What’s the best age for a woman to freeze her eggs? Doctors weigh in

Aging really messes with your head. One minute, you’re spiraling about the years flying by; the next, you’re hyping yourself up with affirmations like, “You’re only as old as you feel!” Personally, I feel 25 even though my feet are firmly planted in 30-something territory. Unfortunately, biology doesn’t care about my feelings, and lately, I’ve been wondering if my fertility agrees.

During a recent trip to my gynecologist, I admitted I was (quite) single and not currently interested in kids, but had been thinking about egg freezing in case I want them in the future. Unfortunately, cost — it can be up to $20,000 a cycle without insurance — is a major issue for me.

I expected my doctor to aggressively push me to find a way to come up with the cash, so I was surprised when he told me not to worry because “40 is the new 30” for pregnancy and that I didn’t have to assume my eggs would be dust in eight years. While that was comforting to hear, I wanted to dig deeper.

In recent years, more women have been having children at older ages. For the first time, in 2023, there were more births among women 40 and older than teenagers, according to a report from the National Center for Health Statistics released earlier this year. It’s part of a decades-long trend of American women, especially those under 30, having fewer children.

But the driving factor isn’t that fewer women are seeing fertility declines in their 40s — it’s more about medical advancements, changing societal attitudes around motherhood and the cost of raising kids, experts told NBC News.

Dr. Lucky Sekhon, a reproductive endocrinologist in New York City, tells TODAY.com that in her practice she’s noticed people postponing having kids because they “want to be responsible and wait until they’re financially stable” and to find the right partner.

So, if you’re in your 20s or 30, considering fertility preservation but hesitant to pursue it just yet, here’s what to know.

When does female fertility start to decline?

While more women have been having children at older ages in recent years, “the harsh reality is that biology has not changed,” Dr. Sigal Klipstein, chair of the American Society for Reproductive Medicine’s ethics committee and infertility treatment expert, tells TODAY.com.

The main aspects of female fertility that decline with age are egg quality and quantity — the uterus doesn’t age, Sekhon says — but the rate and extent of the decline can vary from person to person.

Since every individual is different, “age is the best we can do to guess someone’s potential egg quality” before they undergo fertility treatments, Sekhon explains.

Although getting pregnant can be difficult at any age, for women, the “best reproductive years” are the 20s, according to the American Society for Reproductive Medicine. Fertility then starts to decline in the 30s, especially after age 35. The average 30-year-old woman without fertility issues has a 20% chance of getting pregnant in a given cycle, compared to less than 5% at 40, the organization notes.

“Half of women who attempt to conceive in their 40s will face difficulties,” says Klipstein. Of course, some people will be able to get pregnant unassisted in their 40s, but being in this age group “does increase the chance that they will need to rely on fertility treatments such as IVF (in vitro fertilization),” she adds.

What’s the best age to freeze your eggs?

Sekhon says the best age to freeze your eggs is “your late 20s to your very early 30s.”

When a woman freezes her eggs in her 20s, there’s a baseline 20-25% chance of them creating abnormal embryos, Sekhon explains. That number goes up to 30% in the mid-30s, and by 37-40 years old, there’s a 50-70% chance of abnormal embryos.

“When we freeze eggs, we’re still working within the confines of a very inefficient system,” Sekhon explains. This is because each egg has a low conversion rate of egg to healthy embryo.

“You have to factor how many eggs will thaw and how many will fertilize,” she continues. “You’re up against the same issues as natural pregnancies,” but you’re just working with younger, healthier eggs. “When you freeze eggs, you’re freezing potential,” she adds.

So, the older you are when you freeze your eggs, the more eggs you’ll need to feel confident in the outcome down the line, but the harder time you may have getting as many high quality eggs as you want. Essentially, the older you are when you freeze your eggs, the less likely it is that you’ll have a healthy pregnancy from those eggs, according to the American Society of Reproductive Medicine.

Does race factor into fertility as you age?

Some research has suggested that women of certain races experience higher rates of fertility than other populations, such as Black and Hispanic women.

Lack of access to or delaying medical care may play a role, but some research has still found higher rates of infertility in Black women even with access and adequate health insurance coverage, Klipstein explains.

Based on her experience, Sekhon says one explanation may be a systemic bias among providers, who may falsely believe that Black women are immune to infertility, which “goes back to the days of slavery,” when enslaved Black women were forced to reproduce. As a result, a doctor “might inadvertently delay someone from getting the care they need,” Sekhon adds.

To combat these disparities, Klipstein says physicians should “bring up conversations of fertility as part of routine care for all women of reproductive age, and particularly for those populations at increased risk of infertility.”

Can you extend your fertility naturally?

“(Fertility treatment) is a significant expense and not everyone has access to it, and it isn’t fair,” says Sekhon. Reducing costs has to be legislated, she adds, but in the meantime, she encourages people who work for companies that may be in a position to cover it to start that conversation with HR. There are also some grants that can help with treatment coverage.

But for people who simply can’t afford to pay for egg or embryo freezing, is there a natural way to extend fertility?

While fertility does decline with age, research has found that certain lifestyle choices — like maintaining a healthy weight, limiting alcohol and smoking, moderating caffeine, exercising sensibly and managing stress — can all play a role in supporting fertility. Smoking in particular can decrease your egg count and quality, Sekhon points out.

But it’s also important to recognize that a healthy lifestyle can’t stop age-related fertility decline, Klipstein says. Most women become unable to get pregnant unassisted in their mid-40s, according to the American Society for Reproductive Medicine.

The idea that “if a woman is healthy, takes good care of herself, exercises and has regular menstrual periods, that she will most likely be fertile” is a myth, Klipstein adds.

If you’re deciding whether egg or embryo freezing is the right path for you, both Klipstein and Sekhon believe it’s a choice that requires a lot of thoughtful consideration.

“This decision is a highly personal one, and I recommend that women have honest and in-depth conversations with their physicians regarding the best options for their particular situations,” says Klipstein.

No matter which path you choose, Sekhon says to remember you can only “control things to a point,” and you’ll never know how something will work out until you try.

This story first appeared on TODAY.com. More from TODAY: