When Lindsey F. was diagnosed with breast cancer at age 22, she asked her oncologist two questions: Will I lose my hair? Will I ever be able to have children?

While most of Lindsey’s friends were dating around at the time, she was set on having a family in the near future with her soon-to-be-husband. And so without thinking twice, she froze her eggs, knowing that chemotherapy could increase her risk of infertility.

She had a short three-week window to undergo egg extraction surgery until beginning chemotherapy. First, fertility specialists induced ovulation, froze the eggs she had released from her period and matured them with hormones. Then, they grew eggs she didn’t yet have.

“I remember it being so painful,” she says. “But my sister made it so much fun. We were saying “Oh, there’s a Stephanie! There’s a Samantha! There’s a John!”

Lindsey is among a growing population of women who are opting to freeze their eggs. According to data acquired by TIME from the Society for Assisted Reproductive Technology, in 2009, 500 women had frozen their eggs. By 2013, that number nearly tripled in part thanks to removal of its classification as an “experimental” technology as of 2012, and Apple, Google and Facebook’s commitment to subsidizing egg freezing for their employees starting last year.

It hasn’t always been a success story, however. Since its inception in the 1986, specialists thawed the water-dense eggs, which typically resulted in the formation of crystals within the egg’s cytoplasm, which determines crucial genetic information about a new fertilized egg, according to Dr. Marjorie Dixon, MD, FRCSC, FACOG, REI, CEO and medical director of Anova Fertility and Reproductive Health. Now, the vitrification technique ensures the eggs are flash-frozen to preserve the integrity of egg’s cytoplasm.

While egg-freezing outcomes are more hopeful than they once were, it’s not for everyone. Here’s what you need to know before making the leap.

How it works:

A fertility specialist will genetically test your embryos using a transvaginal ultra sound and freeze them, according to Dr. Dixon. They then take one out of the freezer that was extracted at a time when you were chronologically younger, so there’s less of likelihood you’ll miscarry or experience other health problems.

“When you’re freezing eggs,” she says, “it’s not enough to freeze five eggs. Ideally, to ensure a take-home baby and good outcomes, when we warm them and freeze them, we want somewhere between 19 and 30 eggs.” Often it takes numerous cycles to freeze a sufficient amount of eggs. The younger you are, the easier it is to obtain enough on the first shot. Dr. Dixon tells patients the surplus of extracted eggs acts as an “insurance policy” should you need to access them later in life.

The eggs are cryopreserved using liquid nitrogen and safely transported to a storage facility monitored 24/7. Their shelf life is indefinite, but most specialist recommend using them between five to 10 years.

Reasons to consider egg freezing

I do discuss the benefits of egg freezing with women in their 30s who are not thinking of having children for another three to five years, as egg quality is highest before age 35,” says Dr. Tuong-Vi Nguyen, MD, MSc, a psychiatrist with a specialization in reproductive and perinatal psychiatric disorders at McGill University.Most women do experience psychological benefits as a result of this procedure. However, it is important not to overexaggerate the benefits of egg freezing as there is no 100 percent guarantee that a successful pregnancy will result from this procedure.”

Egg freezing historically benefited those undergoing chemotherapy or suffering from health conditions. In fact, recent research from the New England Journal of Medicine found that women experiencing infertility due to polycystic ovarian syndrome (PCOS) have a greater chance of taking home a live birth from thawed eggs as they do fresh eggs using the time-tested in vitro fertilization method. (Research is still mixed on its efficacy for those experiencing non-PCOS-related infertility).

Now, the Journal of Law of Biosciences cites numerous motivations behind social egg freezing.

  • Those without a partner over 35 who want to ensure quality of eggs
  • Those in their 20s with a long career path ahead
  • Those who haven’t found the right partner to help them conceive
  • Those who opt out of intercourse with a male
  • Those who wish to donate eggs to an infertile woman of their choice or to medical research (you will need to undergo a full medical evaluation to be cleared for donation before you start the process)

Procedure risks

Women above the age of peak fecundibility should address certain health concerns with their doctor before getting pregnant, according to Dr. Dixon, when you’re more at risk for developing complications like gestational diabetes, pre-eclampsia, and hypertension.

Other risks regardless of age:

Ovarian hyperstimulation syndrome: In very few cases, egg-freezing medication might over-stimulate the ovaries, creating a buildup of fluid.

Multiple births: Due to the use of IVF to implant the eggs, there is an increased risk for multiples. “When we perform insemination, we can’t control how many eggs and how many sperm connect,” says Dr. Dixon.

Logistical error: While rare, prepare for anything to happen—from equipment failure leading to premature thawing, to the loss of eggs during shipment from one center to another.

Child development:

While more follow-ups are needed to track the long-term development of live births conceived through egg freezing, a relatively small study from the Journal of Fertility and Sterility shows frozen eggs lead to more confident and sociable children, building on previous research proving they’re generally physically stronger, too. A recent long-term study found them to possess no more genetic abnormalities than their traditionally conceived counterparts.

Financial costs

According to UCLA Obstetrics and Gynecology, the cost of egg freezing is largely determined by your insurance plan, if any. At USC Fertility, it costs approximately $10,000 for one round of egg freezing, which includes the cost of testing, monitoring, and medication. Certain insurance plans might cover the first of potentially multiple rounds.

Emotional costs

Freezing your eggs can present emotional complications. According to a recent study from the Journal of Sterility and Fertility, 16 percent of women experienced moderate to severe decision regret. Contributing factors included:

  • Overestimating their likelihood of achieving a live birth
  • Failing to freeze enough eggs
  • Receiving insufficient emotional or psychological support

Even if they didn’t end up using their eggs, 89 percent of respondents were satisfied with the choice to freeze their eggs since it offered them a greater sense of control over their reproductive path.

Featured image by Kirstie Perez

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