Egg Freezing for Fertility Preservation for Women with Cancer

A cancer diagnosis can feel overwhelming, and decisions often need to be made quickly. In the midst of focusing on treatment, many women are also thinking about their future, notably, their ability to have children. This is because many of the treatments for cancer (e.g., chemotherapy, radiation, and surgery) can have long-lasting and irreversible implications on a patient’s reproductive potential. 

The good news: advancements in oncofertility have made it increasingly possible for patients with cancer to preserve their reproductive potential before starting treatment. 

Why should I consider egg freezing for fertility preservation?

Many cancer treatments, including chemotherapy, radiation, and certain surgeries, can negatively impact ovarian reserve and overall reproductive health. For women with diagnoses such as breast cancer or ovarian cancer, treatment may lead to temporary or permanent infertility. 

Fertility preservation allows you to preserve healthy eggs or embryos before treatment begins. These eggs and embryos can later be used with assisted reproductive technologies like in vitro fertilization (IVF), giving you the option to build a family when you are ready.

For many women, this provides:

• A sense of control during an uncertain time

• More flexibility in family planning

• A backup plan if fertility is compromised

How can I preserve fertility before cancer treatment?

There are several fertility preservation options, and the right one depends on your diagnosis, timeline, and personal preferences. Both egg freezing and embryo freezing require about two weeks of ovarian stimulation, but in most cases, they do not significantly delay cancer treatment when coordinated promptly with your oncology team. A consultation with a fertility clinic experienced in oncology-related fertility care is critical to determine the best approach.

1. Egg freezing 

The goal of egg freezing is to collect and freeze mature eggs before starting chemotherapy or radiation. The process begins with ovarian stimulation, where daily injectable medications are taken to encourage the ovaries to mature multiple eggs.

• Length of treatment: ~10–14 days

• Monitoring: You’ll have ultrasounds and bloodwork every few days to track follicle growth and hormone levels

• Trigger shot: Once the follicles reach the right size, a final injection (“trigger”) is given to mature the eggs

Egg retrieval is then performed about 35–37 hours later under light sedation. 

After retrieval, your embryologist will identify any mature eggs that will undergo a rapid-freezing technique called vitrification. Eggs can remain frozen for many years, if not indefinitely, without a significant decline in quality.

For patients with hormone-sensitive cancers like certain breast cancers, your physician may recommend modified stimulation protocols (such as adding letrozole) to keep estrogen levels lower during treatment.

2. Embryo freezing

Embryo freezing follows the same initial steps as egg freezing, but includes an additional fertilization stage with sperm. After the eggs are retrieved, they are fertilized with sperm from a partner or sperm donor in the lab. The resulting embryos are then cultured for several days (typically 5–7 days) and then frozen. 

Prior to freezing, optional genetic testing such as preimplantation genetic testing (PGT) may be performed. Similar to frozen eggs, frozen embryos can be used in the future without any known shelf life. 

Embryo freezing is often associated with slightly higher success rates per transfer than frozen eggs because we already know which eggs were successfully fertilized and developed, and embryo quality can be assessed before freezing. If a first IVF cycle is not successful, and if time allows, some patients will choose to proceed with another IVF cycle before starting cancer treatment so that they can feel optimistic about their future options. 

3. Ovarian tissue freezing

Ovarian tissue freezing is a newer fertility preservation method where ovarian tissue is surgically removed and frozen for future reimplantation. This can be especially helpful when there isn’t enough time for the standard egg freezing process or in children/adolescents who have not yet undergone puberty. Ovarian tissue freezing is not yet widely available. If this is the right treatment for you, you may need to travel in order to proceed. 

How soon should I undergo fertility preservation before cancer treatment?

Timing is crucial as fertility preservation should happen before chemotherapy or radiation begins. In most cases, the egg freezing process can be completed in about 10–14 days. Thanks to “random start” protocols, stimulation can begin at almost any point in the menstrual cycle, minimizing delays in cancer treatment. Most oncology teams have resources and pathways in place to help connect you expeditiously to a fertility specialist. 

How much does fertility preservation cost for cancer patients?

The cost of egg freezing and embryo freezing can vary widely but generally ranges from $12,000 to $22,000, depending on the medications required and whether additional add-on treatments are indicated (e.g., intracytoplasmic sperm injection for IVF or PGT). 

However, many programs exist specifically for cancer patients and may offer discounted medications and fertility preservation grants. Many fertility clinics partner with nonprofit organizations to reduce the financial burden, so it’s worth asking your teams about available resources.

What are the future success rates of IVF with previously frozen eggs?

The success of IVF with previously frozen eggs depends on several factors, including the patient's age at the time of egg freezing, the number of eggs frozen, and the overall egg quality. On average, each frozen egg has about a 5–12% chance of resulting in a live birth. For women under 35, freezing 15–20 eggs offers a strong chance of at least one future live birth.

What are the future success rates of IVF with previously frozen embryos?

The success of IVF with previously frozen embryos depends on several factors, including the age of the woman at the time the embryos were created, the quality of the embryos, and the overall health of the uterus. In general, frozen embryo transfer success rates are high, with live birth rates often around 50% per transfer for women under age 35. For embryos that have been genetically tested and are euploid, that number can be as high as 70%. 

Can cancer treatments affect the success of using frozen eggs or frozen embryos later?

In most cases, eggs or embryos frozen before treatment are not affected by future cancer therapies. Their quality is a reflection of your age and ovarian reserve at the time they were frozen.

Some factors that may influence future fertility are whether radiation to the pelvis was required, whether abdominal or pelvic surgery was performed, or whether you are on any long-term cancer medications. A fertility specialist can help guide you through these considerations after treatment is complete.

Can fertility preservation affect my future cancer treatment options?

For many cancers, especially hormone-sensitive conditions like some types of breast cancer, the use of fertility medications requires certain preparations. Specialized protocols using medications like letrozole help to keep estrogen levels lower. Reassuringly, studies show that egg freezing and embryo freezing do not significantly delay treatment or worsen outcomes when properly coordinated. Collaboration between your oncology and fertility teams will help ensure that your cancer care remains the top priority.

What are the risks of egg freezing and embryo freezing for cancer patients?

Egg and embryo freezing are generally safe, but there are some considerations.

Short-term risks

• Ovarian hyperstimulation syndrome (rare with modern protocols)

• Procedure-related risks (bleeding, infection)

• Temporary hormone-related side effects

Cancer-specific considerations

• Hormone-sensitive cancers may require modified stimulation protocols

• Timing must be carefully coordinated to avoid delaying cancer treatment

Emotional impact

• The process can feel overwhelming during an already stressful time

Despite these risks, for many patients with cancer, the potential benefits outweigh the downsides.

Knowing your options is the first step

Facing a cancer diagnosis is never easy, but understanding your fertility preservation options can help you make informed, empowered decisions about your future.

If you or someone you know is navigating cancer and is concerned about fertility, early referral to a fertility clinic specializing in oncofertility can make all the difference. Preserving your ability to have a family later is not just possible, it’s increasingly accessible with the right fertility care team.

FAQs: Fertility preservation and cancer treatment

Should I freeze my eggs if I have cancer?

For many women diagnosed with cancer, egg freezing is an option to help preserve future fertility before treatment begins. Chemotherapy, radiation, and some surgeries can affect ovarian function, so meeting with a fertility specialist as early as possible after your cancer diagnosis can help you understand your options and timeline.

Does insurance cover fertility preservation for cancer patients?

Insurance coverage for fertility preservation varies widely depending on your state and insurance plan. Many states now require some level of coverage for medically indicated fertility preservation, and financial assistance programs may also be available to help offset costs. Your oncology and fertility teams will have resources to help you navigate this process. 

How can I preserve fertility before cancer treatment?

The most common fertility preservation options include freezing eggs, freezing embryos, or ovarian tissue prior to treatment. The best approach depends on factors such as your age, relationship status, cancer type, and how quickly cancer treatment needs to begin.

How soon should I freeze my eggs or embryos before chemotherapy?

Ideally, fertility preservation should happen before starting chemotherapy or radiation, since these treatments can irreversibly damage the ovaries. In many cases, an egg or embryo freezing cycle can be completed in about 2 weeks, so it is important to speak with a fertility specialist as soon as possible after your cancer diagnosis.