EGG FREEZING & FERTILITY

What does fertility have to do with art? The incredibly intricate design behind the female body.

​I'll start by saying that this post is written to share my experience with egg freezing and not to express my opinion about it for others. Everyone's body is so different and there's no one experience here that can possibly be the same. I'm writing about it because I learned a lot that I didn't read on the internet, nor was told by medical professionals. If I'm being honest, this was one of the most physically and emotionally draining things I've ever done. That being said, I have so much gratitude for my body and the modern science behind fertility. ​

Over the past few years, I have had multiple friends express their concern about my fertility...specifically that I was 35 and unmarried. I was never offended by it, but often turned off by their opinions that I should be concerned. I have always been free-spirited, positive, and optimistic that I will get what I want out of life. I've also always been hesitant to mess with fate. But after the fifth or sixth friend approached me about it with genuine concern, I heeded their advice and called a fertility clinic.

Initial Testing
I signed up for what's called a Fertility Evaluation Package. The evaluation takes a deep look into your egg health, follicle count, and medical history. The consultation is a flat fee of $500 and consists of some lab draws and an ultrasound. You can choose whether you want to freeze your eggs (unfertilized) or freeze embryos (fertilized). 

A week after the tests, I was called back to the clinic for my results. I found out that my physical health was in top shape, but that my AMH (Anti-Müllerian Hormone) levels were below average for my age. This is the hormone level that helps to indicate ovarian reserve and the ability to produce healthy and mature eggs during ovulation. I measured at .73, while the average of someone my age should be closer to 1.7. Because of this result, I decided to go ahead with the egg freezing process. 

I opted to do a deep cleanse before freezing my eggs. I stopped drinking alcohol, cut out all caffeine, started running again, and stayed as active as I could. I did everything I could to be in positive surroundings. I lost 5 lbs (a results from going off of birth control and not drinking), my skin was glowing, and I felt amazing. I began this cleanse in March with the intention of doing it for a month or two, but it lasted for almost 6 months since I didn't have a "successful" retrieval until September.

How Much Egg Freezing Costs
Let's talk about this first. I don't usually divulge how much things cost, but I do feel it's important to share this information since I was completely in the dark about it. There wasn't a lot of documentation when I started researching the cost of "Ooctye Cryopreservation" -aka- egg freezing. Most of the articles I read quoted the process at around $6,000. The fertility package that I purchased was itself $7,000, and I was completely unaware that each round of medications would cost another $5,000-6,000 on top of that. In addition those costs, there are also Coordination of Care fees and fees for procedure anesthesia. There are also multiple supplements that you need to take during this time. On average, I was consuming 20-25 pills a day, average over $100/month. And don't forget about the initial testing fees.

I went through multiple rounds of injections, totaling over $22,000. On top of the cost listed above, it also costs $500/yr to store your eggs. As of today, I plan to store mine for 5-6 years, so let's just estimate that $25,000 will be my total cost. I had not anticipated this large of an investment, and I can tell you right now, had I known it was going to cost that much, I would not have signed up for it. Once I began the process, I really felt like I needed to keep going since I had "already paid for it". What's crazy is that I'm still getting bills in the mail from the clinic and other vendors.

Please note: The above total only accounts for freezing your eggs. There are additional costs for actually utilizing the frozen eggs for IVF.

How the Protocol Works
Everything I read online said that the process was pretty simple and painless. I know everyone's bodies are different but that was not my experience at all. Here's exactly how my protocols worked:

Round 1 - June, 2019 

1. Purchase medications. Round 1 = $6,000
2. Go off of birth control. I'd been on it for over 20 years and I was nervous to put my body through this big change.
3. Take a low-dose birth control pill for 2 weeks as prescribed. Simple. 
4. Go in for a few rounds of blood work and ultrasounds to detect ovulation.
5. Begin injections. Eek. 

During my first round, I was on three injections a day, two in the morning and one at night. They go right into your lower abdomen and help to increase follicle quantity and growth. I was responsible for mixing my medications and injecting them into my body myself. There was a lot of room for error so I really took my time for these injections. Only one of the medications was painful, and it stung like hell - Menopure. It was hard to get used to sticking a needle into human skin - I had to push a lot harder than I had expected. After a few days of multiple injections I was already running out of places that weren't sore on my stomach, but I physically felt great otherwise.

After the fourth day of injections, I went into the clinic for an ultrasound and blood work. This was my first check-in after starting the injections to see how my body was responding. I received a call later that day to let me know that the protocol wasn't working and that I needed to stop the process all together. I received the news at work and was in total shock. I was devastated. Had I done the injections wrong? Did the doctor pick the wrong protocol? Did I buy the wrong supplements? Was there something wrong with my body?

The sadness turned to anger when I thought about the $6,000 worth of medications in my refrigerator that I had purchased and was now stuck with. I was so mad when I thought about all of the sacrifices I had made over the summer to go through this process. I talked to my family, boyfriend, and friends about how I was feeling. I took some time to reflect over the next few days and ultimately decided that I wanted to try a second round. I had already invested over $13,000 and was determined to make this work.

I started my second round a few months later after giving my body some rest and enjoying the summer without all of the previous rules and regulations. 

Round 2 - Aug, 2019

1. Purchase medications. Round 2 = $6,000
2. Take a low-dose hormone pill for 2 weeks. Easy.
3. Go in for a few rounds of blood work and ultrasounds to detect ovulation.
4. Begin injections. Double the strength of the first round.

I was on 5-6 injections each day this time. I had only gotten through 3 1/2 days of injections my first round and was nervous to pump my body with such strong levels of hormones. On the fourth day, I went in, again, for a blood draw and an ultrasound. I was so anxious because this was the appointment that determined my failure the first round. I received a call later that day that everything was on track and that we could keep moving forward.

I was on injections for the next 18 days and the doses increased. There was the introduction of a new injection that helps to prevent ovulation. The science of growing the eggs while trying to keep them from releasing was really fascinating. I went into the clinic every day for blood draws and ultrasounds to check on the follicle count and sizes.

During this time, I was very careful with my body, but I did try to live my life as normally as possible. I walked for hours a day with my dog to get exercise since you have to avoid a heightened heart rate or abdominal movement. I still went boating, and to weddings, and even a music festival - I was literally doing injections out of a cooler in the car before a concert - doable but you need to plan (and no alcohol for me). And yes - you still can (and should!) have sex. I wrongly assumed to avoid it to be extra careful while the eggs are overgrown but my nurse highly suggested anything to help raise estrogen levels. 

Each day, I got a call with the green light to move forward with the next day's set of injections. On the 20th day, I received instructions to take my "trigger shot". The trigger shot is what tells the eggs to release so we can actually retrieve them. The needle is BIG (see the first image in this post), and you have to insert it into your butt cheek. It's better to have someone there with you (my sister FaceTimed me during the event which was funny and comforting at the same time). Two days after the trigger, I was finally in the clinic for the retrieval. I had made it.

The Procedure
Trip came to the clinic with me for the procedure and I was so thankful to have him there. You aren't able to have anything in your stomach for 12 hours before the procedure so I hadn't had even a sip of water since the evening before. I put on a gown and met with the anesthesiologist to go over the next steps. Within a few minutes, my doctor was in the room and we were counting down from 5. The next thing I (kinda) remember is waking up with Trip next to me in the recovery room. 

Results
The procedure from start to finish took less than 30 minutes but I was fully sedated for it. In the end, only 2 eggs were extracted during my retrieval. We had hoped for 10-12. 

I received a call from the clinic four days after my procedure letting me know that they were only able to preserve 1 egg. We had measured 10 growing follicles in the days before my retrieval, and were on the right track to extract multiple eggs. I know that the preferred number on extraction was 12 eggs, so I was devastated by the results. I tried to keep a positive attitude and am thankful to have one frozen egg, but it was not the result we had hoped for.

I was able to meet with my doctor a few weeks after I had learned of my results. What I learned after talking to her is that I, simply put, am moving toward low fertility. The results of my extraction were a direct indication of this. My life decisions were never dictated by the notion of a ticking biological clock, but it's a real thing. 

Recovery
I read that the recovery was minuscule, but again, I would totally disagree and felt ill-informed about it. I slept for 24 hours straight. I had serious cramping in both ovaries for almost 4 days after the procedure. ​I took almost the entire prescription of pain killers, which I had hoped to avoid. I was also bloated for four months after my procedure - my body had a hard time bouncing back.

Frustrations
The hard aspects of this process were:
1. The clinic conducted all of my initial tests while I was still on birth control which would result in compromised hormone levels and, therefore, test results. I told them before I began any testing that I was on it, but they were "surprised" to learn I was still on it when we started the protocol. This may seem like an obvious thing, but no one told me and I didn't know. 
2. The clinic also had me begin my injections only a few weeks after going off of birth control. That also compromised my hormone levels. It would have been more effective to take a few months between going off the pill and starting the injections to allow my body to adjust back to its natural state before beginning the process.
3. It cost me 4x what I had originally anticipated.
4. I only have one egg to rely on for IVF, should I ever need it.
5. Going to the clinic every day is time consuming. Having your blood drawn 12 days in a row gets to be a lot.
6. It took 8 months from the time I booked my initial fertility evaluation to the time of my actual procedure and really consumed my headspace during that entire time.

That being said, I am so grateful for my family, friends, and especially Trip during this experience. There were days where I was depressed, overwhelmed, ill, and extremely angry. While I had a smart doctor and (mostly) really kind nurses, mistakes were made that were emotionally and financially exhausting. 


Lessons Learned

1. There are a LOT of needles. You can have someone help you with the injections but they are easy to do and mostly painless. You get used to it quickly and by my second round, I felt like a pro. 
2. Hormones make you hormonal. Try to pay attention to how you're feeling and talk about it with loved ones.
3. Ask questions...especially the hard ones. Care professionals don't necessarily know what you don't know. Don't be afraid you'll sound dumb. You're not dumb,
4. Pick a clinic you trust and go with your gut. You will be in close contact with your nurses.
5. You have to do injections every day...you can't travel without them and some need to be refrigerated. This process is better done when you have a few weeks at home. 
6. There are some "no's" during cryopreservation. I avoided caffeine and alcohol pretty much all together. I haven't tried it yet, but no Botox for patients undergoing fertility injections.
7. The injections can create bruises around your abdomen. They are noticeable and at the end, my whole stomach was purple and green.
8. My fingernails and hair grew like crazy. It also completely reversed my electronic hair removal which I am now in the process of re-doing. Recommendation: do laser after you freeze your eggs.
9. You have to be very careful exercising. Your ovaries grow from the size of almonds to tangerines. Some exercises like twisting put you at risk for ovarian torsion. Put your gym membership on hold if you can.
10. Use backup contraception.
11. It took months after the procedure for my body to return to normal. It had just been through a lot.
12. Account for recovery time after the procedure. You won't be able to go back to work the same day. I'd say my full recovery was around 4 days.
13. Treat yourself! This is not an easy process and you deserve a lot of credit for going through it.

Final Thoughts 
I wish that I had talked to people who had gone through the process before making any decisions. Don't listen to everything you read online. I firmly believe that my decisions would have been very different if I had more information in the beginning. That being said, I would absolutely advise taking the fertility evaluation if you have any concerns about your fertility health. This experience has helped me to better prepare for my future, have the hard conversations with my partner and my family, and appreciate my body's ability to go through this process. I am thankful to have a frozen egg should I need to use it. The human body is such a piece of art and I am grateful for mine.