Introduction
With Singapore’s new policy allowing social egg freezing for single women starting in July 2023, I embraced the opportunity to begin this journey. My aim in sharing my experience is to provide you with valuable insights if you’re considering this path. I want to offer a deeper understanding of the time, commitment and financial costs involved. I hope my experience can be a source of knowledge for anyone interested in this process.
Read more about the egg freezing process as explained by fertility clinics here, here and here.
Read more about my personal reflections at the end of cycle one of egg freezing.
Elective Egg Freezing : The process in numbers
# of self- administered injections — 16
# of doctor consultations — 6 x 30 minutes (including first consult)
# surgeries — 1 day surgery, under general anesthesia
# of days of medical leave entitlement — 3 (1 hospitalization and 2 medical leave)
# of days of extreme post-op fatigue — 4
# of days no exercise — estimated 6 weeks (since second week of jabs)
# of types medication taken (supplements included) — 9
Total bill for one cycle : $11,500 (approximation w/ GST)
Step 1 : Doctor and fertility centre selection
Given that my firm’s insurance covers the procedure, I had to select from their approved panel of doctors. In my choice, I prioritized (i) an IVF specialist, (ii) a female physician, and (iii) the clinic with closest proximity to my home, especially since I currently work remotely full-time. Since I had no plans to relocate abroad, I didn’t explore centers offering egg transportation services.
Stage 2 : First consult and mandatory counselling
I scheduled my initial consultation with the doctor to align with the beginning of my menstrual cycle, as advised by them, in order to facilitate hormonal level testing. I took a blood test and had a first consultation with the doctor where she assessed my motivations.
On the very same day, a nurse from the affiliated fertility center reached out to me, to arrange for an extensive 1 hour counseling session, which I completed within the same day. During this session, they provided detailed information regarding (i) the timeline for the entire process, (ii) the assorted risks associated with it, and (iii) what to anticipate in terms of the effectiveness and outcomes of the egg retrieval. I had to sign some consent forms.
Stage 3 : Second consult and start of hormone injections (Day 4 of menstrual cycle)
Singapore regulation requires a 14-day waiting period between the counselling session and the actual start of the egg freezing process. It was about a month before I got in touch again with the clinic.
I had to give the clinic a heads-up when Day 1 of menstruation came knocking, so as to schedule my next appointment on either Day 3 or Day 4 of my menstrual cycle. The consultation included an ultrasound scan to assess my ovarian health and address any lingering questions after the mandatory counselling session. The doctor also reviewed my hormone test results and decided to place me on the antagonistic treatment plan. I also started my daily Gonal-F (FSH — follicle stimulating hormone) that day in the doctor’s clinic where the nurse demonstrated an injection on me. Alongside that, I was prescribed a daily supplement called Revosit and had to take 10 tablets of Letrozole to support my egg development
The Gonal-F injections weren’t too difficult to self-administer and surprisingly not very painful (possibly thanks to my well-endowed abdominal area).
Watch an instructional video of how to administer a Gonal-F jab here.
Tip : Once the time for the first injection is established, the subsequent daily injections have to fall around +/- 1 hour in that time frame, so choose the time that works for you! I had to continue this routine for 9 days. It is also helpful to alternate sides when injecting, meaning if you jabbed on the left side of the abdomen yesterday, go for the right side the next time.
Stage 4 : Third / Fourth consult and review of follicle count (Day 8 / Day 10 of menstrual cycle)
During this visit, the goal was to see how my follicles were responding to the Gonal-F injections. At that point, I had 23 follicles, but they were growing larger, more numerous, and quicker than expected, and they were doing so in a somewhat scattered manner (for example, the smallest one was around 1.2cm while the largest had already reached 2.1cm, with maturity typically at around 2.5cm). To address this, the doctor decided to reduce my Gonal-F dosage. Additionally, I was given Orgalutran (Antagonist) syringes to start using daily. These antagonist injections help prevent the larger follicles from getting even bigger. The Gonal-F injections continued alongside this new addition.
Watch an instructional video of how to administer an Orgalutran jab here.
Tip : Orgalutran injections really hurt! Mainly because of those larger needles on the syringe. The clinic nurse gave me some tips to make it easier — she suggested pinching more fat while injecting, and to release the pinch as I pushed down the plunger to prevent any bruising. I managed to get the hang of it but the pain usually kicked in a few minutes after the injection, kind of like the twinge you might feel after getting a COVID vaccine shot. To manage two jabs in a day, I did an upper and lower abdomen strategy (whilst continuing the left, right strategy).
Stage 5 : Fifth consult and the barrage of instructions (Day 13 of menstrual cycle)
The doctor counted my follicles one last time and decided when it was time for the egg retrieval surgery. This also determined when I needed to do the trigger injection. They prescribed Decapeptyl (instead of a hCG), which I had to give myself at 10 pm that night. The surgery was scheduled for 36 hours later. They also gave me a 5-day course of Augmentin to start the night before the surgery and Vivomixx supplements to start right away. That night, I had to give myself a total of 3 painful injections.
Summary of process to date : Contrary to what I’ve read online, I experienced almost no side effects during this process. No PMS symptoms, no bloating or unexpected weight gain, no injection pain, and no bruising. I guess I’ve been pretty lucky in that regard. However, my ovaries were pretty swollen, about the size of oranges. It was so sensitive that when my cat accidentally stepped on my abdomen, it hurt like crazy. I had also stopped all forms of exercises due to the dull pain and for my own safety. The doctor advised against jogging, zumba and any twisting actions.
Stage 6 : Egg retrieval surgery (Day 15 of menstrual cycle)
I had to be at the hospital early by 9:15 am for a 10:00 am procedure. The pre-surgery preparations were surprisingly straightforward — just some paperwork to fill out, and a quick change into hospital scrubs. I also needed to arrange for someone to pick me up around three hours after the estimated 30-minute surgery, which should be roughly around 2:00 pm if everything went smoothly. At 10am, I was led to the operating theatre.
I quickly found myself hooked up to several machines, monitoring my blood pressure, with an ECG on my chest, and an O2 level monitor on my finger. The anaesthetist was pretty spritely and was enthusiastically explaining everything that was going to happen, probably to calm me down as he knew it was my first time under general anesthesia. A “simple procedure” he called it, which included a cocktail of Lignocaine (local anesthesia), Augmentin (Antibiotics), Ondansetron (anti-nausea) and finally Propofol and Fentanyl (general anesthesia).Once the general anesthesia was pumped in me, everything went black for a few seconds and before I went out cold.
Before I knew it, I felt the anaesthetist forcefully tapping both my shoulders, waking me up from my anesthesia-induced slumber. The fertility doctor who was right beside me shared the good news — they had retrieved a total of 13 eggs, which were being sent off to the embryologist to determine which ones were healthy enough for freezing.
I felt surprisingly okay and, to my relief, not a hint of pain. The nurses wheeled me back into the ward. For this surprisingly simple surgery, I counted a total of three doctors (fertility, anaesthetist and embryologist) and four nurses in the theatre.
Before they discharged me, the nurse had to check my urine for any signs of continuous bleeding before I could go home.
Stage 7 : Post-operation recovery
Right after the surgery, those first couple of trips to the bathroom felt uncomfortable, like a dull pain when you attempt to pee. I could also not stand up straight for two days, having to slouch on the couch or just lie in bed for hours.
I found myself needing an extra 3 to 5 hours of sleep during the days that followed. Normally, I’d feel sleepy only around midnight, but during those days, I was nodding off by 10 pm, despite getting plenty of shut-eye in the afternoon. Due to extreme fatigue, I never left the house. I only left the house on Day 4 post-op for lunch and dinner outside. Even then, I had to rush back home immediately to catch up on sleep.
The doctor did mention there might be some side effects, like colicky pain in my lower abdomen, but that only kicked in on Day 3 after the surgery. Surprisingly, I didn’t experience any bleeding or bloating, just an overwhelming sense of exhaustion.
My post-op medication regimen included Dostinex (anti-bloating medication), Augmentin (antibiotics) and continued Vivomixx supplements. I was also prescribed some painkillers but I never used them.
Final Stage : Final consult and results review (Day 6 post-op)
During the final consult, the doctor confirmed that 11 eggs had been successfully frozen in this cycle, which she assures me is a reasonable outcome given my diagnosis of PCOS. She suggested a second round of social egg freezing and advised me to focus on improving my nutrient intake, particularly by taking more Revosit and Vitamin D, for at least 3 months before proceeding. During the ultrasound scan, my ovaries were still five times the normal size, akin to the size of oranges instead of their normal walnut size. As a result, she recommended extending the exercise restriction for another 4 weeks. I guess I can only take gentle walks from now.
Financial Costs of one egg retrieval cycle (quotes exclude GST)
Mandatory Counseling — $67
Hormone Blood Test (to evaluate suitability for elective egg freezing) — $280
6 x Consultations — $570
5 x Ultrasound scans (during consultation) — $450
Hormones — $2,580
Supplements (Revosit & Vivomixx) — $190
Medication (Antibiotics, anti-bloating, painkillers) — $330
Surgery package (includes 2 years of storage fee) — $3,800
Doctor surgery fee — $1,620
Anaesthetist surgery fee — $600
Closing thoughts
Read more about my personal reflections at the end of cycle one of egg freezing.
Even when the financial aspects are covered, I realized there’s a significant personal effort required in this process. It means overcoming one’s fears of surgery and needles, making time for regular doctor appointments (which might not always align with a typical work routine), ensuring a refrigerated place to store those daily injections (inconvenient for those who try to juggle annual leave, traveling and egg freezing due to limited days off), and being prepared for potential side effects such as bloating and PMS, along with the restriction on physical activity due to swollen ovaries. Moreover, given the significant time and financial investments required for each cycle, it’s advisable to consider dietary adjustments to enhance the quality of the collected eggs (I skipped coffee and alcohol the entire period), but alas one needs to start at least 3 months ahead for any visible results..
To those who might be uncertain about embracing motherhood, I can understand the apprehensions. Nevertheless, I would wholeheartedly encourage anyone who desires it to pursue this path before the window closes.