Fertility

Egg Freezing

Your Guide to Egg Freezing

The Process, Who May Benefit, Risks, and Aftercare

Not being ready for pregnancy now does not mean you do not want children in the future. Work commitments, family plans, relationships, or medical treatment may not align with your preferred timing for parenthood. Egg freezing is one fertility preservation option that involves retrieving and storing mature eggs for possible future use.

However, egg freezing does not guarantee a future pregnancy. Outcomes depend on age at freezing, ovarian reserve, the number of mature eggs stored, sperm factors, embryo development, and health at the time of pregnancy. A comprehensive assessment by a fertility specialist is therefore important before treatment.

Who May Consider Egg Freezing?

1. Women who are not planning pregnancy soon: If you are prioritizing work, education, finances, or other life plans, or have not yet met a suitable partner, a fertility assessment can help you discuss whether egg freezing is appropriate.
2. Women preparing for treatment that may affect fertility: Certain chemotherapy, radiation therapy, hormonal treatments, and pelvic or ovarian operations may affect ovarian function. If your condition and treatment schedule allow, seek an early referral to discuss egg freezing, embryo freezing, or other preservation options.
3. Women at risk of diminished ovarian reserve: A history of ovarian surgery, endometriosis, ovarian tumors, or early menopause in the family may warrant earlier assessment and planning.
4. People considering preservation before medical or gender-affirming treatment: Some hormonal and surgical treatments may affect reproductive function. Discuss options with both your primary treatment team and a fertility specialist before treatment begins.

What Assessments Are Needed Before Egg Freezing?

1. Medical History and Reproductive Planning

Your doctor reviews menstrual patterns, pregnancy and surgical history, gynecological conditions, family history of early menopause, current medications, and your preferred timing and family size. If treatment for cancer or another illness is planned, the teams also coordinate the treatment type, start date, and suitability for ovarian stimulation.

2. AMH Blood Test

AMH helps assess ovarian reserve and predict the likely response to stimulation and egg yield. It mainly reflects egg quantity rather than quality and cannot independently predict natural pregnancy or guarantee a particular number of mature eggs.

3. Transvaginal Ultrasound and AFC

Ultrasound is used to count antral follicles in both ovaries and look for ovarian cysts, uterine fibroids, endometriomas, or other pelvic findings.

4. Hormone Testing and Preoperative Assessment

Depending on your needs, tests may include FSH, LH, estradiol (E2), prolactin, thyroid function, blood counts, and coagulation tests. Assessment for anesthesia and egg retrieval is also arranged.

5. Infectious Disease Screening

Relevant screening is usually required before treatment to support safe laboratory handling and storage.

How Many Eggs Should Be Stored?

There is no single number that is right for everyone.

The target number of mature eggs depends on:

1. Age at freezing
2. The number of children you hope to have
3. Egg survival after warming
4. Fertilization and embryo development
5. Sperm quality
6. Future uterine health and overall health

As age increases, more mature eggs are generally needed to achieve a comparable chance of having a child. If the first cycle yields relatively few mature eggs, your doctor may discuss another cycle according to your needs. Multiple retrievals are not necessary for everyone.

What Are the Risks and Limitations of Egg Freezing?

Ovarian Hyperstimulation Syndrome (OHSS)

Some patients with a strong response to stimulation may develop enlarged ovaries, bloating, abdominal fluid accumulation, or other symptoms. Your doctor adjusts medication according to AMH, AFC, and your response during treatment to reduce the risk of moderate or severe OHSS.

Uncertainty About Future Outcomes

Future outcomes also depend on egg survival after warming, fertilization, embryo development, sperm quality, uterine health, and overall health. The number of children you hope to have also affects how many eggs may be needed. Egg freezing cannot guarantee a future pregnancy or live birth.

Preserving Options Starts with Understanding Your Fertility

The decision to freeze eggs should not be based on age or a single AMH value alone. A comprehensive assessment helps clarify your ovarian reserve, the likely number of mature eggs obtainable, and what egg freezing may mean for your plans.

The Reproductive Medicine Center at Sung Jun Hung Women’s and Children’s Hospital provides fertility assessments, egg freezing, laboratory cryopreservation, and future reproductive planning, with professional support throughout your care.

Sperm Cryopreservation

Your Guide to Sperm Freezing

Who May Benefit, Testing, Storage, and Future Use

Fertility preservation is relevant to men as well as women. Sperm count and quality may be affected by illness, treatment, surgery, age, and reproductive health conditions. If you are preparing for treatment that may impair sperm production, or anticipate difficulty providing a semen sample in the future, consider discussing sperm freezing before treatment or surgery.

Sperm freezing is a relatively quick preservation option. It usually does not require prolonged medication or waiting for a particular biological cycle. However, a medical assessment and semen analysis are still needed, and sperm quality may change after freezing and thawing.

Who May Consider Sperm Freezing?

Men Preparing for Cancer or Other Medical Treatment

Chemotherapy, pelvic radiation, some hormonal treatments, and surgery involving the testes or reproductive system may affect sperm production. If the schedule allows, sperm freezing should be completed before treatment that may damage reproductive cells. The American Society for Reproductive Medicine (ASRM) recommends preserving sperm before cancer treatment whenever possible.

Men with Reduced Sperm Count or Motility

If semen analysis shows a low sperm count, reduced motility, or substantial variation in sample quality, your doctor may recommend storing sperm in advance in case sufficient sperm cannot be obtained on the treatment day.

Men with Collection Difficulties or Anticipated Ejaculatory Problems

Men with spinal cord injuries, neurological conditions, ejaculatory disorders, or planned surgery that may affect ejaculation can discuss preservation in advance.

Men Who Require Surgical Sperm Retrieval

For some men with obstructive or non-obstructive azoospermia, sperm can be retrieved from the epididymis or testes. Unused sperm may be frozen to reduce the need for repeat retrieval procedures.

Men with Occupational Risks or Specific Reproductive Plans

If work may involve exposure to heat, radiation, or chemicals, or if frequent travel, military service, or other commitments may affect future treatment arrangements, semen analysis can help guide a discussion about preservation needs.

The Sperm Freezing Process

Step 1: Semen Collection

Our hospital provides a private collection room. The complete semen sample is collected by masturbation into a sterile container.

Do not use ordinary condoms or lubricants that have not been approved by the laboratory, as their ingredients may harm sperm. If any part of the sample is lost, tell the laboratory staff so the results can be interpreted appropriately.

Step 2: Semen Analysis

The laboratory assesses liquefaction, semen volume, sperm concentration, total sperm count, motility, vitality, and morphology.

A single result may be affected by abstinence duration, fever, illness, stress, sleep, and completeness of collection. If results are abnormal, your doctor may recommend repeat testing or referral to a specialist in male reproductive urology.

Step 3: Sample Processing

The embryology laboratory processes the sample according to its quality and adds cryoprotectant to help reduce damage from ice crystals and temperature changes during freezing.

Step 4: Division into Storage Units and Freezing

The sample is usually divided into several units, cooled according to laboratory protocols, and stored in liquid nitrogen storage systems.

Dividing the sample allows only the required units to be thawed for treatment, rather than using the entire stored sample at once.

Step 5: Confirm Storage Details

The hospital records the number of units stored, sample quality, storage date, and relevant consent documents. Keep your contact details up to date and complete storage renewals, payments, and other required procedures when notified.

Can Freezing Damage Sperm?

Some sperm may lose motility or fail to survive freezing and thawing. The number of viable, motile sperm after thawing may therefore be lower than before freezing.

However, frozen sperm has long been used in assisted reproduction. Pregnancy outcomes depend not only on whether sperm is frozen, but also on post-thaw quality, the treatment method, egg quality, and both partners’ reproductive health.

What Are the Limitations of Sperm Freezing?

Not all sperm survive thawing: Tolerance to freezing varies between individuals, and some samples show reduced motility after thawing.

Future parenthood is not guaranteed: Embryo development and live birth also depend on egg quality, uterine conditions, embryo factors, and both partners’ overall health.

Storage and use must meet applicable requirements: Storage, renewal, disposal, and future use of reproductive cells are subject to Taiwan’s assisted reproduction laws, signed consent documents, and institutional policies.

Men Have an Important Role in Early Fertility Planning

If an illness or treatment may affect sperm production, discuss fertility preservation before treatment rather than waiting until it is completed. Earlier referral often provides more opportunity to arrange suitable preservation without delaying essential medical care.

The Reproductive Medicine Center at Sung Jun Hung Women’s and Children’s Hospital provides male fertility assessments, semen analysis, sperm freezing, and assisted reproduction consultations to help preserve options for your future family plans.

Ovarian Reserve Assessment

AMH Testing & Ovarian Reserve Assessment

Understanding AMH Levels and What They Mean

“Is my AMH normal?” “Does a low AMH mean I cannot get pregnant?” “Does a higher AMH mean better fertility?”

AMH is a blood test commonly used in fertility assessment. It helps estimate ovarian reserve and predict the response to ovarian stimulation. However, it is not a test of egg quality, a prediction of natural pregnancy, or a guarantee of future parenthood.

AMH should not be interpreted as a single number in isolation. Age, menstrual patterns, AFC, medical and surgical history, and current reproductive plans all matter.

What Can AMH Tell Us?

An Estimate of Ovarian Reserve

AMH broadly reflects the number of small follicles available for recruitment in the ovaries.

The Likely Response to Ovarian Stimulation

Before egg freezing or IVF, AMH helps estimate how the ovaries may respond to medication and how many eggs may be obtained. A lower AMH may be associated with fewer eggs, while a higher AMH may indicate a stronger response requiring dose adjustment and monitoring for OHSS.

Support for Personalized Treatment Planning

Your doctor considers AMH together with AFC, age, and body weight when selecting a stimulation protocol and medication dose.

How Is AMH Tested?

AMH is measured with a blood test and does not require surgery.

AMH usually varies less across the menstrual cycle than some other reproductive hormones, so testing is generally not restricted to cycle day two or three. If FSH, LH, or E2 are being measured at the same time, your doctor may still schedule testing early in the cycle to support interpretation.

Hormonal contraceptives may temporarily affect AMH levels. Tell your doctor about any contraceptives, hormonal medication, or other treatments before testing. Do not stop prescribed medication on your own.

How Are AMH Levels Interpreted?

There is no single normal AMH value that applies to every age, testing method, and clinical situation.

Reference ranges vary between laboratories, testing platforms, and age groups. Avoid interpreting your result using a fixed value found online without clinical context.

AMH Below the Expected Range for Your Age

This may indicate fewer recruitable follicles and a lower egg yield during egg freezing or IVF.

However, a low result does not necessarily mean there are no eggs, ovulation has stopped, or natural pregnancy is impossible. Age, menstrual patterns, and ultrasound findings must also be considered.

AMH Within the Expected Range for Your Age

This suggests ovarian reserve is broadly consistent with age. It does not guarantee normal egg quality or exclude tubal, uterine, ovulatory, or male fertility factors.

AMH Above the Expected Range for Your Age

A higher AMH usually reflects a greater number of small follicles, but it does not necessarily mean a higher chance of pregnancy.

Patients with higher AMH and AFC may respond more strongly to stimulation and require attention to OHSS risk. Whether the finding is related to polycystic ovary syndrome must be assessed alongside menstrual patterns, hormone findings, and ultrasound results.

What Should I Do If My AMH Is Low?

The first step is to check whether the result is consistent with your age, ultrasound findings, and other test results, rather than starting supplements on your own.

Your doctor may assess:

• Menstrual patterns and ovulation
• Antral follicle count
• FSH and estradiol (E2)
• A history of ovarian surgery or disease
• Current hormonal medications
• Near-term reproductive plans
• Whether egg freezing or assisted reproduction should be considered

There is currently no treatment that can replenish eggs already lost from the ovarian reserve. Planning focuses on choosing an appropriate approach based on existing ovarian function and your reproductive timeline.

Should AMH Be Monitored Regularly?

The need for repeat testing depends on age, the initial result, medical history, and reproductive plans.

Frequent testing is not necessarily needed if there are no specific risks and pregnancy is planned soon. Your doctor may recommend follow-up if AMH is lower than expected for age, you have had ovarian surgery, you plan to delay pregnancy, or you are facing treatment that may affect ovarian function.

When monitoring changes, using the same laboratory or a comparable testing method can help reduce variation between testing systems.

AMH: Frequently Asked Questions

Does a low AMH mean premature ovarian insufficiency?

Not necessarily. Premature ovarian insufficiency cannot be diagnosed from AMH alone. Menstrual patterns, FSH, E2, and clinical findings must also be considered.

Does a normal AMH mean there are no fertility concerns?

No. It suggests ovarian reserve is broadly within the expected range, but it does not confirm normal egg quality, fallopian tube function, uterine conditions, or sperm quality.

Can I conceive naturally with a low AMH?

It may still be possible if ovulation continues and sperm and fallopian tube factors are suitable. AMH has limited ability to predict natural conception on its own.

Does a low AMH mean I must freeze my eggs?

Not necessarily. The decision depends on age, near-term pregnancy plans, AFC, likely egg yield, and future family plans. If you are ready to have children now, your doctor may recommend trying to conceive or completing an infertility assessment rather than focusing only on egg freezing.

Can supplements increase AMH?

AMH results may vary because of testing differences and some physiological or medication-related factors. A supplement should not be regarded as a way to increase the egg supply. Discuss any supplements with your doctor to avoid interference with existing conditions or treatment.