Field Guide to Egg Freezing

Many women have been asking me about the egg freezing process, so I wrote a summary of my experiences. I’m 32, and I recently finished 2 rounds of elective egg freezing, or ‘egg retrieval’ as doctors call it.

PSA: You only have to do two weeks of injections. That’s all. 2 weeks.

Why now?

Most women do it closer to mid-thirties, but I had several friends start the process earlier. You are more likely to get more eggs at once, and they will be healthier (egg health degrades year over year). If you know for sure you want this flexibility, it’s best do it earlier. Older women tend to retrieve fewer eggs at a time, and you’re more likely to have to repeat this process.

I also looked at timing. At 32, say it takes 1 year to get engaged (this is highly optimistic), 1 year to get married, and 1 year to get pregnant. At this best case scenario, I’m 35 when I’m having my first baby, which is considered ‘advanced maternal age’. I want more than one child, so add a few years onto that as well. Aside from health reasons, I simply may not want to be having children into my 40s.

Costs?

Unless you work for a company that covers this, it can cost $13-$16k out of pocket, depending on the meds your doctor recommends. There’s also an annual storage fee. I looked at it as an investment in your own DNA, and in being flexible with timing and how you want to structure your life.

It’s an investment in time as well. They say to expect it to take 2–3 months, but you can get it to a 1.5 month cycle if you time it right. If you are on birth control, this can take longer.

I think everyone should get a preliminary ultrasound. It’s easy, fast, and in some cases can be covered by insurance (it’s a few hundred if not). It tells you about how many follicles you have — which translates to the maximum number of eggs that can be retrieved during one cycle. I have lower than average for my age, around 12–15 (2o is what doctors recommend), which I never would have known if I didn’t get the screening.

Make a screening appointment with UCSF > http://coe.ucsf.edu/ivf/

How it works

You have lots of follicles. These follicles take turns maturing an egg, one per menstrual cycle. You will take meds to make all your follicles mature at the same time, so you bloat and feel more and more uncomfortable as you get closer to retrieval. Kind of like a micro-pregnancy. Avoid things like alcohol and other substances. Get lots of sleep. You can’t run or do bouncy exercises.

General Timeline

Whenever you start: Go in for a prelim screening, which is an ultrasound. They will tell you if you are a good candidate. You will have to stop taking birth control for a period of time.

Before you begin meds: Take an injections class at the hospital

1 week before period starts: Estrogen patches (not for everyone)

Period Day 1: Nothing

Period Day 2: Start injections. I did 2 injections at 8pm every night. You can select the time, it just has to be exactly the same every day. I had Gonal-F and Menopur (which came in vials you had to mix, I felt like a scientist). These make all your follicles grow eggs at once. You want a high number.

Injections last for about 2 weeks, and you will have to go into into the clinic to get blood tests and ultrasounds every 2–3 days, to make sure your follicles are developing correctly. I went early in the mornings before work.

About a week after: Start 3rd injection, the antagonist, which stops your eggs from accidentally releasing before the procedure.

A few days later: The ‘trigger shot’, which is your very last shot.

36 hours later: retrieval! You get anesthesia, the process itself takes only about 20 minutes, though you have to be there 1–2 hours before for prep.

For 2 weeks until your period begins: You still feel bloated and sluggish, your follicles are still enlarged. Do not run or bounce around. Taking painkillers is okay (ask your doctor which ones).

Beginning of next period: You are officially reset. Yay! Run! Cheer!

The Procedure

I did both retrievals at UCSF, which has a beautiful new fertility center in Mission Bay/Potrero Hill area. The staff and doctors were all friendly and fantastic. The doctor you’re assigned to is the one who makes decisions regarding your timing and medication dosage, but since the process is so dependent on exact timing, you have to meet with whichever doctor is on rotation. Both my retrievals were done by different doctors, and neither of them my main doctor (all were great).

Starting at midnight before the retrieval, you cannot eat or drink anything, including water. This was annoying. I had a giant meal late at night. Bring food and water with you for immediately after.

You need to have a friend pick you up after the procedure, you aren’t allowed to go home alone. You can actually have the friend hang out with you in the room before the procedure too. UCSF’s patient rooms are sunny and have a beautiful view of the water.

Outcome

I froze 12 in December and 15 in January. My doctor recommended 20 as a good number to ensure a live birth, so I feel comfortable with having 27 total, as I want multiple children. None of this is a guarantee, having more eggs merely increases your chance of having a successful live birth, but doesn’t ensure it. I have heard that each frozen egg has a 10% chance to lead to a live birth.

Other Notes

Needles are no fun, though you at least get to use the small half inch ones. They go into subcutaneous tissue, in your lower abdomen.
Tips: Pinch the area really hard. Go in FAST, like a dart.
Also, be careful. Extra careful. I’ve accidentally poked through my finger with a needle before. The first time was hard, and took me a few tries. I had to not think about it, and count 1, 2, 3 and just do it.

I was surprised by how quickly I got used to it. I went about my daily things, still went out, still spent time with friends, only between 8:00 and 8:30pm, wherever I was or however I was dressed, I had to give myself shots. Just part of my routine.

Most memorable was on my birthday, at my own birthday party. I stepped into a bathroom with a friend (who was a nurse) and she helped me prepare and give the shots. It was the only time I ever had some one else do it. It was a neat experience to share.

Scary fact: Among women over 40, about 15 percent of the eggs produced will be normal.

Common Questions

Why UCSF?
Both Stanford and UCSF came highly recommended, I chose UCSF because I live in San Francisco and it was easier for me to get to.

How do I set up a pre-screen?
http://coe.ucsf.edu/ivf/ or call (415) 353–7475. You can ask if your insurance will cover this (but it’s only a few hundred, you should do this regardless).

I don’t think I can handle needles!
You can handle needles. I was afraid of this part too, but you take an injections class (you don’t actually have to inject yourself in the class), and you just do it. It’s just a step in the process. You’re stronger than you think.

How long do injections last?
Only about 2 weeks! It’s all preparation shots, and then one trigger shot, and you’re done. 36 hours later you have your retrieval.

Are you worried that now you’ll have to use IVF for pregnancy?
There’s a misconception that after egg freezing, you won’t be able to get pregnant by any other means. You have about 400 mature eggs throughout the course of your lifetime, there are still plenty in there. You can still conceive naturally — IVF using your younger eggs is now just an additional option available to you later should you need/want to use it.

What does [x partner] think about it?
I was surprised how often I got asked this. My first reaction was, well it doesn’t matter, this is my decision. And then I realized, any partner who deserves your time should be absolutely supportive and encouraging of this.

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