Egg freezing, or oocyte cryopreservation, is a method of fertility preservation that involves retrieving and storing a woman’s unfertilized eggs for future use. An Intrauterine Device (IUD) is a small, T-shaped contraceptive device placed inside the uterus to prevent pregnancy. Many individuals who use an IUD are also considering egg freezing. This raises a practical question about whether the two procedures are compatible. This article addresses the relationship between having an IUD in place and undergoing ovarian stimulation and egg retrieval.
Compatibility of IUDs and Egg Freezing
Generally, an IUD does not need to be removed before egg freezing. Having an IUD in place is not a barrier to starting a cycle, which avoids the discomfort and cost of removal and reinsertion. Compatibility stems from the distinct anatomical locations involved. Egg freezing targets the ovaries, located outside the uterus, while the IUD is positioned solely within the uterine cavity. Studies show that both hormonal and non-hormonal IUDs do not negatively affect the quality or quantity of eggs retrieved.
The Egg Freezing Process: Stimulation and Retrieval
The egg freezing process begins with ovarian stimulation, where injectable hormone medications called gonadotropins are administered for about 8 to 14 days. These drugs stimulate the ovaries to mature multiple follicles, rather than the single egg matured in a natural cycle. The IUD in the uterus has no impact on this hormonal process. The final step is the transvaginal ultrasound-guided egg retrieval, a minor surgical procedure performed under sedation. During retrieval, a thin needle is passed through the vaginal wall directly into the ovarian follicles to aspirate the eggs, bypassing the uterus entirely.
Hormonal vs. Non-Hormonal IUD Considerations
The type of IUD may introduce slight nuances, though both hormonal and non-hormonal devices are generally compatible with egg freezing.
Non-Hormonal IUDs
Non-hormonal IUDs, such as the copper IUD, work purely by chemical irritation and do not release hormones that interact with stimulation medications. Therefore, the copper IUD presents no conflict with the egg freezing process.
Hormonal IUDs
Hormonal IUDs release a small, localized dose of progestin into the uterus. While some studies suggest these IUDs may require a slightly higher dose of Follicle-Stimulating Hormone (FSH) for stimulation, they do not compromise the final outcome. The high-dose gonadotropins used for ovarian stimulation typically override the minimal, localized hormonal effect. Research indicates that women with hormonal IUDs achieve a comparable number of mature eggs retrieved as those without an IUD.
Preparing for Retrieval: What to Discuss with Your Doctor
Before beginning the cycle, provide your fertility specialist with full details about your IUD, including the specific type and insertion date. Sharing this information allows the medical team to make informed decisions about your stimulation protocol and monitoring. A routine part of the consultation involves discussing the IUD strings, which extend through the cervix into the vagina. The doctor will confirm the strings are in a safe position and will not interfere with the transvaginal ultrasound or the retrieval needle guide. Only in rare circumstances, such as an active pelvic infection or improper positioning, might a physician recommend temporary removal.