August 15, 2019 at 05:00AM by CWC
I’d written about egg freezing pretty extensively for multiple outlets—including Well+Good—before I decided to give it a go. For this reason, I thought I knew what to expect of the process: lots of shots, of course, and some sticker shock (to the tune of $15,000). I wasn’t even remotely nervous. I want babies and am not currently in a place to have them, so the idea of being proactive in some way about my fertility energized me.
Friends who’d been through a freeze were reassuring, too. It wasn’t the favorite thing they’d ever done, but it “wasn’t that bad,” either, and now felt like they had a fertility insurance policy. “Not that bad” seemed like a pretty good trade-off for some peace of mind.
However, there were a few aspects of the process for which I was in no way prepared, despite all of my research and advanced planning. Keep reading to find out what surprised me, and what I and other woman—polled after-the-fact—wish we had known before starting the freeze.
1. That first fertility consult can be super emotional (and disheartening)
My fertility doctor sounded something like this during my first appointment: “Bad news, bad news, bad news, oops, now you’re crying, bad news, goodbye.” This was traumatizing because I hadn’t expected to hear anything negative. I was there to preserve fertility; I assumed that I was in good shape considering that my cycles were regular and I’m not “old” by fertility practice standards.
I’m not alone in this experience of being blindsided by bad news, either. Carmen*, a 34-year-old lawyer in Los Angeles, tells me she still lacks confidence in her fertility based on a doctor’s read of some of her test results, despite the fact that she successfully froze eggs. Meanwhile, Kristi*, a 32-year-old reiki master also living in Los Angeles, says her doctor’s outlook on the likelihood she’d have a successful freeze was grim—an experience also shared by Jane*, 40, an influencer whose doctor told her that trying to freeze her eggs would be a “hopeless” endeavor. It’s not the doctors’ fault that the news is bad, of course, nor is there any way around the hard truths of fertility. I just wish I’d known that the initial consult can be a doozy, emotionally.
2. No matter what anyone tells you, the shots are not easy
Prior to starting my freeze, I heard from multiple friends that the shots taken to kickstart ovarian hormone production were NBD but girl, they lied to me. For starters, there are a lot of them, and not all are pre-mixed. So, you’re not just injecting yourself every day for nearly two weeks—in my case, you’re injecting yourself multiple times with chemistry experiments you’ve concocted with the help of some YouTube videos. The sheer responsibility of the process made me so incredibly nervous that I’d have anxiety all day until it was shot time, at which point I’d have full-blown panic attacks.
This isn’t even to mention the actual moment of injection. I would not have been able to do the first one had it not been for my best friend’s help. Having been through the process, she kindly offered to assist me in executing my first round of shots. When it came time to stick a needle full of scary hormonal stuff into my abdomen, I vehemently shook my head. “Nope, not doing it,” I said. She assured me I could and so I did, but if she hadn’t been there I probably would’ve chickened out. Which would’ve been a bummer because the shots cost something like $5000.
From that initial injection, it does get easier… sorta. One halfway honest friend told me she played rap music to get herself through the needle portion of the program, so I did the same. (I recommend “Apesh*t” by The Carters, FYI.) Even still, halfway through the nearly two-week process I broke down and did not think I could continue. It’s just… a lot. It’s time and anxiety and physical weirdness and emotional heaviness around the fact that your life choices have, for better or worse, led you to this moment. Oh, and BTW, some of the shots burn like a motherf*cker, and while you won’t die if you forget to get rid of the air bubbles, you will yowl in pain for a few minutes.
3. Outcomes vary wildly from person to person
Just because your friend, who is the same age as you and sees the same doctor, has a good outcome, you are in no way guaranteed one, too. Some people get 25 eggs, some people get 12, and some people get 1. This large discrepancy in results can lead to serious disappointment and even heartbreak.
Part of this is because the process of egg retrieval, I discovered, relies largely on chance and estimated guesswork. Your doctor, for example, prescribes medication doses just so in order to spur the production of eggs. Too conservative, and you don’t produce enough. Too liberal and you could over-produce, which sounds like a good thing but can lead to some pretty serious health consequences. Similarly, deciding when to pull the eggs from your body is mostly based on smart guesses—too soon and not enough will be mature, too late and they’ll be overripe and thus unusable. And even if you just miss one of your own shots, you might have to start the process all over again.
While you’ll have some indications from your doctor about how successful your retrieval is likely to be, ultimately the number of eggs frozen is a happy or sad surprise delivered to you on the day of your retrieval. This number is often amended later, too, in order to account for the fact that typically, only around 80 percent of eggs retrieved are mature enough to be frozen. In my case, that number was actually closer to 40 percent, so while the news I received on the day of my procedure was very good, the revised number I was given a few days later was not so great. I wasn’t aware that this could happen and so I was (once again!) very distraught, especially after having already celebrated what I thought was a super successful freeze.
4. A person’s egg ‘number’ is a touchy subject
The number of eggs successfully retrieved for egg freezing can be a sensitive subject, as the fewer eggs you get, the lower your likelihood of having a live birth result from them. (This chart illustrates how your likelihood of a live birth depends on many factors, including the number of eggs frozen, your age at the time of retrieval, and your age at the time of implantation.) My best friend was sensitive about her number, so I did not tell her mine; however, my clueless best guy friend announced it to the table at a dinner for which she was in attendance. I felt terrible.
Whether your number is high or low, I’m personally very reluctant to share mine with others. Even if you got X and you don’t feel good about it and want to talk about it, consider that some people get just one or even none and don’t really want to hear that your X number is cause for concern—know what I mean? Besides, your egg number is just one piece of the very individual fertility equation, so the comparison game really is the death of both joy and hope here.
5. Egg freezing comes with real risks
Everyone—friends, my doctor, the internet—told me I would be back to work the day after my procedure. However, I developed a rare reaction known as Ovarian Hyperstimulation Syndrome (OHSS), which laid me up for two full weeks. No one had even mentioned this was a possibility, least of all my doctor.
OHSS, says Jacqueline Ho, M.D., assistant professor of obstetrics and gynecology at the Keck School of Medicine, is a condition which occurs in some patients after their ovaries are stimulated by the injectable medications. After ovulation, your ovaries naturally produce a substance called VEGF. The more stimulated your ovaries are by the fertility medications, the more VEGF is produced. This can lead to OHSS, where the ovaries become extremely swollen and leak lots of fluid into your abdomen. Its very unpleasant symptoms include nausea, bloating, vomiting, and diarrhea.
OHSS occurs in three grades—mild, moderate, and severe. Mine was the latter, which occurs in just 1 to 2 percent of patients. My stomach swelled so that it looked like I was around seven months pregnant, I couldn’t eat anything for an entire week, going to the bathroom caused excruciating pain, and getting to the fridge for more Gatorade was a Herculean task. I can safely say that it was sickest I have ever been in my entire life. My OB/GYN later told me that in extreme cases, fluid can accumulate around the lungs and obstruct breathing—which is why it’s important for anyone who has symptoms of OHSS to seek medical care ASAP. (Oh, and did I mention that hyper-stimulation can degrade the quality of your eggs? Fun!)
My body is just now, four months later, returning to normal. It still gets more bloated than usual at certain points in my cycle, and my digestion has been so off I had to get a colonoscopy to check the severity of lingering inflammation. I have to imagine, based on my conversations with Dr. Ho and other fertility specialists, that my doctor must have known that OHSS was a possibility. Yet she never brought it up—something that deeply frustrates me. Had I known OHSS was a possibility, I would have arranged for someone (read: my mom) to take care of me, since I was not able to take care of myself, and I would have been better prepared to deal with it in the moment. Without the support of my doctor, I relied on my acupuncturist, a friend who’d also been through it, and Google for guidance.
6. Egg freezing does not guarantee peace of mind
Am I happy I froze my eggs, despite the whole OHSS trauma? My answer is somewhere on the spectrum between “I don’t know” and “I guess?” Directly afterward, I was filled with regret, but once the pain and misery of OHSS subsided, I felt slightly better knowing I could add a couple of years to my biological clock’s countdown to midnight. And almost every woman who had a successful freeze that I spoke to for this story, reported being happy they’d frozen their eggs.
With that said, I don’t feel the huge sigh of relief I was promised. Having eggs on ice did not solve the problem of being without a partner. I suppose it gave me a few more years to find him, but TBH I still, despite my eggs, want to have a baby naturally. I also want two kids, and there’s no way of knowing if my egg reserve will allow me more than one until we try to fertilize and implant them—especially given that their quality was potentially compromised by the OHSS. So again, I’d rather start trying to have babies ASAP than rely on these eggs, which is not possible because I don’t have a partner.
My freeze was technically considered successful, too. Those who were not so lucky—like Alexa*, 40, who went through the process twice and retrieved just one egg—feel even less reassured by the process, as you might imagine. And while some who go through this process end up becoming pregnant on their own without relying on their frozen eggs, an unsuccessful egg freezing still isn’t exactly a reassuring experience. Kristi, for example, is now more anxious than ever to find a partner given that she didn’t have much luck with her experience.
Ultimately, that’s the thing about egg freezing—it’s such an individual process that knowing what to expect, or whether it will be worth it, is pretty much impossible. I’m just hoping this fills in some of the gaps I feel are not being addressed in the current pro-egg freezing conversations. It’s important to understand that you can’t *definitely* outsmart your biological clock, but if you have $15,000, a warrior’s spirit, and reasonable expectations, you can try.
*Names have been changed to protect identities.
I strongly encourage reading as many stories as you can when it comes to the freeze, so follow mine up with actress Olivia Munn’s and Ladies Get Paid founder Claire Wasserman‘s. Then, find out why I’m not alone in feeling like men need to get more involved in the fertility journey.
Author Erin Bunch | Well and Good
Selected by CWC