertility expert, a board-certified Obstetrician and Gynecologist and a Fellow of the American College of Obstetricians and Gynecologists. Dr. Landay attended medical school and completed postgraduate training in Obstetrics and Gynecology at the University of California, Los Angeles.