Better Support for Women Freezing their Eggs
Practical Suggestions for Partners, Friends, Family, and Employers
As a well-timed nod to International Women’s Day, I froze my eggs on Friday.
My journey with egg-freezing began nearly 9 months ago, in the weeks after my former partner announced that he didn’t see us getting married after an almost five-year relationship. We separated a few months later. I moved out, set up a new home for myself and started putting together a new plan for my life.
The timeline from getting on the waitlist at UCSF to getting my egg-freeze report back yesterday (20 retrieved, 14 mature enough to cryopreserve) went like this:
- Add name to the waitlist for an appointment (June 2019)
- Wait 4 months for a consult (Oct 2019)
- Complete preliminary assessments: history, ultrasound, labs (Nov 2019)
- Follow up appointment to confirm protocol (December 2019)
- Secure prior-authorization from insurance company (January 2020)
- Call pharmacy to get prescriptions sent via mail-order (February 2020)
- Baseline ultrasound (February 24, 2020)
- 9 days of stimulation (February 24 — March 3, 2020) with Menopur and Gonal-F
- 4 days of antagonists (March 1–4, 2020) with Ganirelix
- An HCG & Lupron co-trigger (March 4, 2020) 36-hours before the retrieval
- 5 more ultrasounds and 6 sets of labs throughout 10 days of injections
- Egg retrieval (March 6, 2020)
In the months leading up to my egg freezing cycle I also made some minor lifestyle changes. I stopped using topical retinol (buh-bye Drunk Elephant) in December 2019 since Vitamin-A derivatives are correlated with birth defects and have a long-half life. I cut alcohol mid-January. I started taking prenatal vitamins and fish oil from Natalist a few weeks before my injections began. Despite inconsistent guidance on exercise while going through the process, I continued to ride my Peloton during the first week of injections but avoided exercise during the second week to reduce the risk of ovarian torsion.
There’s nothing quite like this multi-step process to clarify your commitment to motherhood and prepare you for the poking and prodding you’ll face in pregnancy.
Starting every morning in the waiting room of the UCSF Center for Reproductive Health is a sobering way to start the day. I came to realize that whether you’re an IUI, IVF or social preservation patient, we all share some common feelings: grief, fear, and longing. Being in that room meant that I had to re-live the uncomfortable reality that the partner I planned to have children with is no longer part of my life, that I don’t know if or when I will find *the* person to conceive and co-parent with, and that the deep desire to start a family is not something that I’m in a position to act upon at this moment.
Count me as the counterexample that every woman freezing her eggs is a liberated, career-optimizing, choice-positive optimist. Some of us find ourselves in the reproductive endocrinology suite because we know that we are running out of time or choices. In a courageous act with fairly involved physical, emotional and financial cost, we do what we can with what we can, when we can. If you haven’t been there, you might miss the fact that there’s a sadness to being in that waiting room.
Receiving the refrain of congratulatory messages after egg retrieval was on one hand an appropriate acknowledgment of the conclusion to a physically arduous process. It also presented the opportunity for me to articulate why and how this milestone didn’t necessarily deserve celebratory sentiments.
With 14 eggs on ice, I have an approximately 80% chance of one and 47% chance of two future live births. This is not quite the “insurance” policy that many clinics might position the egg-freezing process as. I’m not guaranteed to get a baby from these eggs and in fact, to enhance my chances of that, I’ll need another cycle to bank more mature eggs. UCSF recommends freezing 15–20. Counting on these eggs to turn into my future children is not a smart statistical wager and it is a failure of this emerging clinical practice to commercialize false hope against a biological clock. If you or someone you know is considering egg-freezing, take the time to understand what the data means for your future family planning.
With over 36,000 egg freezing procedures performed in the last decade and venture capitalists funding new clinics like Kindbody and Extend Fertility, there’s an ever-increasing likelihood that a woman in your life will be weighing how egg-freezing fits into her life plans. Whether you come in contact with her while she’s excusing herself early from a social function to inject herself with massive doses of fertility drugs, coming into the office late from a scheduled ultrasound, anxiously preparing for egg retrieval, or trying to jump back into regular life while dealing with the discomfort caused by post-procedure ovarian hyperstimulation syndrome (a common but fairly underplayed side-effect), I implore you to instead ask, “how are you feeling” as a sign of your support. The amount of hormones, post-procedure discomfort, and emotional considerations mean that she could really benefit from the people in her life showing special concern for her. Unless solicited, it’s not a time for you to offer your opinion on her choice, or even to presume she needs cheerleading.
What she needs from day to day and moment to moment is up to her.
Chances are, there may be complex inner emotions that reflect some sorrow, a sense of failure, and debilitating uncertainty about how the future may look. Projecting a celebratory-quality on this highly personal process is presumptive and could inadvertently drive isolation and social anxiety. While I was acing my injections and skirting side effects of the medications with relative ease, my mind went all sorts of twisted places towards the end of the stimulation process. My estradiol levels went from a baseline of 35 pg/mL to nearly 4,000 pg/mL. This is a biologically over-amped state. I cried multiple times a day.
The people who made non-assumptive inquiries about my total wellbeing won my affection, attention, and admiration in the most effective way.
I am grateful to be part of the first generation of women maneuvering modern life with the new option of elective egg-freezing. Supporting the women in your life navigating individual fertility journeys is also an emerging social consideration. I hope the below suggestions offer some new strategies specific to egg-freezing.
Please comment or drop a line if you have something to add. Let’s crowdsource our way to more wisdom.
Do:
- Ask her how she is feeling today.
- Demonstrate appropriate empathy and understanding.
- Send messages 💌 that reinforce her positive qualities.
- Ask if she would like a friendly escort to her monitoring appointments.
- Volunteer to drive her home from the egg retrieval.
- Understand that the physical recovery process will take a minimum of 1–2 days, possibly longer.
- Offer to pick up meals or handle easy errands during the days before and after the egg-retrieval.
Do not:
- Make overly congratulatory statements that assume she is privileged, lucky, or should be satisfied with her “option” to freeze her eggs. While these things may be true, she may not be feeling this way about undertaking the process.
- Suggest that her choice is a good “insurance” policy (this reinforces a common marketing misnomer).
- Tell her that she “doesn’t need” to do this or “won’t need” to use her frozen eggs (…you’re not a sorcerer 🔮 ).
- Project your personal beliefs about reproduction.
- Make any assumptions about the physical, emotional, or financial level of difficulty involved.
- Propogate euphemisms such as “what’s meant to be will be“ or “everything works out this way for a reason.” (👆🏻 credit: )
