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Everything About Social Egg Freezing
Social freezing = a plan for the future
23.12.2025 | 15:44
Why?
At Nadezhda Hospital, we have been working for years to raise awareness about the lifespan of egg cells and the option of social egg freezing—a procedure suitable for women who wish to have children but are currently at a stage in life where they are not yet ready.
Many women still do not know that both the quantity and quality of eggs begin to decline after around the age of 35.
If a woman hopes to have a child in the future, it is important to think about this in time, as the chances of pregnancy decrease with age.
Timely action means checking ovarian reserve, deciding to pursue pregnancy, or considering social egg freezing.
The egg-freezing procedure is a fast and reliable way to secure your future.
10 days + 3 visits = a plan for the future!
Regardless of the day of your cycle. Fast, gentle, and secure at Nadezhda Hospital.
All you need to do is call today—we start tomorrow! 0882 193 970
More information about the steps of egg freezing can be found HERE.
What is ovarian reserve? What “capital” do we start with?
Everything begins around the ninth week of pregnancy, when the earliest precursors of a baby girl’s future egg cells begin to form. At that stage, they number several million, but by birth only around 1,000,000 to 1,500,000 remain.
These are all the eggs a woman will ever have—known as her ovarian reserve—and from that moment onward, their number continues to decline. This reserve cannot be replenished or renewed.
The initial supply varies from woman to woman. The quantity of future egg cells is determined mainly by genetics, although it can also be influenced by the course of pregnancy.
By the time puberty begins, only around 250,000 to 300,000 eggs remain in the ovaries—meaning the ovarian reserve has already decreased nearly fourfold.
Once menstruation begins, approximately 15–20 eggs start preparing for maturation each month. They grow inside small fluid-filled sacs called follicles, where they are protected and receive everything needed for development.
The follicles that “wake up” each month for maturation—known as antral follicles—are large enough to be seen on ultrasound. Their number and size are among the indicators specialists use to assess ovarian reserve.
Throughout her reproductive life, a woman ovulates only around 300 to 500 times. The remaining follicles naturally break down. In each cycle, usually only one dominant follicle fully matures, while the others undergo follicular atresia—a process in which they self-degrade instead of waiting for the next cycle.
The number of egg cells begins to decline gradually around the age of 25, and this depletion accelerates sharply between 35 and 37 years of age.
At the same time, egg quality also decreases, as the proportion of eggs with chromosomal abnormalities rises.
Between ages 35 and 40, eggs with chromosomal damage increase from 20% to 45%. Within just two years, the number of non-viable eggs can double, and between ages 37 and 42, they may account for over 80% of ovarian reserve.
By age 45, a woman’s chance of conceiving and giving birth to a healthy child using her own eggs is below 1%.
The depletion of ovarian reserve occurs without symptoms, and this process cannot be stopped or slowed with medication.
Women at increased risk of premature ovarian reserve depletion include those with:
- thyroid disorders
- autoimmune diseases
- endometriosis
- pelvic surgeries
- a family history of early menopause
For women with diminished ovarian reserve, the best chances of future pregnancy lie in using:
- their own eggs, frozen before age-related decline, or
- donor eggs
Modern egg-freezing technologies successfully preserve a woman’s opportunity to achieve motherhood at the time she chooses.
When does ovarian reserve begin to decline?
The later it begins, the faster it progresses.
Ovarian reserve—the number of eggs a woman has—naturally decreases over time. Age is one of the main indicators of its condition.
The leading causes of this gradual depletion are genetic; it is part of our biological programming.
For most of a woman’s life, ovarian reserve declines slowly and steadily. However, at a certain point, this process accelerates dramatically. For most women, this turning point occurs between the ages of 35 and 37.
After this age, the proportion of eggs with chromosomal abnormalities also increases rapidly—meaning not only quantity, but quality declines significantly as well.
Over the next five years, a woman typically loses around 90% of her remaining eggs, and within another five years, her ovarian reserve may be nearly exhausted.
Menstrual cycles may continue for several more years, until they stop completely at an average age of around 51, but the presence of a cycle does not necessarily mean that viable eggs remain.
An interesting fact: even in women who have reached menopause, isolated follicles may still be found. However, these are not capable of leading to pregnancy.
Different Women, Different Scenarios
No two women are the same. While most women follow the general pattern described above, there are individual variations.
Some women are fortunate exceptions, with a much stronger ovarian reserve that declines later in life. These women may still conceive and give birth at 45 years old.
The other scenario, however—known as premature ovarian reserve depletion or premature ovarian insufficiency—can leave women facing infertility much earlier than expected, often just when they feel they are beginning an important new stage of life.
When Does Ovarian Reserve Become Depleted?
It is happening more often—and earlier—but why?
In recent years, specialists have observed a concerning trend: premature ovarian reserve depletion is becoming increasingly common at younger ages.
Many possible contributing factors are being discussed, most of them linked to modern lifestyle habits. These factors may damage egg cells directly or interfere with the normal function of the ovaries:
- increased exposure to synthetic hormones and hormone-mimicking chemicals
- smoking
- higher levels of heavy metals and chemical pollution in large cities
- daily stress and excessive oxidative damage from free radicals
- excessively high or low body weight
- overconsumption of processed foods containing preservatives, additives, and flavor enhancers
However, medicine still does not have one clear explanation for this phenomenon.
Why Does It Matter?
What difference does it make whether we have 10,000 or 50,000 eggs left—if only one is needed to become a mother?
The answer is simple: ovarian reserve is the main factor that determines our chances of success.
Because of individual differences and additional complicating factors, it is now clear that our reproductive potential is determined not by our chronological age, but by the biological age of our ovaries.
What is premature ovarian reserve depletion?
This is a condition in which a woman is no longer able to produce mature eggs and therefore cannot conceive naturally, much earlier than the usual timeframe – before the age of 35. In some cases, this may even occur a decade earlier.
The causes can be many and varied:
- Heredity – if your mother or grandmother experienced early menopause (at 40 or earlier), it is very likely that your ovarian reserve may also be depleted earlier than that of your peers.
- Chemotherapy – many of the medications used to treat cancer irreversibly damage the delicate structures of the ovary and destroy future follicles.
- Radiation therapy, including radiotherapy.
- Autoimmune diseases, including disorders of the thyroid and adrenal glands – damage to ovarian reserve occurs both due to the disease mechanisms themselves and the side effects of certain medications used for treatment.
- Surgical interventions on the ovaries or their supporting structures.
When one of the most important decisions in life – becoming a parent – depends so heavily on this hidden biological clock in our bodies, it is essential to understand it as much as possible in order to plan and make informed choices.
The option of preserving future fertility is provided by egg freezing for social reasons (social freezing).
How is ovarian reserve assessed?
Several tests are required in order to evaluate a woman’s ovarian reserve. Unfortunately, these are not part of routine gynecological preventive care. They are usually prescribed only after consultation with a reproductive specialist, when difficulties with conception have already arisen. As a result, many women who otherwise regularly monitor their reproductive health may remain unaware of any decline in their ovarian reserve, especially since this process occurs silently, without any symptoms.
Any woman who is planning a future pregnancy can take proactive steps and undergo ovarian reserve testing, particularly if she has risk factors for premature depletion, as described previously.
Hormonal blood tests:
AMH (Anti-Müllerian Hormone) – produced by granulosa cells of early developing antral follicles. This hormone can be measured on any day of the menstrual cycle and reflects the number of remaining eggs. Low AMH levels indicate a reduced or depleted ovarian reserve. Its levels decrease proportionally with the decline in the number of remaining eggs. AMH is considered by specialists to be the most accurate and reliable marker of ovarian reserve. A note of caution: if you receive an unexpected result, it may be worth repeating the test, as AMH is known to be somewhat variable and results may differ between laboratories.
FSH (Follicle-Stimulating Hormone) – measured on the 2nd or 3rd day of the menstrual cycle and provides important information about ovarian reserve. This hormone is produced by the pituitary gland and stimulates the ovaries each month to develop a mature egg. As ovarian reserve declines with age, higher levels of FSH are required to stimulate follicle development. FSH levels may vary from month to month, but elevated values – even a single measurement – can be a warning sign of reduced ovarian reserve. However, low levels do not always guarantee good ovarian function. For proper interpretation, FSH is usually evaluated together with two other hormones: LH (Luteinizing Hormone) and E2 (Estradiol).
LH (Luteinizing Hormone) – produced by the pituitary gland, it stimulates final follicular maturation, ovulation, and follicle rupture. Measuring LH in the early follicular phase (day 2–3 of the cycle) helps interpret FSH results correctly, and the ratio between the two is an important clinical indicator.
E₂ (Estradiol) – the main female sex hormone, playing a key role in ovarian function. It is secreted by the growing follicle, and its rising levels signal the pituitary gland to reduce FSH production. However, if estradiol rises too early in the cycle, it may artificially suppress FSH levels, making an impaired ovarian reserve appear normal. Therefore, estradiol measurement helps determine whether the FSH result is reliable or should be repeated in another cycle.
Gynecological ultrasound examination
A transvaginal ultrasound is used to assess the number of visible antral follicles in the ovaries and complements the information obtained from hormonal tests. It provides the reproductive specialist with a basis for a final evaluation of ovarian reserve. Although this number may vary between cycles, it offers a quick and useful “snapshot” of ovarian function.
It is important to emphasize that correct interpretation of all test results can only be made by a reproductive specialist, and always in combination with ultrasound findings.
Our specialist on the topic:
Dr. Georgi Stamenov:
“In previous centuries, it was believed that the primary role of every woman was to get married and have children. Today things are different. It still remains true that a woman is meant to continue life, but she also needs to take care of many other aspects of her personal development before becoming a mother – to seek fulfillment, stability, and a suitable partner, which is not an easy task in today’s world. That is why egg freezing is essentially nothing more than a promise of future motherhood.”
– About the modern woman’s choice to plan her future;
– About the secrets hidden within the egg cell;
– Whether time affects it;
– About the possibilities for quickly and reliably preserving eggs here at “Nadezhda” Hospital.”
