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Does Health Insurance Cover Egg Freezing?

Image:  David W / Flickr

Everything you need to know about egg freezing: what is it, what does the process look like, is it safe, will your health insurance cover it, and how much should you expect to spend?

It’s a common dilemma for women: have children and put your career on hold, or focus on your career and risk not being able to conceive later in life? It makes sense, then, that egg freezing, also known as oocyte cryopreservation, is increasing in popularity each year. But while more women seek it as an option, there are many financial questions around the procedure. For many, it comes down to: will insurance cover egg freezing?

“For decades, there has been a rise in the number of women having children in their 30s and 40s,” says Dr. Jane Frederick, a reproductive endocrinologist and the medical director at HRC Fertility in Orange County, CA. “Whatever the life circumstance might be for conceiving late in life, now more than ever, the advances in egg freezing can offer women all over the world a chance to slow their reproductive time clock, and take control of their reproductive choices.”

Though the procedure has been around since the 1980s, it was only recently, in 2012, that the American Society for Reproductive Medicine declared that egg freezing is no longer considered an experimental procedure. As the average child-bearing age continues to go up, it’s important for women to consider fertility treatments such as egg freezing that can increase the chance of a successful pregnancy later in life.

Egg Freezing: Health Insurance Coverage, Costs

In most cases, egg freezing is not medically necessary, and thus is not covered by most insurance plans. And, unfortunately, fertility treatments tend to be expensive.

Egg freezing typically costs between $8,000 and $15,000 (although such prices tags are decreasing as the procedure grows in popularity). In most cases, you’ll also be required to pay an annual fee of a few hundred dollars for storing your eggs in a fertility center.

Exceptions

  1. If you have a diagnosed fertility problem or if you’re about to undergo treatments such as radiation or chemotherapy (thereby effectively limiting your fertility in the future), there’s a chance you’ll be able to get some of the egg freezing costs covered.
  2. If you work in tech, you’re also more likely to get egg freezing coverage from your employer-provided health insurance. 27 percent of tech companies cover advanced reproductive procedures (such as egg freezing), compared to 14 percent of companies not in the technology sector.

Additional Costs 

In addition to the cost of egg freezing itself, it’s important to keep total pregnancy costs in mind. These can vary based on the complexity of your pregnancy and delivery, your health insurance plan, and the specific hospital and doctor you choose. You should also take into account monthly checkups, ultrasounds, regular lab work and additional tests. Though insurance may help cover some of these costs, expect and prepare to pay out-of-pocket for the rest.

Why Women Choose to Go Through with Egg Freezing

Despite the high cost, egg freezing is still the right choice for many women. By 2018, it’s estimated that 76,000 women will freeze their eggs.

“The decision to freeze eggs is a highly personal one that allows a woman to have reproductive autonomy,” says Dr. Kara Nguyen, an obstetrician, gynecologist, and reproductive endocrinologist at Shady Grove Fertility.

According to Dr. Nguyen, the two most common reasons women decide to freeze their eggs are for:

  1. Fertility preservation in the face of a medical condition (as in the case where cancer treatments may affect ovarian reserves and reproductive potential) and
  2. Elective fertility preservation (they may be focusing on their careers, going through grad school, traveling, waiting for the right partner, waiting to be in the right financial situation, etc.).

There are also cases where women are undergoing fertility treatment through in vitro fertilization (IVF) and sperm becomes suddenly unavailable. In such cases, a woman’s eggs must be frozen and wait until sperm is made available. Dr. Nguyen also mentions that some women may opt to go through the egg freezing purely for religious reasons:

“Women with religious concerns may choose to fertilize a select number of eggs and freeze the remaining eggs for future use.”

When Should Women Freeze Their Eggs?

No matter the reason, it’s becoming increasingly appealing to have a backup option if you don’t conceive in your early 20s or 30s. While there’s no set age limit on freezing your eggs, it’s important to note that the rate of female fertility begins to rapidly decline throughout a woman’s mid-30s.

“There’s not one right time for every woman,” says to Dr. Jennifer Eaton, a reproductive endocrinology and infertility specialist at Duke Fertility Center. “Women are born with all the eggs they’ll ever have, and that supply diminishes over time. To really take advantage of premium egg quality and quantity, women should ideally pursue cryopreservation in their prime reproductive years, meaning their 20s and early 30s.”

While there is no cut-off age for when women should go through the egg freezing process, the earlier that one has the procedure, the higher the chance of success. According to Dr. Eaton, potential patients undergo testing to help women gain deeper insight on their egg quantities and ovarian health, and thereby support them in making better-informed decisions about whether to proceed.

What Does the Egg Freezing Procedure Look Like?

The initial stages of the egg freezing process is similar to traditional IVF. The first step any woman must take is to consult with a doctor to discuss the process, risks, and costs. It’s also important to confirm that you are a good candidate for successful egg freezing and have a high potential for success.

Testing

According to Dr. Nguyen:

“We first test the patient’s fertility to evaluate her current status and if egg freezing is a good choice for her right now. Following testing, there is an extensive discussion with a reproductive endocrinologist to determine if egg freezing is the right choice with clear expectations of possible benefits, limitations, and alternatives to family building.”

Hormonal Injections and Egg Development

After deciding to undergo fertility treatment, you will be injected with fertility medications that contain hormones that will induce the maturation of multiple eggs at once (in a natural menstruation cycle, one egg is released at a time). “These injections are like the insulin shots that diabetics give themselves [and are] done usually once a day,” says Dr. Nguyen. “Blood work and ultrasounds are used to monitor the progress of the egg development. A final injection is then used to encourage the eggs to release into a small pocket of fluid called a ‘follicle’.”

Egg Retrieval

The eggs are then retrieved from these follicles under the guidance of ultrasound and the help of anesthesia. The greater the number of eggs that can be retrieved, the greater the chance for fertilization and pregnancy in the future (the goal is to collect between 15 and 25 eggs per cycle). According to Dr. Nguyen, this final procedure takes approximately 15 minutes – with most patients back to their normal schedules the following day. Following the procedure, eggs are frozen using cryopreservation technology for storage until the patient is ready to use them. The entire process can be done over a period of two menstrual cycles.

Are There Risks Associated with Egg Freezing?

“As with any medical procedure, there are certain risks associated with cryopreservation,” says Dr. Eaton. “It is rare, but using injectable hormones to stimulate ovarian function can lead to ovarian hyperstimulation syndrome in some cases. There can also be complications during the retrieval process.”

Physical Risks

While most women don’t experience major side effects, as with any medical procedure, there are certain risks. Ovarian hyperstimulation is rare, but the hormone injections used can lead to several hormonal changes, resulting in side effects similar to those you typically experience during a normal hormone fluctuation (or PMS). This can include:

  • bloating,
  • fluid retention,
  • insomnia, and
  • mood swings.

Because the medications are administered via injection, there’s also a chance of soreness or redness around the injection site. All of the side effects go away once you stop taking the medication, and only 1-in-4 women experience these side effects.

Following the procedure, you may feel groggy from the mild propofol-based anesthesia, and experience some soreness or cramping. Again, it’s rare for the side effects to last longer than a few days.

Emotional Risks

One risk that some women forget to take into consideration: the emotional risks.

“Freezing eggs can give couples false hope,” says Dr. Eaton. “Choosing to preserve your eggs can feel empowering and hopeful, but there is no guarantee of success.”

Egg Freezing Is Ultimately Your Choice

Egg freezing is certainly the right choice for many women and their partners, but at the end of the day the choice comes down to you. Before you do, make sure you look into the risks and financial costs associated with it. And if you do decide on it, check to see if your health insurance policy will cover your egg freezing procedure.  As with any potential pregnancy, a solid cushion will ease the stress so you can focus on the (many) positive aspects of the experience.

Ronald Barba contributed to the reporting of this piece. 

Rachel Lustbader: Rachel Lustbader is a graduate of the Sargent College of Health and Rehabilitation Sciences at Boston University, where she studied health science and public health. She has worked in multiple areas within the healthcare field, including biotechnology, pathology, and research project management. Rachel is a regular contributor to HealthCare.com.

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