Couple sits at a table having a conversation with a medical provider.
Making sense of the process – simonkr / E+ via Getty Images

Egg freezing step by step

Most of us wouldn’t sign up for a marathon without investigating a few training plans first, right? The same is true for something as important as deciding whether or not to freeze your eggs. Ovia is here to support you on your fertility journey. Let’s break down the egg freezing process for you.

Step 1: Choosing your fertility clinic or doctor

The American Society for Reproductive Medicine (ASRM) suggests scheduling a consultation with prospective fertility clinics to ask about their egg freezing methods, success rates, costs, storage, and policies for disposing of unused eggs. Most importantly, you should choose a doctor you feel comfortable with and trust. 

Step 2: Your baseline fertility evaluation

Once you choose your doctor, you will have several appointments and evaluations. These include appointments for:

  1. Consultation with your fertility doctor (aka reproductive endocrinologist)
  2. Transvaginal ultrasound to count the number of eggs (follicles) on your ovaries. (If this baseline testing is encouraging, you might decide to opt out of egg freezing completely or to delay egg harvesting.) 
  3. Blood test examining your fertility hormones
  4. Follow-up appointment several weeks later to review lab test results and your ovarian stimulation protocol

Ovarian stimulation protocol is the name for the sequence of medications you will give yourself over the next 3 to 4 weeks to stimulate your ovaries to produce multiple mature eggs.

Step 3: Ovarian stimulation

In a normal monthly cycle, your ovaries form multiple fluid-filled sacs called follicles, but only one mature egg, which your ovaries release when you ovulate.

Ovarian stimulation medications mimic your natural menstrual hormones (estrogen and progesterone), but fool your ovaries into growing multiple mature eggs simultaneously.

Most of the medications used for ovarian stimulation must be injected with a needle. You or your partner or family member can do this. You will have another appointment with a nurse to review the medicines, how to mix them and inject them, and to review the timeline and plan for your egg retrieval process.

Where you are in your cycle, timing, and the results of your fertility evaluation determine the best protocol for you. Here is a typical ovarian stimulation protocol and commonly-used medications:

  1. A short course (1-2 weeks) of birth control pills, estrogen, Lupron, or Aygestin (a form of progesterone) before starting injections. 
  2. Self-administered hormonal injections medications for the next 9-12 days. The injections will most likely be some combination of follitropin alfa or beta (Follistim AQ, Gonal-f) or menotropins (Menopur) to stimulate your ovaries.
  3. Hormonal injections on days 9-12 to prevent your ovaries from releasing an egg too soon. Medications could include leuprolide acetate (Lupron) or cetrorelix (Cetrotide).
  4. A trigger shot 36-37 hours before your scheduled retrieval procedure time to complete the “ripening” of your eggs. These injections are usually Lupron (leuprolide acetate) or hCG (human chorionic gonadotropin), sold as Ovidrel or Novarel. 

The purpose of the first 1-2 weeks of medications is to help align your follicles so they all start maturing simultaneously.

During days 9-12 of the fertility injections, you can expect to have 5-7 monitoring appointments with blood tests and vaginal ultrasounds to evaluate your response to the medications. These appointments typically take about 30 minutes.

Step 4: Egg harvesting

Your doctor will schedule your egg harvesting or egg retrieval appointment once ultrasounds and bloodwork show that you have enough mature eggs. Egg retrieval is usually 9-12 days after starting the fertility injections in a typical cycle.

The actual harvesting procedure only takes about 15 minutes and is not painful. You will be given anesthesia and pain medication to keep you comfortable and very briefly asleep (conscious sedation). Next, your doctor will use ultrasound to safely direct a special suction needle through your vagina to remove mature eggs from your ovaries.

Clinics usually monitor you for one to two hours after the procedure before sending you home to rest. Plan on taking the rest of the day off from work and avoid heavy lifting or intense exercise for the next week to protect your ovaries.

Step 5: Flash freezing your eggs

After harvesting, your eggs are quickly frozen in a process called vitrification. Vitrification prevents harmful ice crystals from forming and results in higher egg freezing success rates. Eggs will be stored at subzero temperatures until you are ready to use them.

Once you’re awake, your care team should tell you how many eggs they retrieved. It will probably take 24 hours to know how many mature eggs were frozen.

When the time is right, your eggs can be thawed, and hopefully fertilized with sperm in a lab, and implanted in you or a gestational carrier’s uterus through in vitro fertilization (IVF).

Step 6: Live your life and plan your future fertility

The decision to freeze your eggs is as complicated as all the steps in the egg freezing process. Egg freezing can offer you more options, but it does not guarantee you a future baby. If you have more questions about the egg freezing process, head over to our FAQ. 

Reviewed by the Ovia Health Clinical Team

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