Elective Egg Freezing

MFS has provided an egg freezing service since 2000 and so the clinic understands that women who elect to freeze their eggs for non-cancer medical conditions or who want to ‘preserve’ their fertility for non-medical reasons require a specific approach to their treatment and care to:

• to satisfactorily address the reasons and possible emotional issues which have made them consider elective egg freezing
• maximise the success of the egg collection

Egg freezing at MFS is handled by a dedicated team of clinical staff whose experience enables them to deliver a total care package addressing the clinical, scientific and emotional requirements of elective egg freezing.  This unique service is the result of MFS being one of the first UK clinics to offer egg freezing and of being the first and only clinic (as of June 2009) to have had livebirths following the freezing of the mothers’ own eggs and the subsequent thaw, fertilisation and transfer, after the birth of four babies since June 2002.

Through thorough investigations, scanning, consultations, follow-up appointments and counselling, the three-stage elective egg freezing service ensures that the woman understands both the potential and limitations of egg freezing and feels fully informed of the chances of possible success before any treatment begins.

Who may benefit from elective egg freezing?

A woman may elect to have egg freezing treatment for reasons including:

• she has a non-cancer medical condition which may either shorten her ‘fertility life’ or which will prevent her trying to conceive until treatment for that condition is complete, such as:
• severe endometriosis
• recurrent ovarian cysts
• any condition which, in the opinion of her doctor, may result in premature ovarian failure or the removal of her ovaries
• a history of early menopause in her family, through her mother, or aunts or maternal grandmother
• depression or a temporary mental condition for which she is currently receiving treatment
• she is a single woman who is not currently in a relationship but who would like the option of genetic motherhood in the future. She may try to conceive using her thawed frozen eggs in the future, at a time when her own fertility may have reduced and the quality of her fresh eggs may have diminished. This is sometimes referred to as ’social’ egg freezing.

As with IVF using ‘fresh’ eggs, success rates are significantly influenced by a woman’s age.  Therefore MFS strongly recommends that a woman considering elective egg freezing begins treatment before her 38^th birthday.

• MFS is unable to register patients/clients under the age of 18
• any woman considering elective egg freezing must  satisfy the clinical and counselling teams that she understands the potential and limitations of egg freezing and feels fully informed of the chances of possible success before stage 3 egg freezing treatment begins

What does elective egg freezing treatment involve?

The elective egg freezing service includes three stages of investigations, consultations and treatment:

• stage 1: ovarian reserve testing - to measure a woman’s fertility potential and her possible response to fertility drugs. If the results of the ovarian reserve test are suitable, the woman may proceed to the next stage of possible treatment.
• stage 2: the elective egg freezing preparation service (EEFPS), which includes treatment assessment, a counselling session and guidance on:
  • the success rates of egg freezing
  • risks of treatment
  • the results of the woman’s ovarian reserve test and their impact on her fertility potential, or on the success of stimulated treatment required for egg freezing
  • the impact of her age on the quality of eggs and the chance of a healthy pregnancy
  • the assessments necessary to move onto any future treatment
  • the consent the client must give before any treatment may begin
  • if the woman satisfies the counsellor that she is able to deal with the emotional implications of elective egg freezing and meets the clinical and scientific criteria, she may progress to the next stage of the elective egg freezing treatment service
• stage 3: egg freezing treatment. Treatment is tailor-made for each client, depending on the results of the ovarian reserve test and treatment assessment:
  • daily injections or a nasal spray (usually naferelin or buserelin) ‘down regulate’ the woman’s usually monthly cycle to a temporary menopausal state in preparation for the stimulation phase of the cycle
  • gonadotrophin drugs given by daily injections stimulate the ovaries to produce more eggs than occur in a natural cycle. An MFS doctor or fertility nurse specialist will advise on the most suitable method for each client
  • the dose of stimulating drugs each client needs is carefully calculated to optimise the number of follicles and mature eggs
  • the woman will need to attend the clinic for ultrasound scans during the stimulation phase to monitor the number and size of the growing follicles
  • when the follicles have grown sufficiently she will be advised of the day of her egg collection (usually about two to five weeks after she first starts taking the fertility drugs)
  • egg collection is performed with ultrasound guidance under conscious sedation and with pain relief
  • the collected eggs are washed and placed in labelled dishes before being put into an incubator where the environment mimics the inside of the body
  • a nurse - and a partner or friend - will be with the client constantly throughout the procedure
  • the eggs are prepared for freezing using either the slow-freeze or vitrification processes, or a combination of both, as advised by the laboratory team
  • using the slow-freeze method: the embryologist puts the eggs through a series of solutions to remove and replace their water content with a cryoprotectant to help preserve the delicate cell structures and avoid crystallisation during the freezing and thawing processes. They are then loaded into labelled glass straws and put into liquid nitrogen where they will remain at ‒196°C until possible future use
  • using vitrification: the embryologist removes the ‘cloud’ of cells from around each egg and within less than 60 seconds, places it on a film-like ‘leaf’ in a droplet of cryoprotectant. This is then inserted into liquid nitrogen which rapidly cools the eggs at a rate of ‒20,000°C per minute. This flash-freezing technique changes the liquid cryoprotectant to a glass-like solid in which the egg is preserved and then immediately stored in liquid nitrogen at ‒196°C
• the eggs are stored until the client wishes to try to conceive with them. Currently eggs may be stored for up to 10 years, although this may be extended in exceptional circumstances

When the client is ready to conceive, following a repeat consultation, including a Welfare of the Child assessment and satisfactory possible further counselling, MFS can thaw the eggs, fertilise them using ICSI with partner or donor sperm and transfer any resulting embryos to her uterus.  This stage of treatment is not guaranteed as part of the elective egg freezing treatment and, should it go ahead, incurs an additional cost.

What is included in the elective egg freezing treatment cost?

Each of the three stages of treatment is invoiced separately and there is no guarantee of progressing to the next stage of treatment until the results of the investigations and assessments are known.

The ovarian reserve test includes:

• measurement of AMH
• measurement of the FSH hormone level and of the FSH:LH hormone ratio
• an ovarian ultrasound scan to perform an antral follicle count (only if the client attends MFS for the ovarian reserve test, rather than the postal option)
• a 30 minute phone consultation with one of the egg freezing team clinical staff to discuss the results
• a letter detailing the results and advice on suitability of the elective egg freezing preparation service
• a phone or face-to-face counselling session

The elective egg freezing preparation service includes:

• a 1 hour face-to-face consultation with one of the egg freezing team clinical staff to discuss the clinical, scientific and emotional requirements of elective egg freezing
• a compulsory phone or face-to-face counselling session
• a 30 minute face-to-face follow-up appointment to discuss the opportunity, or otherwise, to proceed with elective egg freezing treatment
• up to two optional phone or face-to-face counselling sessions, as per all treatment packages

Egg freezing treatment includes:

• ultrasound monitoring scans
• teaching how to give injections
• egg collection
• egg freezing and storage for first year

What is not included in the elective egg freezing treatment cost?

• cost of fertility drugs
• storage costs after one year
• cost of donor sperm (if required)
• cost of ICSI for thawed frozen eggs (if/when required)
• the HFEA levy for the creation in vitro, or transfer of, embryos (if required)

How long does elective egg freezing treatment take?

Around four months from the beginning of the elective egg freezing preparation service to completion of any possible egg freezing treatment cycle, depending on the drug protocol.

Costs

Stage 1

Cost of ovarian reserve test at MFS: £300

Stage 2

Cost of elective egg freezing preparation service (EEFPS) at MFS: £460

Stage 3

Cost of egg retrieval, egg freezing and first year’s storage at MFS: £2,800

Cost of further annual storage at MFS: £170

Go to the MFS Cost Calculator^©

More information

• Success rates with egg freezing
• Go to more information on donor identity and the law

Also, go to the MFS Patient Treatment Information page and download the following infosheets:

• Ovarian Reserve Test
• Egg Freezing - Elective
• Fertility Treatment with Donor Sperm
• Embryo Transfer Policy and eSET
• ICSI