September 12, 2023
6 Minutes

I Have PCOS. Can I Freeze My Eggs?

I Have PCOS. Can I Freeze My Eggs?
Written by
Navya Muralidhar
MSc Clinical Embryology & Embryologist
Amilis makes fertility digestible, accessible, and affordable to help you take charge of your reproductive health and live on your own timeline.

In an eggshell...

  • Absolutely, women with PCOS can freeze their eggs as an option to preserve their fertility and plan their chances of having a baby.
  • While it doesn't treat PCOS-related infertility, it offers peace of mind.
  • The process is quite similar, and having PCOS might include modified treatment medication, along with screening for OHSS.
  • Unfortunately, the NHS doesn't usually cover egg freezing for PCOS, so it's often a private choice in the UK.

PCOS often doesn’t appear all at once, but rather as small red flags 🚩 

You’re looking at your cycle tracking app and see that your periods haven’t been that regular for the past few months.

Maybe that acne is flaring up. 

Or there’s unexplained facial hair growth. Maybe you go on the scale and see an increase in weight. 

After a month or two of noticing these, you go to your GP. 

Post running a few tests, you may be diagnosed with Polycystic Ovary Syndrome. 

Polycystic Ovary Syndrome (PCOS) affects women’s hormones, often leading to irregular periods. It also comes with a bunch of other symptoms:  hair growth, weight gain, mood swings, and fertility issues.

Speaking of fertility- if you were deciding on preserving it via egg freezing, is having PCOS a hiccup in your plans?

Well, no. And we delve into exactly why, with this article.

What Is Egg Freezing?

Egg freezing is a process that helps women save their eggs for fertilisation later. It involves screening tests, hormonal medication for a week or two, and then having your eggs retrieved from your ovary and frozen for later use. 

At the screening stage, a hormonal test called AMH (Anti Mullerian Hormone) and an ultrasound test called AFC (Antral follicle count) will be done.

It is also possible to detect PCOS with your AMH and AFC levels.

Can Women with PCOS Freeze Their Eggs?

In short: yes! 

Women with PCOS can freeze eggs just as their non-PCOS counterparts. There is no difference in the quantity or quality of eggs either.

But the process may have some tweaks based on where you lie in the spectrum of PCOS symptoms. While egg freezing won’t treat PCOS-related infertility, it can help you preserve your fertility and plan your family later, on your own terms.

Is Egg Freezing Different for Women With PCOS?

A major part of the process such as the retrieval and lab work is similar regardless of whether you have PCOS. But there are a few ways your egg-freezing cycle might be different compared to your non-PCOS counterparts:

Fewer Cycles

As PCOS can lead to increased numbers of eggs growing with hormonal stimulation, this can make the number of cycles needed lesser.  

However, some studies mention how the increase in numbers may sound like good news, but there are still instances of poor oocyte quality and low fertilisation rate.

Ultimately, it’s the number of mature, good-quality eggs that matter. If this is higher, the chances of needing another cycle decrease.

Risk of Ovarian Hyperstimulation Syndrome (OHSS)

Women with PCOS tend to have a higher AMH and a higher chance of small immature follicles in the ovaries.

When the ovaries are stimulated during an egg-freezing cycle can lead to more eggs being recruited to grow, as more follicles react to hormones. 

This can lead to excessive egg growth, thus increasing the risk of Ovarian Hyperstimulation Syndrome (OHSS). 

OHSS can lead to enlarged ovaries and fluid retention in the abdomen, along with pain. However, doctors tend to notice the onset of OHSS during the blood tests done throughout your stimulation period. Hence, they should be able to detect it prior, if you’re a PCOS patient at risk. 

They can then modify the protocol to a lower dosage or cancel the cycle if necessary. 

If you do happen to develop mild OHSS after your egg retrieval, it’s best to contact your healthcare provider if you notice abdominal swelling, discomfort, vomiting or nausea.

You may then be prescribed medication, such as pain relievers, and diuretics and plenty of rest until it subsides.

Reduced stimulation dosage

Normally, egg freezing medication includes a class of hormones called gonadotropins which help the follicles grow and mature.

But with PCOS, there’s increased sensitivity to gonadotropins which may elevate their risk of OHSS. 

Hence, rather than usual protocols, modifications such as replacing the HcG trigger for maturation and lowering the dose of gonadotropins can be helpful for PCOS patients.

IVM+ egg freezing

If you have a high risk of OHSS and a risk associated with regular stimulation protocols, IVM (In vitro maturation)+ egg freezing may be proposed as the best course. 

This involves extracting eggs from all follicles naturally recruited during a menstrual cycle, and then maturing them in the lab. 

This means: 💊 no meds or very minimal injectables, reduced treatment time, lower costs and little to no risk of OHSS. 

During this stage, the immature ones grow to become mature and are then frozen via vitrification as usual.

Birth control

If you have PCOS and irregular or absent periods, you may actually be prescribed birth control before your egg-freezing cycle. 

Wait, what? 🤨

While it may seem counterintuitive, hormonal birth control pills can help induce periods and facilitate the best timing for your egg-freezing cycle.

They also help suppress the growth of ovarian cysts, which may be a win-win here!

Can Women with PCOS Freeze Their Eggs on the NHS?

Unfortunately, usually not. 

The NHS usually only funds egg freezing for women undergoing treatment that will affect their fertility.

However, there are other options to take and local ICBs to contact, to gather more information on whether the NHS can fund your treatment based on your location. You can refer to our guide on NHS and egg freezing for all details.

How Amilis can guide you on your egg-freezing journey

With so many misconceptions around PCOS,  knowing that egg freezing is still a possibility, can be a relief. 

Along with navigating the hurdles of PCOS, your egg-freezing journey shouldn’t pose any additional ones.

And we at Amilis, are determined to make that happen. 

We provide you free 1-1 consultations, a personalised quiz, and all egg freezing resources on a single platform so you’re informed and confident about your reproductive health and choices. 

Coupled with our AMH test and fertility clinic comparator, you'll be able to start your journey or start having discussions such as “should I opt for egg freezing with PCOS?” from vetted, egg-freezing clinics across the UK.

We hope to make this journey informed, supportive and easy to navigate, at every step.

You’ve got this🤞🏻

References
Written by
Navya Muralidhar
MSc Clinical Embryology & Embryologist

An embryologist by degree, and an educator by heart, Navya has completed her Bachelors in Genetics, and her Masters in Embryology and now strives to deconstruct the complex, into educational and informative articles surrounding her field of interest. She's specifically focused on time-lapse technology, IVM, and pre-implantation genetics. When not writing, you can find her at her favourite or newest coffee shop in town, sketching away, or listening to a podcast.