Using your eggs


Ready To Use Your Frozen Eggs?

Are you ready for Part 2 of your egg freezing journey?  Mazel tov!  Most women who bank their eggs are laser focused on Part 1, retrieval and freezing. The mechanics of Part 2, actually using your frozen eggs to conceive, can be overwhelming to contemplate — and may not happen when and how you envisioned. 
Whether you have decided to become a  single mother, found the partner of your dreams or are finally prepared to expand your family, fasten your seat belts!  You are now entering the wild world of IVF – and putting your frozen eggs to the ultimate test.
Using Frozen Eggs to get pregnant

Getting Pregnant With Frozen Eggs

Step 1: Clinic Consultation

Schedule an appointment with your clinic mid-cycle (day 5-13).  Make sure you have your medical records ready including recent pap smear and mammogram results. 
  • Baseline ultrasound
    • To check your antral, or resting, follicle count
  • Blood work
    • TSH/FT4, CBC, Vitamin D, CMV, Communicable testing (HIV, HepB, HepC, RPR)
  • Psychologist appointment
    • There is no mandatory rule, but many clinics require that you see a psychologist prior to starting IVF. If you already see one, save some money and get your current Doctor to write and evaluation based on the clinic’s criteria.  
You’ll have to do a battery of tests so get a head start and ask your clinic for a pre-work up checklist (and price list) so you know what to expect.  Most clinics will require:
  • Hysteroscopy
    • Your doctor may perform a hysteroscopy (HSC) and/or hysterosalpingogram (HSG)
  • What’s the difference between and HSC & HSG:
  • HSC assesses the health your womb. While under mild sedation, your Doctor will use a fiber-optic telescope to examine your uterus and remove, if necessary, any irregularities such as fibroids, polyps or scar tissues.
  • HSG assesses the health of your fallopian tubes. First, a radiopaque dye is inserted into your uterine cavity followed by an x-ray to determine a) if your fallopian tubes are blocked and b) pinpoint the location of the blockage.

A Note on Sperm Source

If you have you have a partner or recruited a sperm donor, then you are good to go. Otherwise, its time to start sperm shopping. There are many factors to consider — everything from race and genetics to height and eye color — so do not rush this decision.
First, you need to find a sperm bank that provides the level of service you need. Some women are comfortable choosing their sperm donors online (eerily similar to a search), while others will opt for a more hands-on personalized service. Once you have selected your donor, the sperm bank will ship the frozen sample directly to your clinic.

Step 2: Preparing Your Body

When your Doctor gives you the green light, its time to start preparing your body for your transfer.  The protocol for a fresh transfer (i.e., not refrozen while genetic testing is done) and FET (frozen embryo transfer) is typically 6 weeks (almost 3x egg freezing sim cycle)! 
You’ll start by taking estrogen (orally) and progesterone (vaginally or via injections) to prepare your uterine lining (endometrium) for the embryo transfer.  During this period, you will be monitored via blood draws to assess the development of your endometrium. Based on your blood work, your doctor will perform a final ultrasound to ensure your lining is 8 mm or above and ready for the embryo transfer. If your body did not responded well to the medication and you’re lining is not at minimum thickness, the cycle will be cancel.
It’s critical that your body and mind are as healthy as possible! 
  • Acupuncture has been proven to help increase blood flow and reduce stress. 
  • Yoga is also another great tool to prepare for your transfer  
  • Eat well (dark leafy vegetables and lean protein)
  • Take your prenatal vitamins (including Folic Acid and DHA) and low dose aspirin (80 mg)

Step 3: Thawing & Fertilizing

Your frozen eggs will be removed from the storage vat and quickly rehydrated or warmed. Typically, most clinics state that 90% of frozen eggs survive thaw.  If you are using fresh sperm, your partner or donor, will provide their “sample” on the day of the thaw. Otherwise, frozen sperm will be thawed or brought to room temperature in about 30 minutes.
Time to fertilize. Because the outer wall (or zona pellucida) hardens when eggs are frozen, ICSI (intracytoplasmic sperm injection) is used to fertilize frozen eggs. This technique involves directly injecting a single sperm into a single egg with a needle instead of allowing sperm to penetrate the egg naturally in a Petri dish.
Within 24 hours: your clinic will let you know your embryo (fertilized egg) count 
How many eggs should I fertilize? Do you want to fertilize all or just a portion of your frozen eggs? If you have not already made this decision, now is the time to finalize your plan of attack. Reserving some of your frozen eggs will give you the option to change your sperm source later, while fertilizing all of your eggs will enable you to genetically test the embryos and have a clear indication of embryo quality.

Step 4: Embryo Culture & Genetic Testing

Once eggs are fertilized, they start to start to grow and divide to become embryos.  Some will stop growing, others will grow to Day 5 or Day 6 blastocysts — eligible for genetic testing.  Your clinic or lab will check in every few days to keep you updated. 
The more you know about the health of an embryo prior to implantation, the better the odds of a successful pregnancy. Advances and innovations in the preimplantation genetic testing field have significantly impacted transfer and subsequent live birth rates. The decision to use preimplantation genetic testing of any kind is up to you. The tests are not cheap, however the information they provide can have a significant impact on the success of your transfer.

Step 5: Embryo Transfer

FET is a fast (about 15 minute), fresh or frozen transfers are a fast (15 minutes), non-surgical procedure whereby your Doctor will uses a catheter and abdominal ultrasound to implant embryo(s) directly into your uterus.
Post procedure, you will stay flat for about 30 minutes (thinking good implantation thoughts or having acupuncture) and then lay low for a couple days.
How many embryos should you transfer? You will need to make this call with your Doctor taking into account several factors, most importantly your embryo quality and age. Although the ASRM has published guidelines, the decision is ultimately based on your specific situation.

Step 6: Pregnancy Test 'Beta'

Post transfer, you will continue to take the hormone medication (progesterone and estradiol) to boost implantation success. So, when will you know if you are pregnant? Ahh… the dreaded 10 day wait or maybe the longest few days of your life has begun. 
You will take two to three pregnancy tests or “betas” and have your answer!  Your hCG levels should double between beta 1 & 2.  So please take the first test with a grain of salt as many embryos implant and then stop growing.
If you are pregnant, you will continue hormone medication (yes, more shots) until the placenta is viable (about week 10-12).  You will “graduate” from your fertility clinic and start to see your OB/GYN at this point.
If you are not pregnant, hang in there!  Be kind to yourself and give yourself enough time to grieve.  You will have the child you are meant to have.