Egg Freezing 101: A Guide to Future-Proofing Your Fertility

When global superstar Priyanka Chopra was in her early 30s, her mother, Dr Madhu Chopra, an obstetrician gynaecologist convinced her to freeze her eggs while time was on her side. 

“It gets so much harder to get pregnant after 35 and to carry to term and all of that, especially with women that have been working all our lives,” Chopra shared in an episode of Dax Shepard’s Armchair Expert podcast last year. “I also hadn’t met the person I wanted to have children with… That’s anxiety-inducing.”

This move proved prescient as it led to the birth of her beautiful daughter, Malti Marie, with Nick Jonas through surrogacy after she turned 40.

She summarised, “I felt such a freedom. I did it in my early thirties. I could continue on an ambitious warpath that I wanted to achieve. I wanted to get to a certain place in my career.”

Chopra is one of few celebrities who have opened up about their fertility journeys, in particular the procedure known as oocyte cryopreservation or egg freezing. This involves the harvesting of eggs by injecting medications to induce ovulation, similar to IVF.

It is recommended that between 20 and 30 mature eggs should be harvested depending on one’s age.

“The idea is to harvest a lot of eggs, so you get a large group to freeze at once,” explains Dr Harmeet Khurana, a consultant obstetrician gynaecologist at Neptune Hospital, New Delhi. These eggs are then retrieved through a transvaginal procedure under anaesthesia. 

The retrieved eggs are stored in liquid nitrogen at a temperature of -196 degrees Celsius, so they can be used at a later date to convert to a viable pregnancy.

As per Indian law, the period for storage of frozen eggs is capped at ten years. In 2012, the American Fertility Society removed the experimental tag from this procedure, ensuring that it became an increasingly popular option for delayed conception around the world.

“Women are opting for it both for medical as well as social reasons,” explains Dr Khurana.

“When young girls are diagnosed with cancer in their 20s or early 30s, the radio therapy they are subjected to may damage their eggs. Hence, freezing them is a sound decision.  It’s also a good option for certain genetic disorders like Turner’s Syndrome, which results in premature ovarian failure, so eggs aren’t produced after a certain age; or endometriosis where eggs are removed to suppress the extreme pain a patient faces during periods.”

The social reasons Dr Khurana highlights include a desire to achieve one’s professional goals before starting a family, concerns about finances, and most importantly, a delay in finding the right partner. Even large corporate firms like Apple, Google, and Facebook are motivating their female employees to freeze their eggs so their best years can be devoted to the company instead of child-rearing.

Lawyer Nandini Khaitan was worried she would regret not freezing her eggs later in life. “I wasn’t sure if I wanted to have children, but I was keen to have the option open if I decided to at a later stage,” she shares. Though her decision was taken at age 37, it was propelled by the revelation from her ovarian reserve test which declared her fertility level as being that of a younger woman’s. 

“That gave me the assurance to go for the procedure, even though earlier I wasn’t sure.”

The younger the better is the way to go as far as egg freezing is concerned. A study conducted in May 2021 by the Journal of Assisted Reproduction and Genetics concluded that a woman has over 40 per cent chance of conceiving with eggs frozen in her 30s while only a six per cent chance if the eggs are frozen in her 40s.

“The earlier you do the procedure, the higher your chances of the eggs resulting in pregnancies at a later stage, but there is no ‘golden age’. Most people think of 30 as a cut-off, but post-Covid we are seeing even 25-year-olds with fertility issues,” says Dr Rajeev Agarwal, a Kolkata-based gynaecologist, fertility specialist and laparoscopic surgeon, who frequently performs the procedure and spreads awareness on it through his podcast, ‘The Fertility, Motherhood & Wellness Show: True Stories with Dr Rajeev’.

The concept is indeed attractive for women, but one cannot discount the physical and emotional problems it brings along with it. 36-year-old lawyer Mita Goyal* narrates, “I had always imagined myself with children, even though I hadn’t been in a serious relationship for years. But after the first preparatory round of hormone injections, I couldn’t do it. It was too painful and tedious to self-administer the injections and visit the hospital all alone. I didn’t see the point of putting myself through it when I had no emotional support.”

The procedure, which is the same for IVF, can be very physically and emotionally taxing. Fertility patients need to be injected with hormones every day for 10-11 days, as each injection has a life of only about 90 minutes. During this process, women go through a rollercoaster ride. At best, they may experience mood swings, bloating, nausea, and constipation. However, there can also be bleeding, significant weight gain and severe pain.

The harshness of the physical symptoms has sometimes led women to give up the procedure mid-way. 38-year-old journalist Priya Patel* felt chronic fatigue, and a flare-up of her fibromyalgia right after starting the hormone medications.  She narrates, “I started getting migraines, hair fall, nausea, terrible pain in the legs, and my skin was acting up. The procedure didn’t seem worth it! I know it’s insurance and I appreciate why people do it, but it didn’t work for me, nor for a couple of my friends who faced similar experiences. Everyone should know what they’re going in for. They may also face these and other problems.”

While there is no medical evidence that egg freezing worsens lifestyle diseases or other underlying medical issues, anecdotal references can be found to prove otherwise.

According to medical experts, the absolute worst fallout of the procedure is a rare condition known as ovarian hyperstimulation syndrome. This happens when the medications create very high hormone levels resulting in the enlargement of the ovaries, fluid in the abdomen, and electrolyte abnormalities. Though it’s rare, people with underlying conditions like PCOS, or a low body mass index (BMI) are more susceptible to it. Khaitan unfortunately faced this condition which led to her being quite ill and laid up in bed for 8-9 days.

Apart from the physical toll, the procedure also weighs on you mentally, because in the words of Dr Agarwal “There is no guarantee that the embryos will convert to a viable pregnancy – no matter the time, effort and money involved.”

A 2023 study titled ‘Outcomes of Social Egg Freezing’ published in the Journal of Clinical Medicine studied 167 women through 184 social egg-freezing cycles. It concluded that the pregnancy rate achieved per embryo transfer was only 48 per cent and the live birth rate per embryo transfer was as low as 35 per cent.

One should also be prepared for the high expenses involved. It begins with the doctor’s consultation fee, followed by payment for hormonal medications, the cost of the actual procedure including checking into the facility for half a day and finally the annual payment for storage of the frozen eggs. 

Depending on where you choose to do the procedure and the number of eggs you choose to freeze, this translates to roughly INR 2-3 lakhs. The annual storage amount varies from INR 10,000 to 30,000 per frozen follicle. Dr Khurana highlights that the expenses are indeed a deterrent, especially for younger women with more viable eggs. “The expenses have to be justified because having your eggs frozen is no guarantee for life birth.”

Despite its shortcomings, egg freezing is indeed laudable for the promise of conception. As Dr Agarwal puts it, “The women who opt for egg freezing do it because it’s a necessity for them, not a luxury.

 It is an insurance for their future.” For every woman who suffers physically and mentally, there are others who sail through the procedure with minor discomfort. Jaya Jain*, a neurologist went through seven unsuccessful rounds of IVF before conceiving at age 37. In hindsight, she feels she should have frozen her eggs when she started at age 31. 

The option of freezing one’s eggs is wonderful – you are free to have your career, do your thing because pregnancy and motherhood is a sacrifice no matter what anyone says!”

Egg freezing, whether as the first step to IVF or as future insurance for conception, is certainly a revolutionary concept. However, it isn’t the only way to enjoy motherhood. There are many other options you could explore, such as adoption and surrogacy. Ultimately, it’s your uterus, so this decision should be solely yours.

*Some names have been changed on request.