Clocking in: one scientist’s decision to freeze her eggs; the logistics (3/3)
This is a three part story about my journey to freeze my eggs. In part 1 I discuss the science and process of egg freezing. In part 2 I discuss the motivation behind why I chose to freeze my eggs. In part 3 I discuss the detailed logistics of the procedure as they pertained to my particular case.
This section may be of most interest to people considering going through the procedure themselves (either egg freezing or IVF, which involves a similar course) to get a picture of the logistics and costs involved. Part 1 and part 2 of this blog series are of more general interest, but this part contains some neat pictures: the eggs retrieved, my ovaries, the injection setup, etc. that warrant a skim.
As detailed in parts 1 and 2 of the series, after researching the science and fixing on the philosophy, I decided to freeze my eggs. I did further research to decide on a fertility center. I chose to go with USC Fertility, which is a nearby center (I am based in LA) associated with USC. They are on the cutting edge of fertility research, each doctor is associated with both research and practical cases using state of the art proven techniques. I saved up for, and paid cash for the procedure. In total, the procedure cost me about $10,000, a price tag which included medicine, doctors visits, consultations, and an operation under anesthesia to retrieve the eggs.
I started planning for the procedure about 6 months before undergoing it, doing research, choosing USC, and picking Dr. Bendikson as my physician. Dr. Bendikson is a lively, young, very blonde doctor who showed up to my surgery in fantastic heels. She has a family herself, is a professor, distinguished surgeon and researcher, and her sense of balance appealed to me during my research and initial consultation.
I have an IUD. I was on my second before the procedure, now am on my third, and I can only rave about the Mirena IUD. It has allowed me to be without a period for 8+ years and provided the most effective form of birth control, only requiring maintenance every 5 years to boot! After the initial consultations, I decided I would remove my IUD. Research was inconclusive as to whether this form of birth control/period regulation would cause any issues with the egg retrieving cycle or with their use down the line; the statistics were simply too small. Since I had control over this portion, I chose to remove my IUD and place it back in after the procedure.
Removing the IUD then became the bottleneck to starting the procedure. Since I was certain to get my period, I wanted to make sure I didn’t get it at an especially inopportune moment. I began to have “nightmares” about getting my period, these nightmares involved nothing more than a typical period but left me with the sweats. If you think about it, menstruating is pretty nightmarish, just something that most young women are accustomed to. It was a privilege to not menstruate for most of my 20s, and not going through the hormonal cycling and monthly bleeding made focusing on school and sports all the easier.
My health insurance did not cover the egg freezing procedure, although I was able to get fertility consultation from a renowned doctor in their network, a variety of the required tests, a referral discount of 20% for a portion of the procedure at USC Fertility, and my IUD removed and replaced under their coverage. All of which saved me an estimated $3,000 in total. All the tests indicated I was an excellent candidate for the procedure.
I looked ahead to my calendar to plan the timing of this and saw a long spell of traveling for work, Switzerland, the U.K., Poland. I had countless meetings, wrote a lot of code, gave several talks, and briefly slept in a castle. Then I came back to Southern California to do a 10 day silent meditation course (previously blogged about here and here) and had more travel on the horizon. None of these seemed like good opportunities to get my period or start the egg freezing procedures which would require me to be present in LA for their entirety and to abstain from sports.
Finally I returned and managed to schedule removing the IUD. Five weeks later I got the period I had “dreamed” of, and my medical team and I were able to start the egg freezing cycle.
The Cellfie and What Next
The operation extracted 17 eggs. 16 of my 17 later successfully frozen eggs are depicted here! There was a runt “+ one late PB” that was originally not mature at extraction but made the cut for freezing. All made it through the freezing process for a full 17/17 report card. In this photo, we can see in glorious detail that the egg is large: approximately the size of human hair or a period (.). In fact the human egg is the largest human cell.
It is possible one of my future children is depicted here! A miracle of science to be able to see and really special no matter what my future decisions are.
If I choose to use these at some point in the future, they are frozen in pairs. We would unthaw and fertilize the pair, implant one or both of them and hope for the best. Based upon how well that went, we could choose to unthaw more to do further implanting or testing. I wouldn’t need to do further shots, but prior to implanting I would need to again get my period and take some oral hormones for a few weeks. If I use these eggs, the worst and most invasive part (injected hormones and surgery) is over. Moreover, if I decide to try to get pregnant the old fashioned way yet run into trouble, I’ll have the option of benefiting from my past forethought and quickly proceeding with IVF vs. having to wait for potentially many cycles to retrieve enough eggs.
Egg Freezing: a day in the life
What follows is my “just the facts” diary of my life while freezing my eggs. The TL;DR is: I went about living it, and it’s possible to do so even while maintaining the logistics necessary. I include it here as I found such accounts lacking in my research and I hope it might help those considering the procedure, or supporting their friend or partner undergoing it.
On the first day of my period, I drove to the pharmacy, which specializes in fertility medicine, and spent $1,934 on drugs in cold hard cash.
I went into the office and got bloodwork done and an ultrasound (not to mince words, this involves sticking a probe up your vagina). They gave me a tutorial how to mix and inject the drugs. One, Follistim, came in a handy pen with the only disadvantage that it had to be refrigerated. I dial the dosage, found some fat around my belly button, poked in the needle and inject. The other, Menopur, had to be mixed in a multistep procedure and then injected in a similar manner.
Throughout the procedure I had little caffeine (black tea now and then) and no alcohol–this was par for the course for me, but such a regimine might be relevant for others, and is thought to increase fertility. I went in to work. I started the cycle that evening. I was set to do two injections each evening between 5 and 7 pm designed to grow my follicles (Follistem) and stimulate my ovaries to produce eggs (Menopur). This first day I poked myself with a needle, and bent one putting it in the sharps container. The injections didn’t hurt, but the Menopur was prone to leaving bruises. That evening I went to the Opera with my boyfriend.
I went in to work and did my injections in the evening.
I again visited the doctor’s, and I was set to visit every other day until the home stretch. I could do this in the mornings before work. I did my injections, visited their financial counselor, and wired $3,860 in cash to USCR for the surgery and $3,244 in cash to USC for the monitoring, appointments, and freezing. Day 3 I got offered my dream job, which I can take during a sabbatical offered by my prestigious fellowship! It’s a job I could never take (literally, it is not allowed) while pregnant, and would be extremely difficult to take with kids, so I was pleased to have yet another indication that I was making the right decision.
This day I also called a friend to discuss the important issue of who was to be the benefactor of my eggs should I die. This was important to me as I feel, even as my father is dead, his “meme” or meaning of his life is embodied in me. If possible, even if I die young I want my eggs to be used. This friend was so good as to offer to help make that possible (by finding a suitable person or couple who needed/wanted an egg donor). I’m thankful to have a god-eggparent in the event of my death to help fulfill my wishes and in the event that doesn’t work out willed my eggs to be donated to an egg bank. One day, after I’ve decided for sure how to use my eggs, I may decide to donate all or the remainder to a person or couple who has dreamed of getting pregnant but has been unable.
I ran errands. I took my evening injections. I watched the moon with friends.
I went into the doctor’s. Those big black dots are my follicles beginning to grow and the cluster outlines my ovary. One of them is already at 10mm on that side. This day I made the choice to travel to San Francisco to see a pre-screening of The Martian hosted by my friends at the VC firm Founders Fund in San Francisco. I chose to travel by bus rather than fly so I didn’t have to worry about checking my sharps container and drugs. If I were to be separated from the drugs and tools I needed to administer them I needed at the wrong time, I might have to halt the entire expensive and taxing procedure mid-stream. Checking them wasn’t worth the risk.
I put the Follistim on ice as it needs to be refrigerated and got on a Megabus to San Francisco and did some work on the bus. I injected my evening meds in the bathroom of a movie theater and promptly changed into a galaxy ball gown and 4 inch heels. This was one of the most absurd parts of the experience: having to inject in a movie theater bathroom. I met Andy Weir, who wrote The Martian, and had a great time!
While in San Francisco, I received a phone call from my doctor. Based on bloodwork it seemed I needed to be on a higher dose of medicine. I didn’t have enough to cover, and needed to do the pick up in LA — hundreds of miles away. I desperately contacted a colleague who was on a staycation in LA. She agreed to head to the special pharmacy to retrieve the medicine and saved me a lot of headache.
I called the pharmacy and prepaid for my next round, and my colleague picked up my dose of increase Follistim, setting me back another $500. I’ve joked that if I use the eggs one of them might bear her name! Thank you! I took the bus back to LA, worked on the bus, and got home just in time to inject my evening meds.
I went into the doctor’s. One of my follicles was over 14mm so they started me on Ganirelix, which was to be injected at a precise time (in my case 8:45am) every morning. This is to control ovulation. I injected that right at the office, and I discovered it was the easiest to use of the three injections I had done thus far; same procedure to inject only it came in its own syringe. I simply had to unwrap, inject, and throw in the sharps container at the right time. I went in to work. I injected my evening cocktail at home.
I changed into my short galaxy dress. I went to a fancy party at Hyperloop with venture capitalists and Mayor Garcetti, the mayor of LA, with my boyfriend. I saw Maye Musk, Elon Musk’s mother, and complimented her on her outfit. I met a friend, a successful entrepreneur in town, at a fancy cocktail bar in downtown LA, and he, myself and my boyfriend had some excellent meaty intellectual conversation, talking about AI and privacy compatible advertising, over (virgin) cocktails, a refreshing change from my cocktail of evening injections.
I injected in the morning. I went in to work. I got the information about my new job, and the physical and psychological exams I would need to undergo. I injected in the evening at the office in the bathroom. I started pilot ground school that evening. I injected in the evening, at work. I went to a party at the house of the President of Caltech.
I now began to go into the doctor’s every single day leading up to the surgery 3–4 days from this stage. I injected in the parking lot because I was a bit late. This was also surreal.
I went in to work. I flew and landed a plane 7 times in my flying lesson. I injected in the evening at home, and went hot tubbing at Kip Thorne’s place for a work social event.
I went into the doctor’s. I injected at the doctor’s. I again had to order one more day worth of drugs, because based on the results of the day they wanted to have my extraction on day 13 instead of 12 to allow the ovaries to grow just a bit more. This set me back another $500 or so but we worked it out so that I wouldn’t need to go in person to the pharmacy again, which I was thankful for. I injected my morning meds at home. I injected my evening meds at home. I went to some parties.
I asked about the effects of the surgery. The next weekend I had scheduled zero gravity flight, which had long been on the books and was non-refundable at this stage. I had previously thought that a few days after the surgery the physical effects would be over. I had realized by this point that my ovarian follicles were swollen and would remain so well after the surgery. As much research as I had done beforehand, I had missed this point, one of the reasons why I’m including the detailed diary as part of my writeup. The good news was that the doctor said I could see how I feel and to be sure to be gentle. They assured me that the hormones wouldn’t effect my physical qualification for my new job. I went in to work. I injected at home in the evening.
I went into the doctor’s and my boyfriend came in with me–he’s also a physicist but comes from a medical family and he stoically listened to the nitty gritty details of what was to come. They didn’t need to do an ultrasound this day, as the hormones to grow my follicles were at an end and the ultrasound was to guide their effective administration. Instead, they mixed my dosage of the shots which would trigger ovulation. I injected my morning meds at home. I went to a BBQ with work colleagues, a friend’s housewarming, and an art commune party. I injected, somewhere in there, my evening meds!
At 2am this day I took the first dose of the “trigger shot” to trigger ovulation, in my case the drug Lupron. I did not need to go into the doctor’s this morning. At 2pm I took the second dose of the trigger shot.
I did not need to go into the doctor’s this morning as I had my surgery at 12pm! Everything went well! They told me they got 17 eggs and that by the next day we would know how many were mature (usable) and had frozen. My boyfriend picked me up from the surgery, spent the whole afternoon and evening with me and made me pizza. I took the day off work but managed to do some reading.
Just one day later, and the minimum 24 hours after anesthesia I went and gave a physics colloquium at California State University, Northridge. I met with physics faculty all afternoon and went out to dinner with faculty. The doctor’s office called to let me know the good news that they had gotten 17/17 mature eggs that froze! Was so pleased to hear that the whole ordeal was not in vain.
I went on a zero G flight. I got my period again and called the doctor to schedule my followup appointment!
They reinserted my IUD. This was extremely painful and I expelled the first one and screamed quite a bit. The second one made it. I went straight after, still in much pain, to a dentist appointment required by my new job.
I had the followup appointment to my surgery to discuss results. I went into work. I had a flying lesson and landed a plane many times.
I went into work several times, flew planes several others, drove to Yosemite and went on a 14 mile hike.
I could get back to exercise that involved more than walking, and I published the first portion of this blog post series.