Egg Freezing Before Chemotherapy: What You Need to Know

A cancer diagnosis comes with appointments, scans, test results, and treatment plans that often come rushing in at once, leaving little room to breathe, let alone think about the future, including having children. 

Chemotherapy is a powerful, life-saving tool. Unfortunately, it can also take a heavy toll on reproductive health. That is why discussions around fertility preservation, and particularly egg freezing, have become an essential part of cancer care.

How Chemotherapy Affects Egg Quality

To understand why egg freezing before chemo matters, it helps to look at how chemotherapy works. Chemotherapy drugs are designed to attack rapidly dividing cells. This is crucial because cancer cells divide quickly, often uncontrollably. The issue is that chemo cannot distinguish between the “bad” cancer cells and other healthy cells in the body that also divide rapidly.

Among the healthy cells caught in the crossfire are those in the ovaries. The ovaries house developing eggs, or oocytes, which are especially vulnerable to chemotherapy. Over time, this damage can significantly reduce both the quantity and the quality of eggs. For some patients, it can even trigger premature ovarian insufficiency (when the ovaries stop functioning before age 40) or lead to an earlier-than-expected menopause.

The extent of the damage depends on several factors:

• Type and dosage of chemotherapy drugs: Some drugs, particularly alkylating agents, are harsher on fertility than others. These medications damage DNA and prevent cells from dividing, which is effective against cancer but devastating for eggs.
• Age at the time of treatment: Younger women generally have a higher ovarian reserve (more eggs) to begin with, and their bodies may recover more easily after treatment.
• Pre-treatment fertility health: Women who already have low ovarian reserve or fertility challenges may face a greater risk of permanent damage.

Because it is difficult to predict who will be affected and to what extent, many oncologists recommend exploring fertility preservation options like egg freezing before treatment begins.

Egg Freezing: How the Process Works

Egg freezing, or oocyte cryopreservation, before chemotherapy, safeguards your ability to use them later when you are ready.

Here is how the process usually unfolds:

• Hormonal stimulation: For about 10 to 14 days, you take daily hormone injections that encourage your ovaries to produce multiple eggs instead of the usual single egg per cycle.
• Monitoring: During this period, your doctor monitors your progress with blood tests and ultrasounds to see how the follicles (the sacs that contain eggs) are developing.
• Trigger shot: Once the follicles reach the right size, you receive a final injection known as the “trigger shot,” which helps the eggs mature in preparation for retrieval.
• Egg retrieval: About 36 hours later, a doctor retrieves the eggs using a thin needle guided by ultrasound. This is done under light sedation or anesthesia, so you are comfortable and pain-free. Most people go home the same day.
• Vitrification: The retrieved eggs are frozen almost instantly using a rapid-cooling technique that prevents ice crystals from forming. They are then stored in liquid nitrogen at extremely low temperatures until you are ready to use them.

When the time comes to try for a pregnancy, the eggs can be thawed, fertilized with sperm in the lab, and implanted through in vitro fertilization (IVF).

Success Rates of Pregnancy After Egg Freezing

The decision to freeze eggs before chemotherapy often comes down to one big question: Will it actually work? While no method can guarantee pregnancy, research shows encouraging results.

Several factors influence success:

• Age at freezing: Younger eggs are healthier and more likely to result in a successful pregnancy. Women under 35 tend to have the best outcomes.
• Number of eggs frozen: The more eggs you freeze, the greater your chances of eventually having a child. Freezing 10 to 15 eggs before age 35 typically provides a 70 to 80% chance of a future pregnancy.
• Overall fertility health: Pre-existing conditions can affect results.
• Egg survival after thawing: Around 90% of frozen eggs survive the thawing process, and about 75% to 80% of those can be successfully fertilized.

Ultimately, while the odds vary, egg freezing significantly improves the possibility of having a biological child after cancer treatment compared to not preserving fertility at all.

How Long Can Eggs Be Frozen?

One of the reassuring aspects of egg freezing is its flexibility. Thanks to modern vitrification techniques, eggs can remain viable for many years without a drop in quality. Studies have shown successful pregnancies using eggs that had been frozen for over a decade.

The important thing to note is that the age at freezing matters far more than the length of time eggs are in storage. Eggs frozen at 28 will always be 28-year-old eggs, even if they are used when you are 38 or 40. That is why acting before chemotherapy, especially at a younger age, can make such a difference.

That said, each clinic may have its own policies around storage limits, fees, and renewal requirements. Local laws can also influence how long eggs may be stored, so it is always best to confirm with your fertility clinic.

Cost and Insurance Coverage

Egg freezing is an investment, and the cost can feel overwhelming, especially when combined with the financial strain of cancer treatment. On average, here is what you can expect:

• Ovarian stimulation and medications: $3,000-$5,000
• Egg retrieval and freezing: $5,000-$7,000
• Annual storage fees: $300-$600 per year

The good news is that insurance coverage for fertility preservation is improving. Some policies cover egg freezing if it is deemed medically necessary, such as prior to chemotherapy. A few states even have laws requiring insurers to provide coverage for cancer patients facing fertility loss.

Additionally, non-profit organizations like Livestrong Fertility and Fertility Within Reach partner with clinics and pharmaceutical companies to provide discounts and financial aid to patients.

If cost is a barrier, ask your oncologist or fertility specialist about grants, payment plans, or charitable programs designed specifically for cancer patients.

Final Thoughts

Choosing to freeze eggs before chemotherapy is a deeply personal decision. It may feel like one more thing on an already overwhelming list, yet for many, it provides peace of mind and a sense of control at a time when life feels uncertain. The ability to preserve fertility is not just about biology; it is about preserving choice, hope, and the possibility of parenthood in the future.

If you are facing chemotherapy, talk to your oncologist or ask for a referral to a fertility specialist as soon as possible. Even if you are not sure about having children, knowing you have options can be empowering. Science has given us the incredible gift of fertility preservation, and for many cancer patients, it is a light in an otherwise difficult journey.

FAQs

How does chemotherapy affect fertility?

Chemotherapy can damage eggs and reduce ovarian function. The extent depends on the type of drugs, dosage, age, and pre-treatment fertility health. For some, it leads to temporary changes; for others, it can cause permanent infertility or early menopause.

Is egg freezing painful?

Most people describe the process as uncomfortable rather than painful. Hormonal injections can cause bloating or mood swings, while retrieval is done under sedation, so you will not feel pain during the procedure. Mild cramping afterward is normal and usually fades within a few days.

How much does egg freezing cost for cancer patients?

Costs vary but typically range from $8,000 to $12,000 for the full process, plus $300 to $600 annually for storage. However, discounted programs and insurance coverage may lower the expense significantly.

What is the success rate of IVF with frozen eggs?

Success depends on age at freezing and the number of eggs stored. On average, about 90% of eggs survive thawing, 75%-80% fertilize successfully, and 5%-12% result in live birth. Freezing 10-15 eggs before age 35 offers roughly a 70%-80% chance of future pregnancy.

How soon should I freeze my eggs before chemo?

Ideally, the process should begin 2 to 4 weeks before starting chemotherapy. A single cycle usually takes 10 to 14 days, though some patients may choose multiple cycles to bank more eggs. Timing is key, so speak with your oncologist as soon as possible after diagnosis.

Can I start chemotherapy right after egg retrieval?

Yes. Once the eggs are retrieved and frozen, you can begin chemotherapy without delay. Fertility clinics and oncology teams often work together to ensure the timing is safe and efficient.

Are there risks to egg freezing?

Egg freezing is generally safe, but as with any medical procedure, there are risks. Ovarian stimulation can sometimes cause ovarian hyperstimulation syndrome (OHSS), which leads to swelling and discomfort, though this is rare. Egg retrieval is minimally invasive and carries small risks of bleeding or infection.