Social freezing is often described as a way to make family planning more flexible. Freezing eggs can give women additional options for the future and reduce the pressure to decide on pregnancy early on. At the same time, the decision is more complex than it seems at first glance. Social freezing as early as possible isn't the right choice for every woman, but waiting too long can also reduce the chances of success.
“The decision for or against social freezing should always be made on an individual basis,” says Dr. Samia El-Hadad of the Department of Reproductive Medicine and Endocrinology at the University Hospital of Zurich. “It’s not just age that matters, but also ovarian reserve and one’s personal circumstances.”
Not every woman benefits from immediate surgery
Before making a decision, it is advisable to undergo a comprehensive fertility evaluation. The AMH (anti-Müllerian hormone) level and the antral follicle count (AFC) determined by ultrasound provide important indicators of ovarian reserve. However, individual values must always be evaluated within the overall context and with due consideration of the woman’s age.
High AMH and AFC levels may indicate a good egg reserve. In such cases, there is not necessarily an immediate need for action. Instead of immediately proceeding with social freezing for a young woman (e.g., under 30 years of age), it may make sense to first monitor the progression of her fertility over time and conduct regular checkups.
At the University Center for Reproductive Medicine and Endocrinology at the USZ, both hormonal parameters and individual life plans are therefore taken into account during counseling. The goal is to work together to establish a sound basis for decision-making and to avoid unnecessary treatments.
Between Too Early and Too Late
When it comes to social freezing, there is often a perception that eggs should be frozen as early as possible. However, it’s not possible to make such a blanket statement. For young women with a good egg reserve, immediate treatment may not be necessary. In addition, Swiss law limits the storage of frozen eggs to a maximum of ten years. This could mean that freezing the eggs too early results in them becoming unusable, leaving women with none available precisely when they would need them and when their natural chances of pregnancy are lower.
At the same time, the decision should not be postponed indefinitely. Many women do not seek counseling until the end of their third or the beginning of their fourth decade of life. At this stage, it is often the case that the number and quality of eggs are no longer optimal, as they steadily decline with age. In this case, the chances of becoming pregnant are significantly reduced, even with social freezing.
“The challenge is finding the right moment. “Neither freezing up instinctively at a young age nor waiting too long is advisable in any case,” said Samia El-Hadad.
Age affects the effort required and the chances of success
A key factor is the number of frozen eggs. The number of eggs required for a future pregnancy depends on various factors, particularly the age at the time the eggs are retrieved.
Since the number of retrieved eggs decreases with age, but a higher number of eggs is desired as women get older—because a significant proportion are no longer genetically healthy—women of advancing age often require multiple stimulation and retrieval cycles. This not only affects the chances of success but also increases the treatment burden. Since social freezing is generally not a benefit covered by health insurance, the cost factor also plays an important role in the decision-making process.
Social freezing and medical freezing are not the same thing
It is also important to distinguish between social and medical freezing. While egg freezing for social reasons must generally be self-funded, the costs may be covered in certain medical cases. These include, for example, cancer diagnosed prior to fertility-damaging treatment or other conditions that may affect fertility.
Realistic Expectations Through Personalized Counseling
Social freezing can provide women with additional options for family planning. However, this does not guarantee a future pregnancy. This makes personalized counseling—which takes into account age, fertility parameters, and personal life plans—all the more important.
“Our goal is to provide women with a solid basis for decision-making and to help them realistically assess both opportunities and limitations,” says Samia El-Hadad. “It is not the earliest possible treatment that matters, but rather treatment at the right time.”
This makes it clear that the success of social freezing does not depend solely on age or individual lab results. The key lies in the interplay of various factors. A thorough evaluation helps to realistically assess the opportunities and limitations and to determine the right time for each individual to decide for or against treatment.
