Egg Freezing: Only 5.7% of Women Return to Use Their Frozen Eggs Within 7 Years

Last updated: February 2026

Journal Club #6. We read the latest fertility research so you don’t have to.

The Paper

“Elective fertility preservation: a national database study on trends in oocyte cryopreservation and oocyte utilization over a 5- to 7-year follow-up period”

Lee MB, Siavoshi M, Kwan L, Kroener L. American Journal of Obstetrics & Gynecology, 2026;234(2):432–439.

Read the full paper on PubMed →

DOI: 10.1016/j.ajog.2025.08.032

Why This Matters

Egg freezing is marketed as an insurance policy. Freeze now, use later, take control of your timeline. Apple, Google, and Meta offer it as an employee benefit. The number of US patients freezing eggs quadrupled between 2014 and 2021: from 4,153 to 16,436 per year (P<0.01).

What almost never appears in the brochure: how many women actually come back to use those eggs, and what happens when they do.

This study used the SART database, which covers over 90% of US assisted reproduction cycles, to track elective egg freezing patients from 2014 to 2016 over a 5- to 7-year follow-up. It is the largest national dataset on egg freezing utilization published to date.

Key Findings

The headline: 5.7% came back

Of all patients who froze eggs between 2014 and 2016, only 852 (5.7%) returned for egg warming within the follow-up window. The remaining 94.3% had not used their frozen eggs by the 5- to 7-year mark.

Return rates varied by age at freezing. Women who froze at 38 to 42 returned at the highest rate, roughly 8%. Older patients also returned sooner. This makes sense: the closer you are to the end of your fertile window when you freeze, the sooner the need becomes real.

The math that matters

For every 100 women who freeze eggs, about 6 return within 5 to 7 years. Of those 6, the cumulative live birth rate is 28.9%. That means roughly 2 out of every 100 women who freeze eggs have a baby from those eggs within this timeframe.

Two per hundred. That is the per-cycle yield of elective egg freezing, measured at the population level, within this follow-up period.

What happens when women do return

78.5% of women who return get at least one usable embryo. That is reassuring. But over one in five (21.5%) go through egg warming, fertilization, and culture only to end up with nothing transferable.

The 28.9% cumulative live birth rate for returners is real, not catastrophic, but well below what most patients expect when they hear “insurance policy.” For comparison, a fresh IVF cycle for a woman under 35 produces live birth rates of 40% to 50% at many European clinics.

Women are freezing younger

Mean age at retrieval dropped from 36.0 in 2014 to 34.9 in 2021 (P<0.01). The market is shifting toward younger patients, likely driven by employer-sponsored benefits and direct-to-consumer marketing. Younger eggs survive vitrification and thawing better, so this trend should improve future utilization outcomes. Whether it changes the fundamental utilization rate is a different question.

The Caveats (They Matter)

5 to 7 years is not the full story. Many women freeze at 34 or 35 and may not attempt pregnancy until 38 to 42. This follow-up window almost certainly underestimates lifetime utilization. Longer-term research suggests roughly 21% eventually use their preserved eggs. That’s still a minority, but nearly four times the 5.7% figure.

Low utilization might partly be good news. Some women in the 94.3% who didn’t return conceived naturally. Others may have used donor eggs, adopted, or decided not to pursue parenthood. Not returning doesn’t necessarily mean the eggs were wasted. It might mean they weren’t needed.

The lead author was direct about this. Lee et al. acknowledged: “We cannot predict future fertility and who will need or choose to use their cryopreserved oocytes.”

None of this erases the headline number. It adds context. The data says that within the timeframe measured, the vast majority of frozen eggs sit in storage.

What This Means for Patients

The decision to freeze eggs is rational. Nothing in this study changes that. If you’re 33 and don’t have a partner or aren’t ready for a child, freezing eggs at peak quality is a reasonable response to biology’s timeline. The critique here isn’t of the decision. It’s of the framing.

“Insurance policy” is the wrong metaphor. Insurance pays out when you file a claim. The data says fewer than 6 in 100 file that claim within 7 years, and the payout rate when they do is 28.9%. A more accurate metaphor: egg freezing is an option contract. You’re paying for the right to use those eggs later. Most options expire unexercised. That doesn’t make buying them irrational, but it does change how much you should pay for the contract and how much psychological weight you put on it.

Know the numbers before you budget. A single egg freezing cycle in Europe runs EUR 2,000 to EUR 5,000 plus medication, plus annual storage fees of EUR 200 to EUR 500. Many patients do two or three cycles to bank enough eggs. Over a decade, storage alone adds EUR 2,000 to EUR 5,000. If you’re making this investment, make it with full knowledge of the utilization data, not the marketing version.

Age at freezing determines almost everything. Live birth rates from frozen eggs decline with age at cryopreservation. Freezing at 32 gives you materially better eggs than freezing at 38. If you’re going to freeze, the reproductive biology argument for doing it sooner is strong. The utilization data adds a counterweight: most women who freeze younger won’t use those eggs at all.

Limitations

• US-only data (SART database). European utilization rates may differ given different healthcare systems, cultural norms, and access to fertility treatment.
• Retrospective cohort design. No randomization, no control group.
• 5 to 7 year follow-up likely underestimates true lifetime utilization. The 5.7% figure will rise as longer follow-up data emerges.
• The study excluded medical and cancer-related egg freezing. Results apply only to elective (social) freezing.
• Per-age-group live birth rates are in full-text figures behind a paywall. The 28.9% cumulative rate is an average across all age groups; younger freezers likely fare better.
• The study cannot distinguish between “didn’t need the eggs” and “gave up on using them.” Both register as non-utilization.

Practical Takeaway

Egg freezing works for the women who use it. The 78.5% usable embryo rate and 28.9% cumulative live birth rate confirm that the technology is viable. The question is not whether frozen eggs can produce babies. They can.

The question is whether the way egg freezing is sold, as a guarantee, as insurance, as something you’d be foolish not to do, matches the reality of how it’s used. At 5.7% utilization within 7 years, the gap between marketing and medicine is wide. Go in with the real numbers and the decision gets clearer, whatever you decide.

This is part of EuroFertile’s Journal Club. Summaries of recent fertility research, written for patients, not doctors. Browse all research summaries →

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