Have you ever looked at someone’s baby and your ovaries started hurting, but you thought - Hmmmm, not right now, thank you!
Or think back to the immensely popular scene in My Cousin Vinny with Marisa Tomei stomping her high heeled boot on the wooden porch, frustrated by her ticking biological clock. When I was much younger, I laughed at her heartfelt outburst - now, I just want to hug her and empower her to have an active role in her fertility journey.
Egg freezing is a conscious decision some may consider, but many women are simply not aware of their reproductive options. The key to this is education: The more healthcare providers educate their patients, the better equipped these women will be to make informed decisions about their future fertility instead of just “being along for the ride.”
Oocyte cryopreservation, the medical term for egg freezing, involves stimulating a woman’s ovaries to produce multiple eggs for retrieval and freezing them so she can attempt pregnancy at a later date. There are a variety of reasons a woman would choose to freeze her eggs...Delaying one’s biological clock to allow the opportunity to have more time for further education and career growth, finding one’s true partner in life, or focusing on life-saving medical treatment that may result in infertility. No one should feel pressured into a decision but it’s vital to help raise awareness so women don’t regret not knowing their options.
This medical procedure is not right for every woman and while there is no guarantee that a frozen egg will lead to a pregnancy and live birth, it can increase your chances for conception later in life with your own eggs when fertility naturally declines.
Choosing to freeze eggs offers a sense of control in a time when so much is out of our control in society. Read on for the quick lowdown on how it’s done and some considerations to think about in advance.
The first part of the process is completing diagnostic tests which typically requires a simple blood test and transvaginal ultrasound to assess ovarian reserve in the early part of the menstrual cycle. The results will aid your reproductive endocrinologist (fertility doctor) in determining which medication protocol and dose will yield the best outcome for your cycle. Once testing is complete, your physician and care team will provide a basic timeline and help you prepare for the egg freezing cycle - you know, like teaching you how to give yourself injections!
At the official start of your egg freezing cycle, around menstrual cycle day 2, a blood test and transvaginal ultrasound are performed to confirm your hormone levels and ovaries are appropriate for stimulation medications to begin. The purpose of stimulation medications is to cause the ovaries to develop multiple follicles to grow and mature before retrieval happens. This medication is self-administered by subcutaneous injection for an average of 8 to 12 days. During this time, about five to seven monitoring visits are required to assess your progress and adjust medication dosage to optimize outcome if necessary. There is minimal interruption to work or daily life activities as most clinics offer early monitoring hours to help get patients in, out, and on with their day!
Once the follicles have reached the appropriate size and it is time for your egg retrieval to be scheduled, you will take a trigger injection to prepare the follicles for the retrieval to occur. The retrieval procedure is completed in less than the time it takes to get a pedicure, though you will arrive at the office early to meet with your fertility team for instructions and IV placement. Your physician should review what to expect and once again give you an opportunity to ask any last-minute questions that might have come up - bring a list with you so you don’t forget something important you want to know during this exciting time.
The retrieval itself is pretty quick and only takes about 20 to 30 minutes. Light sedation is given so you are asleep and don’t feel or remember anything but you’ll be breathing on your own and will wake up just a few minutes after the retrieval is finished. Once you are feeling well, able to drink, and go to the bathroom the clinic should let you leave the office and head home for the rest of the day. There must be a responsible adult present to drive home as there is no driving after receiving anesthesia on the day of the retrieval. Following the retrieval, the more commonly experienced symptoms are bloating and slight menstrual type cramping, though the easier a woman takes it on herself following the retrieval, the faster she’ll get back to normal. Many women are fine to return to work and most normal activities without overdoing it the next day, as long as it’s not manual labor, while others take a little more time to take it easy.
Once the retrieval is complete, the eggs can be frozen for a minute, a month, a year, or indefinitely until you are ready to make a decision on using them if and when it’s right.
*Disclaimer - All fertility clinics are unique in their procedure policies; this brief process description is a basic overview of what occurs in a general egg freezing cycle.
Important Questions To Consider
I’m going to take a few moments to review some of the frequently asked questions many women have while gathering information so they can gain clarity and make an informed choice they are confident with.
What if I decide not to use my frozen eggs?
They can either be discarded or donated for research. This is the benefit of freezing eggs instead of fertilized embryos avoiding the internal battle of the ethical dilemma that is often present when discussing what to do with frozen embryos.
How much does this whole thing cost?
Unfortunately, the majority of insurance companies consider this an elective procedure and they do not typically cover it. Many clinics strive to keep the treatment at a low cost though and there may be financial savings packages for treatment or creative pharmacy programs offering more affordable medications to save money. Don’t forget to factor in the cost of storing the eggs and make sure you know your coverage for both treatment and medications so you don’t have any unexpected financial surprises.
How will I ever be able to inject myself?
It’s amazing what you can do when you want something bad enough and I promise it’s not as bad as it seems. Your fertility team should make sure you are extremely well prepared and comfortable before beginning any medications. It’s important for you to understand what the purpose of the medication is as well as how to mix and administer it before you take your first injection. Your clinic may offer injection training classes and can direct you to online videos available to watch in the comfort of your home.
What symptoms will I feel?
Many women do not have the dreaded insane mood swings with the injectable medications used in IVF but it’s certainly possible to have some ups and downs during this emotional time with added fuel to your hormones. I will be honest though, it is not uncommon to gain a few pounds during an IVF cycle. Bloating can begin after several nights of medication when the ovaries start responding and follicles are growing and can become worse after the retrieval before it gets better. There are ways you can be proactive and minimize your discomfort as well - make sure to discuss specific recommendations with your fertility team.
Is there a guarantee I will get pregnant in the future?
There is no guarantee that freezing eggs will definitely give you a baby in the future. Freezing eggs does provide some peace of mind that you will have a chance for a biological child in the future if you are unable to conceive on your own. As an example, if you were to freeze eggs when you are 33 years young and then try and use those eggs at the age of 43 years old, there is a higher chance of getting pregnant from better quality eggs with the lower risk of chromosome abnormality frozen when you were 33 and a higher chance of producing a normal child. While no one should promise you a guarantee, the more eggs you have frozen, the better your chances of conceiving if you return to use them - think lottery tickets, the more you have the better your chance to win. The eggs need to survive the freezing and thawing process, fertilize with a partner’s sperm or your selected sperm donor, and grow to embryos that can be transferred for a potential pregnancy. It’s important to select a fertility clinic with an excellent embryology lab with validated experience and both good freezing and thawing rates (hint - this is a good question to ask your physician).
Will I regret it if I don’t do it?
The decision to bank eggs is personal - no one should push you to choose. There is no right or wrong choice as every single woman’s situation is unique. The best advice I can give is to make the decision that will leave you with the least amount of regret. Would you regret not freezing your eggs if in the future you faced infertility? Or would you regret freezing your eggs, if you don’t actually use them down the road?
No one can tell you the answer that is right for you, but it is important to be sure that you are making an informed decision and taking control of your reproductive options. It’s a meaningful decision leaving most women feeling relieved and empowered whichever direction their future fertility goes.
To feel more comfortable going through treatment, check out my IVF Coaching Program for a true ally by your side at each step of the journey. Knowledge is power and I spend considerable time prior to the start of your cycle ensuring you fully understand your treatment protocol, medications, and details of each phase of the IVF cycle. Embrace Fertility is here to educate and support women so they feel both confident and comfortable before, during, and after their egg freezing cycle.