Egg Freezing at London’s Leading IVF and Fertility Clinic

The next stage involves completing all relevant consent forms and preparing for the egg-freezing treatment.

You will receive a link via email to our online consent form portal to access all the relevant HFEA consent forms and clinic consent forms. Please ask for a copy of your consent forms. You can withdraw or alter your form/s at any time — before, during or after your treatment.

At your hour-long consultation, your nurse will cover the following:

An ID check
A discussion about your personalised medication and treatment plan
Witnessing your consent forms

Following your nurse’s appointment, you can buy your medication from your local pharmacy or order online from a home-delivery service. You should also ensure you have the appropriate needles and syringes, and that you have been provided with a sharps bin.

Please follow the storage instructions carefully, as some drugs need to be refrigerated.

The final step is your egg-freezing treatment. This includes ovarian stimulation, egg collection and lastly, freezing and storage.

The egg-freezing procedure involves administering hormonal injections to stimulate the ovaries for around 12 days. All of the drugs used for egg freezing treatment are administered subcutaneously i.e., under the skin. Most patients self-inject the drugs.

Your consultant will give you further instructions on how to prepare for your egg collection, including exactly how and when you should take the medication, as well as anything else you need to know in the time leading up to the procedure.

The eggs are then collected under sedation. The egg collection is a relatively non-invasive procedure and carries minimal risks. You may bring a friend or relative with you, although this is not mandatory. You must, however, have someone collect you after the procedure and stay with you for 24 hours post-procedure.

On the day of egg collection, your mature eggs will be extracted and then vitrified (frozen) for future use. Rarely, no eggs may be suitable for freezing. You will be told how many eggs were collected and the number put in storage.

There are 2 main reasons why women in the UK freeze their eggs:

• Social – to delay their child bearing whilst they find the right partner (46% of those who freeze their eggs are single), to pursue their career or because they are not ready to have children.

• Medical – they are having treatment for cancer which is likely to affect their fertility or they have other medical problems like severe endometriosis.

1. Your age at the time of starting treatment

As per the HFEA data, most women who froze their eggs in 2016 were over 35. The commonest age to freeze eggs was 38. However, the most common age women came back for fertility treatment to use their cryopreserved eggs was 40.

“There are many women freezing eggs into their 40s and even 50s. Given the scientific consensus around age-related fertility decline, it is not clear why patients of this age are freezing eggs and we would caution against this being a sensible option for this group of women.” HFEA

When should women be freezing their eggs?

‘Standard’ fresh IVF does not offer a solution to age-related fertility decline because it cannot reverse the egg degeneration that comes with getting older’. This is why the age a woman is when she freezes her eggs is so important. HFEA

In cases over the age of 35, we know there is a steep decline in fertility and this has an impact on both natural conception and IVF success rates. HFEA

The likelihood of a successful outcome following egg freezing is based on the age at the time of freezing one’s eggs. Hence, freezing eggs prior to early 30s would be the ideal time to have the best chance of a successful outcome in future. However, young women are likely to get pregnant spontaneously and are hence, are less likely to use their frozen eggs. The current 10-year legal limit on storage of frozen eggs means the frozen eggs are to be used within this period.

When one freezes later in life, the process may be more invasive and expensive due to the natural decline in fertility as more cycles may be needed to collect the desired number of eggs. The chances of treatment being successful reduces but one is more likely to use the frozen eggs.

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2. Cost of treatment – how will you fund your treatment

3. Risks associated with the treatment – it is generally a safe treatment

4. Chances of success – The birth rate from frozen own eggs is 18% per treatment cycle

5. Risk of not using the frozen eggs - There is a chance that one may conceive spontaneously and hence, may not use the frozen eggs in the future

6. Risk to baby and mother - Currently 2000 babies worldwide have been born from cryopreserved eggs but long-term studies on safety for children born from this process are not yet available. Evidence to date, shows no differences between the use of vitrified or fresh eggs in the rates of obstetrical problems in pregnancy. There are no increased risks of chromosomal anomalies or significant physical or developmental deficits in the babies born.

“Egg freezing is emerging as a viable clinical technique to preserve women’s fertility, providing the eggs are frozen at a clinically optimum age, and the patient is aware of the risks and possibility of becoming pregnant naturally. The evidence suggests that if eggs are frozen below the age of 35, the chances of success using these frozen eggs is higher than the natural conception rate as the woman gets older.

The results of our analysis are supported by international evidence which suggests egg freezing is a successful and cost-effective method of preserving fertility.” HFEA

Below is a list of commonly used medication for egg freezing treatment. You may be on some of them. Please refer to your personalised treatment plan to see which medication is prescribed for you.

• Norethisterone – oral tablets

These are progestogen tablets usually given in the cycle preceding treatment (normally days 14-25). You should have protected intercourse prior to and whilst you are on them. They are given to help prevent the formation of ovarian cysts. Your period should start 3-7 days after stopping the medication. If it is more than 7 days late, please do a urine pregnancy test and inform your doctor.

• GnRH antagonist – eg Inj Cetrotide subcutaneous injections

This drug is used to help prevent premature ovulation prior to egg retrieval. It is given as a subcutaneous injection once daily, usually from day 6 of the cycle during the stimulation phase of treatment, until the day of the trigger injection.

• GnRH agonist – eg Buserelin nasal spray or subcutaneous injections

This drug “switches off” hormone production within the body during treatment. The most common way to administer this drug is via a nasal spray, one sniff into each nostril four times daily. It can also be given in the form of a subcutaneous injection once a day. It is usually started from day 21 of your cycle in the month preceding treatment. Your doctor will inform you when to stop taking it. GnRH agonists may also be used to mature the eggs prior to egg collection, as a trigger injection in those who are on GnRH antagonists. One may experience menopausal symptoms such as vaginal dryness and hot flushes whilst taking this medication.

• Inj FSH – eg Inj Meriofert, Inj Gonal F subcutaneous injections

These injections are used for ovarian stimulation. They are given as subcutaneous injections for around 9 to 12 days. They aim to stimulate the growth of the follicles in the ovaries that contain the eggs, so that several eggs are produced. They should be administered at roughly the same time every day.

• Inj Growth Hormone – eg Inj Zomacton subcutaneous injections

This drug is given to help improve the response to ovarian stimulation. It is given as a subcutaneous injection on alternate days during the stimulation phase of treatment.

• Inj hCG – eg Inj Ovitrelle, Inj Gonasi subcutaneous injections

This is the also called the trigger injection. It contains hCG, the hormone that matures the eggs prior to egg collection. These are subcutaneous injections, although some brands may need to be taken as an intramuscular injection. These injections need to be given at a specific time (usually 36-37 hours before egg collection). Your doctor will let you know the date and time your injection should be administered.

Egg collection is a relatively non-invasive procedure and carries minimal risks. But as with any medical procedure, there may be side effects, which are typically minor and temporary. 

Possible side effects or risks from the medication can include:

• Hormonal fluctuations leading to bloating 
• Bruising, soreness or redness in the injection site

Post-procedure side effects from the egg collection can include:

• Grogginess (which should abate within 24 hours)
• Abdominal cramping or vaginal soreness
• Vaginal bleeding - this settles in a few days
• A slight risk of infection — antibiotics are typically given during the procedure to minimise this risk
• Irregular periods (which should resolve on their own within a few cycles)

More serious risks of the egg collection procedure are extremely low. 

• The risk of injury to internal organs such as the bladder, blood vessels and bowel is very low. Usually, no further action is needed as it is only a needle stick injury.
• Ovarian Hyperstimulation Syndrome (OHSS) is a complication that sometimes affects young women with very active ovaries. This condition is characterised by swollen ovaries and fluid retention in the abdomen leading to nausea, vomiting and diarrhoea. In rare cases, this requires bed rest and monitoring, and in the most severe cases, treatment requires hospitalisation. 

It is possible to freeze eggs on the NHS if you need to undergo medical treatment that will affect your fertility, for example, chemotherapy or radiation treatment. 

If you would like to freeze your eggs for social reasons (because you want to delay having a child for your own reasons), doing the egg-freezing treatment on the NHS is not possible. 

For this reason, 90% of cycles in the UK are self-funded.