Egg Freezing Before Chemotherapy: What You Need to Know

Fertility is rarely the first thing addressed in cancer care, but for many, it should be. You’re not just fighting to live; you’re fighting for how you want to live afterward. And for people who’ve dreamed of becoming parents someday, the ability to have biological children isn’t just a medical detail. It’s a lifeline to a future they thought they still had time to plan.

Enter egg freezing. Not as a desperate act of hope, but as a powerful, science-backed move of preparation.

How Chemotherapy Affects Egg Quality

Chemotherapy is designed to be ruthless. It tears through the body seeking rapidly dividing cells to destroy. Tumors fall in that category, but so do your eggs, specifically the oocytes quietly maturing inside your ovaries.

The ovaries aren’t collateral damage. They’re direct targets of many chemo drugs. Among the most brutal offenders are alkylating agents, which don't just damage DNA; they annihilate a cell’s ability to recover or reproduce. Eggs exposed to these medications often won’t survive, and the ovarian reserve (the total number of viable eggs) can plummet fast.

Some women bounce back. Others don’t. For some, fertility rebounds months or years after treatment. 

Here’s what influences how hard chemo hits your fertility:

• The specific drugs and their dosage. Not all chemo is equally toxic to reproductive organs. But if alkylating agents are in the mix, the risk is high.
• Your age. Younger women generally have more eggs, so their reserves can absorb more damage before being depleted.
• Your pre-treatment fertility baseline. If your ovarian reserve was already low, chemo can fast-track menopause or cause permanent reproductive shutdown.

In many cases, this leads to premature ovarian insufficiency (POI), where the ovaries stop functioning before age 40. Menopause can arrive suddenly, years ahead of schedule. The damage can be permanent, but the exact outcome is almost impossible to predict.

This uncertainty is why freezing eggs before treatment is often the best way to preserve your biological future.

Egg Freezing: How the Process Works

The science behind egg freezing is complex, but the process is surprisingly straightforward and faster than most people think.

It starts with hormones. You’ll inject yourself with fertility medications for around 10 to 14 days. These stimulate your ovaries to mature more eggs than usual (think 10 to 20 eggs in one cycle instead of just one).

During this stage, you’ll be monitored like a hawk. Ultrasounds will track follicle growth, while blood tests check how your body’s responding. The moment your eggs reach optimal size, you’ll get a final injection (called a trigger shot) that prepares them for retrieval.

Roughly 36 hours after the trigger, you’ll go in for egg retrieval. The procedure is minimally invasive and typically done under light sedation. A fertility specialist uses a thin needle, guided by ultrasound, to collect the eggs directly from the ovaries. The whole thing takes about 20 to 30 minutes, and you’ll go home the same day.

The retrieved eggs are immediately flash-frozen through a method called vitrification. It’s a game-changing technique that prevents the formation of damaging ice crystals. These frozen eggs are then stored in liquid nitrogen, waiting for whenever you’re ready to use them.

Later on, when the time is right, the eggs can be thawed, fertilized in a lab, and transferred via IVF.

Success Rates of Pregnancy After Egg Freezing

This is the million-dollar question: If I freeze my eggs now, will I actually be able to have a child later?

There are no guarantees, but the odds are far better than they used to be. Here's what influences the success rate:

• Age at the time of freezing. The younger you are, the higher the quality of your eggs. Freezing before age 35 tends to yield the best results.
• Number of eggs retrieved and frozen. Think of each egg as a ticket in a very high-stakes lottery. The more you have, the better your chances.
• Your overall reproductive health. Factors like hormone levels, uterine health, and genetic conditions can also play a role.
• Egg survival after thawing. Thanks to vitrification, over 90% of eggs survive the thaw. This used to be a major obstacle, but not anymore.

Around 75% to 80% of thawed eggs successfully fertilize. Additionally, the live birth rate per egg is typically 5% to 12%, depending on the patient’s age at freezing. Freezing 10 to 15 high-quality eggs before age 35 can give you a 70% to 80% chance of having at least one child in the future.

Again, nothing is guaranteed. But these numbers offer strong, realistic hope, not vague promises.

How Long Can Eggs Be Frozen?

Here’s a comforting thought: frozen eggs don’t expire. Once vitrified, they’re placed in a deep freeze that halts biological time. 

So, how long is too long? Technically, there’s no hard limit. There have been successful pregnancies from eggs stored for over a decade. Clinics routinely use eggs that have been frozen for 5, 10, or even 15 years.

What matters more than storage time is your age at the time of freezing. A 28-year-old’s eggs will almost always have higher potential than eggs frozen at 38, regardless of how long they’ve been stored.

That said, there are a few practicalities to sort out with your fertility clinic:

• Annual storage fees. These range from $300 to $600 per year, on average.
• Storage duration policies. Some clinics have time limits unless you renew your contract.
• Transferring eggs. If you move or switch clinics, ask about transport protocols.

Cost and Insurance Coverage

Egg freezing isn’t cheap, but for many cancer patients, it’s an investment in the possibility of parenthood down the line.

Here’s a typical cost breakdown:

• Ovarian stimulation medications can cost $3,000 to $5,000
• Egg retrieval and freezing procedure can cost $5,000 to $7,000
• Annual storage costs $300 to $600

All in, you’re looking at an initial cost between $8,000 and $12,000, plus storage each year.

When it comes to insurance, some plans consider fertility preservation medically necessary when linked to cancer treatment. Others don’t. But there’s good news:

• Several U.S. states now require coverage of fertility preservation for cancer patients.
• Nonprofits like Livestrong Fertility offer grants, discounts, and medication assistance.
• Fertility Within Reach and other patient advocacy groups can help you navigate appeals and secure funding.

Bottom Line

No one plans for cancer. But you can plan for what comes next. Egg freezing might seem like a technical, detached medical process, but it’s deeply human. It’s the decision to hold on to something precious when everything else feels like it’s being taken. It’s the seed of hope you plant now, so that someday, when the storm has passed, something beautiful can grow.

FAQs

How does chemotherapy affect fertility?

Chemotherapy can harm the reproductive system in men and women. In women, it may destroy eggs, disrupt hormone levels, and cause early menopause. In men, it can reduce sperm count or quality. The impact depends on drug type, dosage, age, and prior fertility status.

Is egg freezing painful?

Not exactly. Most people tolerate the process well. Hormonal injections can cause bloating, mood swings, or breast tenderness. The egg retrieval procedure is performed under sedation, so it’s not painful during the process. Afterward, you might experience mild cramping or spotting for a few days.

How much does egg freezing cost for cancer patients?

Expect to pay $8,000 to $12,000 upfront, which includes medications, monitoring, retrieval, and freezing. Storage fees are typically $300 to $600 per year. Some insurance policies and nonprofits help cover or reduce these costs for cancer patients.

What is the success rate of IVF with frozen eggs?

Roughly 90% of frozen eggs survive thawing. Of those, 75% to 80% can be successfully fertilized. The live birth rate per frozen egg ranges from 5% to 12%, with younger eggs yielding better odds. Freezing 10 to 15 eggs before age 35 gives you the best chance of future pregnancy.

How soon should I freeze my eggs before chemo?

Ideally, begin the process 2 to 4 weeks before starting chemotherapy. The full egg retrieval cycle takes about 10 to 14 days. If needed, protocols can sometimes be accelerated to accommodate urgent treatment timelines. The sooner you start, the better your odds of preserving healthy eggs.