LGBTQ Fertility Preservation

Egg freezing, or oocyte cryopreservation, allows you bank your eggs for future use. Eggs frozen from vitrification technology are suspended in time. As a result, eggs can be frozen indefinitely. Main Line fertility provides everything for your egg preservation journey, including cryopreservation and long-term storage.

Age is the most common reason that a person who produces eggs decides to preserve them.

However, other factors that might warrant egg freezing include:

• upcoming oophorectomy

• upcoming gender confirmation surgery such as metoidioplasty or phalloplasty (i.e. “bottom surgery”)

• a family history of premature ovarian failure or early menopause

• a recent cancer diagnosis

• a diagnosis of endometriosis or polycystic ovarian syndrome (PCOS)

If you are starting gender affirming hormone therapy (GAHT), current research indicates that you do not need to freeze your eggs to preserve your fertility.

At Main Line Fertility, we want you to know exactly what to expect from every part of your journey with us. Here are the steps to expect for egg preservation:

1. Reproductive Health Physical

At your first visit, you will be greeted by a fertility care coordinator who will review the new patient visit checklist and your insurance with you. You will then meet with a member of our clinical care team who will review your medical history and, depending on the purpose of your visit, perform an ultrasound and lab work. Our clinical care team will also discuss the benefits of genetic carrier screening and you will have the option to test.

2. Ovarian Stimulation

Over a period of 9-12 days, we will stimulate your ovaries with self-administered injections. These injections utilize a thin needle (similar to what a diabetic might use for insulin shots) and are given subcutaneously, which means below the skin (as opposed to in the muscle). You will also have approximately five to seven early morning monitoring appointments to assess whether the injections are working.

3. Egg Retrieval

Once the monitoring shows that the egg maturing process has worked, you will come to our on-site surgery center where your doctor will gently guide a needle attached to a catheter through your vaginal wall to collect your eggs. The painless procedure will take 10-20 minutes and you will be under twilight anesthesia. Most patients don’t even remember the procedure, and you may bring a partner or friend with you if you’d like. There are no stitches or scars and most patients return to work the following day.

4. Freezing and Storage

Your collected eggs are then frozen using an advanced method called vitrification. Immediately after they are vitrified, your eggs will be placed into one of our liquid nitrogen storage containers in our state-of-the-art laboratory. Mechanisms are in place to ensure the safe long-term storage of your eggs.

The cost of an egg freezing cycle at Main Line Fertility is between $3,000-$6,000 plus the cost of anesthesia ($500 per cycle) and medication ($2,500++ per cycle), depending on which egg freezing package the patient chooses. We also offer comprehensive financing. All Main Line Fertility egg freezing packages include:

Monitoring appointments

Egg retrieval

Cryopreservation

First year of storage

Cryo-storage costs $750 per each additional year.

The most current research shows that long term testosterone use has no effect on egg quality or ability to get pregnant. Stopping gender affirming hormone therapy generally causes fertility to return to what it would otherwise be without testosterone.

You will need to stop testosterone to begin the egg-freezing process. Please discuss your current hormone use with your doctor at Main Line Fertility to create a timeline that is comfortable for you.

Sperm cryopreservation, commonly referred to as sperm freezing, is a method to preserve sperm for later use. After semen is collected a laboratory analysis is completed and then the sperm are frozen in our state of the art laboratory for future attempts at pregnancy.

Reasons to use sperm freezing include:

• Prior to hormone treatment or gender affirming procedures

• Advancing age

• Unavailable to be present for a fertility treatment

• Declining sperm concentration

• High risk exposure (ie- zika, occupational)

• Prior to a vasectomy

• Prior to cancer treatments

• Prior to beginning treatment for any medical conditions that could affect fertility

Before you provide your sample, you must refrain from any sexual activity including masturbation for 2 to 3 days prior to donation. (Longer or shorter periods of abstinence may result in abnormal results.)

You will give your sperm sample at Main Line for via masturbation on-site in our laboratory collection room. The room is equipped with a chair/bed, urinal, sink, and TV/VCR. A limited collection of sexually explicit material is provided in the collection room, or you are welcome to use your own smartphone. (Note: No lubricants or condoms are allowed.)

When you’ve given your sample, you’ll get a complete semen work-up includes concentration (recorded in millions per milliliter), motility (to determine how many sperm are moving in the sample), and morphology (% of normally shaped sperm). You can also opt for genetic carrier screening.

Your sperm will then be frozen and stored in our onsite cryostorage facility for your future use.

Semen analysis – $160

Cryopreservation – $200

Storage – $300/year

Prices subject to change.

Unfortunately, we do not have much data on how past hormone use affects fertility in transfeminine and AMAB nonbinary individuals.

If you’ve been taking gender affirming hormones, you will need to stop for at least three months in order to attempt fertility preservation.

If it turns out you have low sperm count or sperm with poor motility, do not be discouraged from sperm freezing – there are many new reproductive techniques to fertilize eggs despite these limitations.

You can also ask about surgical sperm retrieval if you are unable to give a sample or if your sperm count is extremely low.

Embryo cryopreservation, commonly referred to as embryo freezing, is the process of selecting, freezing, and storing embryos for later use.

The most common reason to preserve embryos is that you have completed a cycle of IVF and you have unused embryos that you would like to save for a future cycle or future pregnancy. There are many advantages to cryopreserving embryos:

• You many not have to go through ovarian stimulation or egg extraction in the future

• You can transfer fewer embryos in your first IVF cycle, thus reducing thus reducing the risk of a multiple pregnancy (twins, triplets, or greater).

• You can ensure that your children will be “genetic siblings” should your fertility or that of your donor be at risk due to surgery, cancer treatment, or gender affirming hormone care.

• Cryopreserved embryos have a slightly higher rate of conception than cryopreserved eggs.

There is a storage fee of $750 per year to store your embryos with Main Line Fertility. Prices subject to change.