Everything You’ve Ever Wondered About Egg Freezing, Answered

Beauty
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If it seems like a ton of people have been freezing their eggs lately, you’re on to something. The NYU Langone Fertility Center, where I did my egg freezing, reported more than a 30% increase in the number of egg freezing cycles during the pandemic. It might have something to do with the reported COVID baby bust—people aren’t having as many kids due to reasons like reduced incomes, extra stress, childless people witnessing parents on the brink, and people straight up not meeting each other to have sex and get pregnant in the first place—causing some to put parenting plans on hold. Personally, I froze my eggs in 2020 specifically because a) I had more flexibility in my schedule to take all the appointments and b) I found out I have fertility coverage through my company benefits and egg freezing is otherwise super costly. (Some people even go to other countries to freeze their eggs where it is more affordable.)

I’m 35 years old and did two rounds of the procedure in 2020—one in September and one in December—and chronicled much of it on Instagram. Below are my answers to the big questions people always ask me about my egg freezing experience.

Can you top-line how it works?

You take hormones via at-home injections so that multiple follicles in your ovaries (which hold your eggs) develop mature eggs extra quickly. After 8 to 15 days of these injections, you go in for retrieval during which they put you under a light form of general anesthesia (you’re unconscious) and the matured eggs are removed from your ovaries with a huge needle. It’s inserted through your vaginal wall (hence the anesthesia!). Physical recovery is about 10 days.

What’s the time commitment?

Assume this will be a big focus for close to a month: ballpark about two weeks of injections with morning appointments on most days, then a day off for the retrieval procedure, and then 10 days of recovery (you can’t work out or have sex during any of this, but you should be able to go back to work). You could also say it’s more like two months if you include the initial consultation and orientation, as well as all the prep work leading up to the process (if you have a lot of calls to make for insurance purposes and getting your hands on the meds, for example, it can be a time suck).

How should I pick a clinic?

You’re about to have a lot of appointments at this place, so a location that is easy to get to is usually top criteria. Equal to proximity, a place with a good reputation was important to me, of course, with a doctor that clearly listened and made it clear they regarded me and my needs as a unique individual. I also paid attention to how organized the facility seemed. This process has a ton of tiny to-dos (appointments to make, medications to order, instructions to receive, and little questions that come up every day), so I wanted to be confident someone would return my calls promptly.

What are all the appointments about?

I had an initial in-person consultation one month before I wanted to do the egg freezing process. They did bloodwork as well as an ultrasound of my ovaries (the ultrasound device is a vaginal wand, just a heads up). This information helped my doctor get an idea of how many eggs they might retrieve based on my biology. In the weeks following, I had an online orientation and had to make a number of calls to make sure I got all my necessary medications (some of which should be stored in the fridge). Then I waited. The whole thing is synced with your period, so as soon as you have your next “full flow” day (meaning you’re bleeding enough to need a cup, pad, or tampon), that’s “Day 1.”

I went into the clinic on the morning of Day 2, they did bloodwork again and called later in the afternoon to assign my shot dosages for the day. For the next two weeks, I was in and out of the clinic for “morning monitoring” appointments. I kept a handwritten calendar because instructions can change every day and this was the easiest method for me to keep it all straight. Those first monitoring appointments were a few days apart but by the end, they became daily. I also got more frequent ultrasounds at these final appointments—they’re watching the follicles to see when the eggs have matured enough and are ready for extraction.

I also want to add a bit of a trigger warning: In pre-COVID times, these orientations were in-person and the clinic waiting rooms didn’t have capacity restrictions, so that meant that a lot of people brought their partners with them. That support is so great, but I also think that the current setup (where you can be camera-off at orientation and partners are not allowed in the waiting rooms) helps relieve some of the comparison people might be apt to make about their own partner status. That’s just something I observed.

Were the at-home hormone injections scary?

Yes. About two or three times a day you’ll inject yourself in the tummy or thigh with a syringe of hormones, some of which you mix up yourself like a chemist. It was super counter-instinctive to jab myself (I cried) and one of the injections (menotropin) actually stings as you inject it. But I had two major helpers in my corner: A Spotify playlist of my favorite jams to get me pumped up, and a generous friend who was about a week ahead of me in her egg freezing process and FaceTime-coached me through my first injections. Your clinic will likely direct you to instructional videos online, and most are solid, but there are tricks I kind of had to figure out hands-on. (I messed up one or two, but it was ok in the end.) In hindsight, I would have budgeted to have a nurse come walk me through that first night, which is around $200 each time in NYC. It’s a side job for some nurses; you can try calling your clinic to ask if anyone on staff would do it. At the very end of the process, when your eggs have reached maturity, you will take precisely-timed and slightly more complex shots called the “trigger shot” 36 hours before your egg retrieval time (this often means it’s late at night late at night). I did budget for a nurse to come do that one for me.

How did the hormones make you feel?

Mentally, not bad, but physically, it was pretty wild. There are a few different types of hormones introduced throughout those 8 to 15 days. The ones I took at the beginning, which speed up the follicle development, actually made me feel sort of euphoric. Then, after about a week, another hormone was added that prevented me from ovulating. After that, I started to get really bloated and super tender: imagine huge, sensitive ovaries and breasts that ache with each step (I would say it was my PMS bloat five-fold). But I didn’t feel mentally “crazy.” I think the biggest emotional issue for me was that I couldn’t work out other than walking and that started to take a toll on my irritability and mood. Another common experience is a hormone “crash” the week after the extraction and that can make people feel depressed—the first time I didn’t have a crash, but the second time I did.

What happens during the extraction procedure?

This was the part I was definitely least prepared for. It was very surreal. I got fully undressed in a private changing room and put on a surgical cap and gown. I consulted with the anesthesiologist, walked into the operating room (which felt like a TV set, TBH), and got myself up on the bed while about half a dozen people prepared around me. I had to sign some final paperwork, then they inserted the needle in my arm for anesthesia, I put my legs up in calf props (rather than the usual foot stirrups) with a sheet covering my vagina, and the anesthesiologist let me know that they were about to put me under. It was scary for me, to be honest. I had to do a lot of yoga breathing as they prepped me, especially because they were having a hard time finding a vein, which prolonged the anticipation. When the sedatives start to flow through my blood, I smelled this odd kind of metallic odor—I’m not sure why. But, the next thing I knew, I was waking up in the recovery room. The actual procedure, once you’re unconscious, takes only 10 to 15 minutes. Waking up was peaceful and I felt really good—until I had to go to the bathroom (more on that below). As I became cognizant, my nurse wrote down the number of eggs extracted on my recovery instructions and sent me home with my partner (you have to have a designated adult come pick you up).

What’s recovery like?

When I woke up, I actually felt great… until I had to go pee. As soon as I sat down on the toilet and my pelvic muscles pressed down, it was very painful. Like, take-your-breath-away painful. That lasted for the next two or three days as everything healed. I also remained pretty bloated and tender for several days. You’re told to continue to refrain from exercise and sex until your next period which comes in about 10 days. I felt pretty off and tender physically until then, but that next period made a big difference in helping me bounce back. In terms of taking time off of work, you have to take the day of the procedure off, and some people take the day after, but not everyone needs it. You’ll be keeping your eyes on your weight and other symptoms of something called ovarian hyperstimulation syndrome (OHSS), an unlikely, but potentially dangerous side effect.

How much did egg freezing cost?

It’s very, very expensive without coverage. In New York City, one round of egg freezing can cost between $10-20 thousand or more each time (including appointments, procedures, and meds), and then you have the annual storage fees of around $600. I have fertility health care coverage through my company (Hearst, the owner of ELLE). They use a benefit company called Progyny that dovetails with our health care plan, which gets most of the procedure covered. I ended up paying less than $5,000 for two rounds. This is an enormous privilege. You might consider asking your company to provide benefits from Progyny, too. Check out their site here. There are other provider types such as Ovia Health, Kindbody, and Win Fertility.

How many eggs did you get?

Reports on the average number of eggs frozen per cycle for a 35-year-old (my age) varies by source. Extend Fertility says 12 eggs, for example, while RMA of New Jersey says 10.8 eggs. (Keep in mind that more eggs are typically extracted than are frozen, as a certain number won’t be viable, so the average extraction number is likely slightly higher than those aforementioned numbers.) Extend Fertility also says the likelihood of having one baby from that amount is above 70%. I don’t share my exact numbers with people because I think it can be a really triggering subject. However, I do want to share that I had numbers I was happy with and I feel like a lot of us 35-and-older need a little hopefulness in this department.

How is egg freezing different than IVF?

Egg freezing is basically the first half of IVF. But with IVF you continue on to fertilize the egg with partner or donor sperm. Those embryos are given about 5 days to grow to make sure they look like they will survive, and then they are frozen. You go through a whole additional process (plus more hormones) to have them put into your uterus to grow.

Should I freeze eggs or embryos?

This is such a deeply personal decision and it took me a long time to decide. I chose to freeze eggs because even though I have a male partner with whom I plan to have a family eventually, I do have friends who froze embryos and, after breakups, wish they’d had some eggs that were theirs alone. I figured since I was not doing full IVF right away to attempt to become pregnant immediately, I would do two rounds of freezing just eggs. There’s somewhat of a concern that because eggs contain more water than embryos, eggs have a higher chance of damage in freezing and thawing, but this has been less and less of an issue with more advanced technology.

Why did you freeze your eggs?

I haven’t been ready to be a mom for a handful of reasons including finding the right partner. I wish so badly that I could have done egg-freezing at 25. The peace of mind this has given me has been unquantifiable. (Even though it shouldn’t be on women alone to worry about fertility.) I stayed in some relationships that were not serving me spiritually and emotionally because I thought I needed to adhere to the “have all your babies by 35” deadline, and I just didn’t have the money to freeze back then. Once I found out about this benefit at work and had a little bit of savings to work with, I seized the moment.

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