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Photography Steph Wilson for Hate Zine

Everything you could ever want to know about freezing your eggs

TextAlice Gibbs

Gynaecologist Dr Chantal Simonis explains why the treatment is on the rise among young women wanting to put pregnancy on hold and how others can benefit from it

With more of us choosing to have children later in life, it is no surprise that the number of women choosing to freeze their eggs is rising – putting motherhood on ice for a few years thanks to a medical treatment that is now even being offered as an employee perk in some businesses.

Egg freezing is one way of preserving a woman’s fertility so she can try to have a family in the future. Although the procedure is relatively new in the UK, The Human Fertilisation and Embryology Authority (HFEA) report that treatment rates rose by 11 per cent from 2016 to 2017. 

Dr Chantal Simonis is a gynaecologist and obstetrician who originally qualified as a medical doctor in Cape Town, South Africa before training in Obstetrics and Gynaecology in the UK. “I always wanted to do Obstetrics and Gynaecology,” says Dr Simonis, “I was inspired by remarkable midwives and doctors while doing my Obs and Gynae attachments at medical school.” 

After being admitted as a member of the Royal College of Obstetricians and Gynaecologists in 1998, Dr Simonis was offered the opportunity to research women with polycystic ovaries (PCO) undergoing IVF treatment, and a natural progression into fertility ensued. Dr Simonis has worked with Wessex Fertility since 2000 and completed her master’s thesis in the effects of IVF treatment in women with PCO in July 2012.

Here, we picked her brains on all-things egg freezing...

Can you tell us a bit about what egg freezing is?

Dr Chantal Simonis: Egg freezing is a procedure to preserve a woman’s eggs so that they can be used at a later date. Some women want to freeze their eggs because they are not ready to start a family, or have not met the right partner to do so. Other women may have a medical reason for wanting to freeze their eggs, such as planned surgery, or treatment for cancer which could cause subfertility.

How does it actually work?

Dr Chantal Simonis: It’s necessary to undergo a full IVF cycle whereby medication is given to enhance follicle maturation, and the eggs are then collected from these mature follicles. Once the eggs have been collected, they are assessed by an embryologist and mature eggs can then be frozen in liquid nitrogen.

Who is freezing their eggs?

Dr Chantal Simonis: Egg freezing may be appropriate for women who wish to delay starting a family. In these circumstances, it’s highly desirable to freeze the eggs when women are under the age of 35 years, as the egg quality tends to be better in younger women.

“Some women want to freeze their eggs because they are not ready to start a family, or have not met the right partner to do so. Other women may have a medical reason for wanting to freeze their eggs, such as planned surgery, or treatment for cancer which could cause subfertility” – Dr Chantal Simonis

When did it start and why do you think it has grown in popularity?

Dr Chantal Simonis: The first human birth from a frozen egg was in 1986. Since then elective egg freezing, also known as social egg freezing, has become more prevalent as more women wish to combine their pursuit of a successful career with the option of also having a family. By freezing their eggs when they are younger, they can keep the option of starting a family at a later stage.

How has the practice developed over time?

Dr Chantal Simonis: The technique for egg freezing has improved significantly over the past few years. At The Fertility Partnership (TFP), we use a new method of freezing eggs which maintains the eggs at their optimal physiological temperature for longer before placing them into liquid nitrogen to freeze them. Current egg survival rates after thawing are approximately 85 per cent.

Should people think about freezing their eggs? When and why? 

Dr Chantal Simonis: Yes, for some women egg freezing can be a successful option for having a child. Women under the age of 30 years who have not met someone they want to start a family with would do well to consider this as a possibility, but bearing in mind it can be a costly process, and success is not guaranteed.

What are the risks and aftercare needed for egg freezing? 

Dr Chantal Simonis: The risks are the same as for any stimulated IVF cycle, and range from relatively minor medication side effects (such as mood changes and hot flushes, minor skin irritation at the injection site) to pain and slight bleeding after the egg recovery procedure. A rare complication is ovarian hyperstimulation syndrome (where too many eggs develop). This causes abdominal swelling and discomfort and in a small minority of women, can be severe enough to require hospital admission.

In what instances would you refuse to freeze someone’s eggs, and why? Is there ever a time when it isn’t possible? 

Dr Chantal Simonis: If a woman was over the age of 35, I would discuss the reduced chances of the procedure being successful. But, depending on the circumstances, I would be willing to consider egg freezing, particularly if the woman was choosing egg freezing for medical reasons. Over the age of 40 years, it becomes very difficult to obtain eggs that will result in a successful pregnancy and we would not recommend egg freezing. It’s estimated that at the age of 43 years, 100 eggs need to be frozen to increase your chances of one live birth.

Is egg freezing something you can have done on the NHS or do you have to pay for it?

Dr Chantal Simonis: Egg freezing can only be done on the NHS if it is for medical reasons. These include reasons such as cancer treatment, which may cause later fertility problems. Egg freezing is expensive and can cost between £2500 and £4000. In addition, ICSI (where each egg is injected with a single sperm) is required for the fertilisation of frozen eggs. This is because the freezing process can cause cracks and hardening to appear in the shell of the eggs, and ICSI is needed to improve the chances of fertilisation. A full cycle of egg freezing, including egg harvesting, freezing, ICSI and replacement of the resulting embryo, can cost a total of between £6000 and £8000.

Can you describe some of your most memorable experiences/patients when freezing eggs? 

Dr Chantal Simonis: I have looked after several women who were freezing eggs, and sometimes embryos, following a cancer diagnosis. It was rewarding to know that during the turmoil of a cancer diagnosis and treatment, they were keeping open their options of having a family one day.

What are some of the most surprising things you’ve learnt from doing it? 

Dr Chantal Simonis: That, in general, there is a very low level of knowledge about egg freezing and the chance of success.

What are the biggest misconnections about egg freezing and how are you trying to dispel them? 

Dr Chantal Simonis: The biggest misconception is that egg freezing is the solution to everything! We must educate young women about the decline in fertility from their early thirties so that they can consider their options before it is too late. It’s heart-breaking to meet a woman in her late thirties or early forties who has her mindset on egg freezing. So many of them have no idea that it may already be too late to freeze eggs successfully. As a profession, we need to address this education gap and try to encourage more dialogue about egg freezing. The Human Fertilisation and Embryology Authority (HFEA) has provided excellent information on egg freezing, but it may be that women who are considering freezing their eggs are not aware of the wealth of information that is available on such sites.

What are the most challenging parts of your profession? 

Dr Chantal Simonis: Not everyone is successful after IVF treatment, and one of the challenges is to guide people through the IVF process with empathy and honesty, providing support in particular when treatment is unsuccessful. Some of my most humbling moments have been to receive letters of thanks from people who have not had a child but have felt that my team and I made their journey a little bit easier.

What are the most rewarding parts of your job? 

Dr Chantal Simonis: I still feel delighted every time I hear a woman has had a positive pregnancy test.

Where do you see egg freezing going in the future?

Dr Chantal Simonis: I’m sure egg freezing will continue to gain popularity. As we develop more techniques to improve not only the freezing of eggs but also the live birth rates after egg freezing, this treatment option will appeal to more people.

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