University of São Paulo Study Reveals Surge in Egg Freezing Demand in Brazil Despite High Costs

Egg freezing in Brazil has existed since 1980, but it was only in 2012 that the procedure was extended to women who had no problems getting pregnant, but just wanted to postpone the pregnancy. With this change, women now have the opportunity to have children using their own eggs, even at an older age, at a time in their lives when this could compromise the quality and quantity of eggs, if they became pregnant naturally.

Despite the high prices and few public clinics, this new scenario also caused Brazil to record an increase in assisted reproduction numbers. According to Anvisa’s National Embryo Production System (SisEmbrio), in 2023, 115,318 embryos were frozen in the country, an increase of 32.8% compared to 2020, which recorded 86,833 procedures. The number of assisted reproduction cycles, which are procedures that go from thawing eggs to the birth of the baby, carried out in 2023, was 56,578, an increase of more than 35% compared to 2020, when 41,586 cycles were recorded.

According to professor Rosana Maria dos Reis, from the Department of Gynecology and Obstetrics at the Faculty of Medicine of Ribeirão Preto (FMRP) at USP, postponing pregnancy through egg freezing is a current trend, as women seek first professional stability and financial independence to later become pregnant. Although there is still no defined limit for the maximum storage time for frozen eggs, Rosana highlights the quality of the technique used more than the duration of freezing. “A Assisted reproduction clinics need to evaluate freezing protocols that best fit their routines to promote better results after heating and thawing eggs.” 

Furthermore, Rosana mentions that protocols should focus on both the survival rate of eggs and the formation of embryos and the birth of healthy babies. “The approach provides women with greater autonomy and freedom, allowing them to consider motherhood even at the age of 40.” But egg freezing isn’t cheap. The treatment varies depending on the clinic chosen, and can cost approximately R$30,000. The SUS offers the procedure for free, but it is not for everyone. 

Currently, there are 181 assisted reproduction clinics across the country and only 11 of these clinics are public, four in the State of São Paulo, one of them in Ribeirão Preto, at the Hospital das Clínicas da FMRP.

In the SUS 

At the Human Reproduction Center at Hospital das Clínicas da FMRP , egg freezing is an option available only to patients facing medical conditions or treatments that could compromise their fertility, such as immunological diseases or cancer.  “Egg freezing is not commonly performed for women who wish to delay it for personal reasons, due to the high demand for this procedure, especially among couples seeking IVF . fertilization on medical recommendation,” says the expert. 

The waiting list for this service can last up to two years, from referral through the public network to care at the hospital. Rosana clarifies, however, that carrying out the procedure, whether in a private or public clinic, does not guarantee a pregnancy. “The objective is to obtain as many eggs as possible, thus increasing the chances of success.”

Rosana notes that the patient’s age and ovarian reserve also play a crucial role in this process. “Younger women tend to have a larger ovarian reserve, which makes it easier to obtain a greater number of mature eggs for freezing.” Estimates indicate that, on average, each frozen egg has a success rate of about 5% in a live birth pregnancy, “so the chance of having a baby with 12 frozen eggs is about 60%. If it is possible to freeze 20, the chances increase.”  But, according to Rosana, getting 20 mature eggs in a single ovulation induction cycle is not very common, with the exception of women under 30.

Freezing

Doctor Maria (fictitious name) is 36 years old and chose to freeze her eggs because she has no idea when she will become a mother. “I know that, with increasing age, the chance of becoming a mother decreases and the possibility of fetal malformation increases, so I decided to freeze it.” The patient found the procedure very simple and painless. “The vaginal ultrasound needs to be done a few days after menstruation and, in my case, as everything was in order, within the parameters considered normal, the injection treatment was started in order to mature my eggs.” 

Maria took a hormone injection at night and a progesterone tablet in the morning, to stimulate the development of ovarian follicles and regulate the menstrual cycle. After six days, she had an ultrasound to assess the progress of egg maturation and continued with the medication for another seven days, before carrying out egg extraction. Ultrasound is important to adjust the medication dosage, if necessary, and to determine the ideal time to extract mature eggs.  The process lasted 13 days for Maria, while for others, according to experts, it could vary from 12 to 15 days, depending on each patient’s response to hormonal treatment.