Thinking of freezing your eggs? If you’re female, under 40 and child-free, it’s hard to avoid the ads. Fertility clinics are partnering with influencers and womens’ magazines, and young women’s TikTok and Instagram feeds are clogged with personalities sharing their egg-freezing journeys.
Freezing your eggs is a way to try to preserve fertility so that you can try to have a child in the future using fertility treatment. Freezing them when you’re younger can mean having eggs of better quality to use when you are older.
Once a course of action for women with serious medical diagnoses, private clinics now offer egg-freezing as an elective procedure.
Messaging around “self-care”, “taking control of your future” and “giving your future family the best possible chance” is aimed at those who may be undecided if they want children, or those who may want them but don’t want to have them yet, or are not in a position tobecause financial, career or relationship factors.
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Raising awareness of fertility is a good thing, but egg freezing is expensive, not without risk and it comes with no guarantees. Here’s how to navigate the market.
The cost
Fertility clinics, like any private healthcare provider, are free to set their own prices. The costs quoted tend to be for one cycle of egg-freezing with a separate cost for the ongoing storage of eggs charged by monthly direct debit.
A trawl of some of the players in the Irish market shows the costs of one egg-freezing cycle range differ by almost €1,400, though it can be hard to compare providers. For example, the cost of one egg-freezing cycle at Therapie Fertility is €2,295. At the Waterstone Clinic‚ the cost is €2,950 per cycle, with a €25 monthly cost for freezing.
Being able to spread the cost over time means a lower upfront cost, but like all loans, it will cost you more in the long run
At Sims IVF, the cost is €3,100 and this includes the cost of storage for one year. At the Merrion Fertility Centre, the cost is €3,690 for egg-freezing and €300 a year for storage.
If you are choosing a provider, it’s important to interrogate the ongoing cost of keeping your eggs on ice. If you freeze your eggs at age 30, but don’t try to have a baby using them until you are 40, the cost can rack up. Paying €30 a month for storage for 10 years is €3,600.
Find out, too, if the monthly storage cost will remain fixed throughout the period of storage, or if this can be increased over time.
Tests
When researching clinics, be sure to ask what tests will be recommended by the clinic, or are required before you can commence. These are likely to be charged separately and you will need to budget for this.
For example, at the Waterstone Clinic, an AMH (Anti-Müllerian Hormone) test, which is an indicator of the number of eggs remaining in your ovaries, costs €125, an ultrasound scan is €120 and a consultation with a specialist to discuss your options is €175. For comparison, the not-for-profit Well Woman Centre advertises an AMH test for €95.
A second cycle?
Egg freezing can be a numbers game. It’s important to know that one cycle may not produce enough eggs to give you the best odds of one of them resulting in a baby in future.
Most patients under 38 years of age will have around seven to 14 eggs collected, according to the UK regulator, the Human Fertilisation and Embryology Authority. There has been no equivalent authority in Ireland.
The Health (Assisted Human Reproduction) Bill, planned for more than 20 years, only passed on June 26th this year. A key element is an authority to regulate fertility and license fertility clinics.
“A treatment would aim for somewhere between 10 and 15 eggs in one cycle. It is true that if you want to receive a 90 per cent likelihood of a pregnancy, you will probably need to have two cycles of treatment,” says Dr Edgar Mocanu, a fertility consultant at the Rotunda Hospital.
“The earlier you freeze your eggs, the fewer you need to have a reasonable chance of success,” says Ria O’Sullivan, communications manager at the Waterstone Clinic.
“As you get later into your 30s, the number of eggs you need becomes larger. Generally, the aim is to bank around 20 eggs, and you may need to have more than one round of treatment to freeze that number,” says O’Sullivan.
One cycle may not produce enough eggs to give you the best odds of one of them resulting in a baby in future
Doing two cycles, excluding freezing costs could bring the cost to about €6,000 if a second cycle isn’t discounted. Ask the clinic if it anticipates that a second cycle will be required, and if it is discounted.
Success rates
Egg-freezing is sometimes viewed as an insurance policy, but there’s no guarantee it will pay out. When paying several thousand euro for the procedure, customers should be aware of the odds of success.
How old you are when you freeze your eggs, and how many eggs you freeze, make a significant difference to whether you will have a baby, according to a paper published in 2022 in the journal, Fertility and Sterility.
Most women who tried to become pregnant using eggs they had frozen, the study found, did not succeed, often because they had waited until they were too old to freeze eggs and had not frozen enough of them. The data came from the New York University Langone Fertility Center.
The data was “sobering” and “should give women pause”, according to Dr Marcelle Cedars, president of the American Society for Reproductive Medicine. Many women “are overly optimistic” about their chances of having a baby when they freeze their eggs, she said.
“The pregnancy rate is not as good as I think a lot of women think it will be,” Cedars said. “I always tell patients, ‘There’s not a baby in the freezer. There’s a chance to get pregnant’.”
If you want to receive a 90 per cent likelihood of a pregnancy, you will probably need to have two cycles of treatment
The overall chance of a live birth from frozen eggs in that study was 39 per cent. But among women who were younger than 38 when they froze their eggs, the live birth rate was 51 per cent. It rises to 70 per cent if women younger than 38 also thawed 20 or more eggs.
“The success rates of egg-freezing will be far higher in women in their late 20s or early 30s,” says Dr Edgar Mocanu.
Egg quality declines with age. “The survival rate of frozen eggs is very good, but fertilisation rates of those eggs are only 60-75 per cent, so not all eggs injected [with sperm] will fertilise, and not all the fertilised eggs will become a competent embryo that will result in a baby,” says Dr Mocanu.
He advises gathering information before choosing a clinic.
“The first question would be, what is the average number of eggs you would obtain for a person of my age,” he says. “Then, what is the success rate of your thawing programme – how many eggs of, say, 10 will survive.”
“Ask, what experience do you have with women using their eggs [to become pregnant and have a baby], because this is the biggest question. If only two women have used their eggs, the clinic’s experience is limited. Ask how many they have treated and how many got pregnant. That’s the most important question.”
Ask a clinic if it publishes its results.
How to pay?
Some fertility clinics partner with lenders to offer payment plans. Being able to spread the cost over time means a lower upfront cost but, like all loans, it will cost you more in the long run.
Therapie, the Waterstone Clinic and the Merrion Fertility Clinic partner with finance provider Humm. Borrowing €2,295 through Humm, spread over 36 months at an APR of 15.93 per cent, will mean a total repayment of €2,849.39.
That comprises a €40 application fee, a monthly accounting fee of €4 paid for 36 months, and 36 installments of €74.04. The interest amounts to €370.39 and fees come to €184. A fee of €9 is applied to payments more than 24 hours late.
Using a personal loan may be cheaper. Borrowing the same amount from Bank of Ireland, for example, will cost you €72.18 a month at 8.5 per cent APR. The total repayment amount is €2,598.55. That’s €251 less than the online quote from Humm.
Like IVF, the egg-freezing entails injecting hormones over several days. Clinics provide a prescription for the medication, but you must buy them yourself from a pharmacy.
Those with a Drugs Payment Scheme (DPS) card will pay no more than €80 a calendar month for prescription medicines. A fertility clinic may recommend a pharmacy, but you could shop around.
Tax back?
Many fertility clinics advertise that you can claim 20 per cent tax back on egg-freezing expenses using the Med1 form.
Healthcare for tax relief purposes is defined as the prevention, diagnosis, alleviation or treatment of an ailment, injury, infirmity, defect or disability, and care in respect of a pregnancy, according to Revenue. In response to a query, Revenue says where egg-freezing is elective, it is not clear if the conditions for tax relief are met.
“The eligibility for the relief can only be determined by the facts and circumstances of each case,” Revenue says.
If you have health insurance, check if it covers fertility treatment. Some Irish Life plans cover 50 per cent of the cost of egg-freezing up to a maximum of €1,000 once in your life. Some Laya plans will cover €1,500 per lifetime. You can’t claim both the tax relief and a refund through your health insurance.
Economics
Having children or not is increasingly an economic issue. Fertility rates in Ireland have declined from 2.0 in 2013 to 1.5 in 2023, according to CSO figures. A value of 2.1 is usually considered to be the level that the population would replace itself in the long run, ignoring migration. Paid extended pregnancy leave and childcare, parental leave, and increased access to fertility treatment is needed to reverse this global trend, according to the International Federation of Fertility Societies.
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