Egg Freezing & Embryo Banking
Since 2004, the NYU Langone Fertility Center’s Fertility Preservation Program has been at the forefront of helping women and couples have babies when the time is right. Fertility preservation for women can be achieved through either egg freezing—also known as oocyte cryopreservation—or embryo banking, which is when eggs are combined with sperm prior to storage.
Our internationally renowned program is led by Drs. Nicole Noyes and James Grifo, both experts in the field. Dr. Noyes is a past chair of the American Society for Reproductive Medicine’s Fertility Preservation Special Interest Group, the society’s largest advocacy group.
Choosing Fertility Preservation
Most people consider fertility preservation when parenthood is not possible or desirable at the present time. A woman is born with all the eggs she will ever have. Eggs released when she is younger are most often of better quality and more likely to result in a healthy pregnancy. Egg freezing or embryo banking allows a woman to preserve her fertility at her current age, so she can become a parent when she is ready.
A woman may choose to preserve fertility for many reasons. She may be receiving medical treatment, such as chemotherapy, surgery, or radiation therapy. Certain medical conditions—including endometriosis, large or recurring ovarian cysts, or, rarely, mosaic Turner syndrome—can negatively impact a woman’s reproductive potential.
Having a progressive disease, such as systemic lupus erythematosus, renal disease, or sickle cell disease, can also prompt a woman to seek fertility preservation. There are also many personal or professional reasons a woman might choose to freeze eggs or embryos: lack of a male partner, a recent or pending divorce, financial uncertainty, job constraints, military deployment, and a host of other life events. Both eggs and embryos can be stored indefinitely.
Egg freezing is the most commonly performed fertility preservation treatment at our center. Embryo banking is becoming a more frequent choice, particularly for young couples just starting their careers. Some patients opt for a combination of both egg and embryo banking, meaning some eggs are cryopreserved unfertilized and others are fertilized first before freezing.
Our physicians can discuss with you the benefits and drawbacks of each option.
Egg Freezing Rates
As of May 1, 2016, the Fertility Center has completed more than 2,600 egg freezing cycles, with more than 450 cycles now done annually.
Of cycles in which eggs have been thawed and used, three-quarters were in women who used their own eggs; the remainder involved donor eggs, which are often procured as part of our Egg Donor Program. Commercial donor egg banks are also used. To date, 98 babies have been born and 6 additional babies are on the way. The Fertility Center’s pregnancy rates from egg thawing are on par with those seen in traditional in vitro fertilization (IVF) cycles.
Some women and couples opt for preimplantation genetic screening (PGS) of embryos. PGS is not performed on unfertilized eggs. This screening procedure helps determine which embryos have a normal chromosome complement and thus are most likely to result in a healthy pregnancy and baby. It also allows for a single embryo to be transferred, which almost eliminates the chance of twins (or more).
Fertility Preservation for Women with Cancer
All the doctors at the Fertility Center are experts in preserving the fertility of women dealing with complex medical conditions. Dr. Noyes is considered one of the leading authorities worldwide in cryopreserving eggs in women who have cancer.
Our doctors have frozen eggs for more than 250 women who have been found to have a malignancy. To date, in the women who have thawed their eggs, six babies have been born. This represents one of the largest single-center live birth reports for cancer survivors worldwide. Like those without cancer, women with cancer most often freeze unfertilized eggs. They can also freeze embryos or a combination of eggs and embryos for use later.
The Egg and Embryo Freezing Process
Both the egg and embryo freezing processes start much like traditional IVF. Medications are taken to stimulate the ovaries to simultaneously mature multiple eggs that can then be retrieved from the body and transferred to our embryology laboratory. In women who have cancer, ovarian stimulation protocols are tailored to each patient’s medical needs.
Below is an overview of the egg and embryo freezing process.
Step One: Consultation and Orientation
Prior to starting the treatment cycle, an initial consultation with one of our physicians must take place. After the consultation, you meet with a clinic coordinator to go over the timing of the treatment cycle and to schedule an orientation session. At orientation, you learn about ovarian stimulation and the freezing process, how to administer medications, what happens during office visits, and how the eggs are removed from the body and handled in the laboratory.
Please note that after the initial consultation and prior to beginning the actual egg-freezing or embryo-banking treatment, you must attend the Fertility Center’s orientation session.
Step Two: Ovulation Induction
In the course of a natural menstrual cycle, the brain produces hormones that stimulate one of the ovaries to release an egg. During egg freezing or embryo banking treatment, you are prescribed those same hormones, known as fertility medications, to stimulate the ovaries to mature numerous eggs at once. Most often, having a greater number of eggs improves the chances of fertilization, and ultimately, a future pregnancy. Our goal is to retrieve between 8 to 25 eggs per treatment attempt.
Step Three: Egg (Oocyte) Retrieval
When the eggs are ready to be retrieved from the body, our experts perform a “harvest” procedure at the Fertility Center using mild sedation. This procedure takes 5 to 10 minutes. The doctor—with the aid of ultrasound visualization—guides a needle through the vaginal wall and into the ovaries to gently suction the eggs from their follicles and into sterile test tubes. After eggs are retrieved, they are transferred to the embryology laboratory. The retrieved eggs are evaluated, and about three-quarters of these are generally considered mature enough for freezing or fertilization.
An anesthesiologist is present for all egg retrieval procedures. He or she administers mild sedation and monitors vital signs during the procedure. As with any surgical treatment, there are risks associated with egg retrieval that should be discussed with your doctor.
Step Four: Cryopreservation in the Laboratory
Eggs that are not fertilized are carefully frozen using cryopreservation technology. Eggs to be fertilized prior to storage are placed with sperm to create embryos. Although eggs are frozen the day they are removed from the body, embryos are frozen either the day after egg retrieval—after fertilization has been documented—or five to seven days after the egg harvest procedure, when the embryo has reached the blastocyst stage. If preimplantation genetic screening (PGS) or diagnosis (PGD) is to be performed, it is done after the embryo has formed into a blastocyst.
PGS and PGD cannot be performed on unfertilized eggs but may be performed later, after the egg is thawed and combined with sperm to create an embryo. Any stored eggs or embryos remain on-site at the Fertility Center.
For some patients, the cost of an egg freezing or embryo banking treatment, particularly when a patient has been diagnosed with cancer, is covered by health insurance. The level of coverage you have, if any, depends on the type of insurance plan you have.
For most patients, health insurance does not cover the cost of fertility preservation treatments for reasons unrelated to a medical diagnosis, although this is beginning to change. If you have an insurance plan, talk with its representatives to find out what level of coverage you may have.
In addition, patients with cancer might quality for outside assistance. Below are some programs that can help.
The Fertility Center participates in the LIVESTRONG Fertility Discount Program, which provides much of the medication that is needed to complete a treatment cycle.
Heart Beat Program
Ferring Pharmaceuticals’ Heart Beat Program provides certain fertility medications, at no cost, to women who have been diagnosed with cancer. To qualify, you must have received a diagnosis and not yet have started cancer treatment.
To learn more about egg freezing or embryo banking, or to schedule an appointment at the Fertility Center, please call the individual doctor’s office phone line or the center’s main number at 212-263-8990 or fill out our appointment request form.