My journey with freezing my eggs
Deciding to freeze my eggs was not an easy decision. I had gone back and forth. A few years ago I went to an OBGYN within my health coverage, within our system they don't do it, but she gave me the places that my insurance covers. She didn't tell me too much, as she didn't know a lot about it, but she told me the price. 12,000 dollars. That definitely deterred my pros and cons list.
After a few years since the OBGYN appointment, I had gone back and forth, back and forth. I had talked to my mom and my therapist about it, a few close friends. As I approached 35 and single, I thought about it more and more.
"Why freeze your eggs?
When it comes to fertility, age matters. As you get older, your eggs diminish in numbers and in quality making it more difficult to conceive or maintain a pregnancy. This change occurs at different rates in different women but does occur in everyone no matter how healthy you may be otherwise.
By the time you reach your late 30s, about half of your eggs will be chromosomal abnormal (too few or too many chromosomes). These chromosomal abnormalities often lead to failed implantation or miscarriage. Unfortunately, by the time you reach your 40s, you only have a 5% change of becoming pregnant each month.
For women who are not ready to conceive but wish to try preserve fertility for the future, freezing your eggs in your 20s and 30s allows you to take advantage of your body's fertility at a time when your eggs are at their healthiest."
"Freezing your eggs allows you to preserve your own eggs when they're young and healthy."
This is from the clinic I went to, CCRM Minneapolis. More information can be found on their website: ccrmivf.com
I am someone who always thought I would have children. I started thinking do I only want kids because this is what is expected of me? I love kids, however, again I was approaching 35.
What made me choose to freeze my eggs? I wanted a choice. Maybe I meet someone in a few years and we want to get pregnant. What if then I struggle because I am "older". What if we have fertility issues, only adding years to my old age. Are there other options for having children, yes of course. Unexpectedly watching my nieces grow up, seeing how much she looks like her Meisinger roots, and how she even does things that I do (like stick out her tongue when concentrating) has made me consider wanting biological kids. Don't judge me, I am just voicing everything I have thought.
Making choices and big decisions has never been a strong suit of mine. I tend to put off the decisions, continuously think about them, then either make a decision after contemplation or the decision as been made for me.
Regardless of my decisional capacities, I did actually decide to go through with it. That is not to say that I am not pissed/frustrated that I had to make this decision. I had to call my insurance, multiple times. If you've called insurance companies, you can imagine my struggles. Most don't know much about medical things, and what is actually covered is vague.
I made an appointment. To get an appointment, you have to go through all your medical and family history, medications and supplements, Pap smear results, plus all the expectations of your "infertility issues" even when you are going there specifically for egg freezing. It took me a long ass time to fill this out. I had my virtual appointment. The doc and I talked how things would work, what to expect, but even as a medical person, I felt that information was overwhelming.
That day (because I had just ended my period -- sorry this will get detailed) I was able to get through the tests quicker. I stopped my birth control - naturally you need to be off birth control to freeze eggs. I have been on birth control since high school. 15-20 years, all I really remember about my periods then was the PAIN. I would go home from school because of the cramping. They ask you about your previous periods, were they regular and how long it lasts, etc. Not really knowing the answers. So I waited. I waited for my next period.
In between this time, you have to do these education modules. These ones talk about the hormone levels, the menstrual cycle and things you need to know in the next part of your journey. This round didn't take a ton of time, maybe 30-45 minutes. You do have deadlines. I pride myself on getting things done on time, I don't think they would have not done my appointment if I didn't get it done, but I'm not trying to cause problems.
Once you get your period, you call the office and set up for an appointment. Essentially you can only wait 3 or so days to get into an appointment. Due to when I got my period, I had to go in on a Monday, there wasn't any wiggle room. I was supposed to work and had to call in, not the end of the world, but that's the kind of stuff that was interrupted. Remember, I am a nurse. I work in a hospital at the bedside with patients. I can't come and go like some different types of nurses and other professions. An appointment for follow up with my doctor was also made for a few days to go over results.
My appointment was blood work and a transvaginal ultrasound. As I waited in the waiting room, I felt out of place, almost feeling like a fraud because I wasn't there for actual infertility issues, at least as far as I knew. Also, majority of people were there with significant others.
The numerous ultrasounds
Endless blood draws
After this appointment, I got a bill from Quest Diagnostic (a lab place) for over a thousand dollars. I panicked. I figured I'd have to pay some money - but that was just lab work! Anyway, through the panic I realized that the place had the wrong insurance so I put it in there and haven't heard from them since. 🤞
Typically, you still have your period when you go in to this appointment. I over prepare for things, so I was thinking to myself do I wear a tampon, will I have a place to remove and replace? I didn't think of the fact that I had to change and they give you privacy for that. 🙄
First I had to pee in a cup. I really think they could invent something better for women to pee into a cup - just saying. I got my urine and then I ALMOST spilt it ALL over. Naturally, I text my best friend to tell her because I was sitting in the bathroom laughing at myself. Then to get a transvaginal ultrasound - some people say it's painful, you feel some pressure. I wouldn't describe it as painful but just some discomfort. Then I ventured to get blood drawn. I was sent home after that.
Fast forward a few days and I have my appointment with my doctor. To be honest, I don't remember a lot of what she said in regards to which numbers were high, which were low etc. The gist of it was one of my numbers was slightly low, the other was high, but ultimately she is not concerned that we won't have success. If I am being completely truthful, I wish they wrote what they told me down so I could go back and remember. Do I have notes written from the appointment? Yes, of course because that's who I am. Does it make complete sense to me? No, not even with the numbers and looking up the ranges.
After going through the education modules again I am reminded of what they were testing for.
"An important step in determining your fertility diagnosis is to understand the quantity of potential eggs that remain in your ovary, also known as your ovarian reserve. Ovarian reserve testing may involved a combination of ultra sounds and blood tests. Ultrasounds are used to count the number of small astral follicles, and a blood test will measure your anti-mullerian hormone, or AMH, levels. AMH is secreted by the small prenatal follicles found in the ovaries at the start of the cycle. A typical AMH level is 1/0 to 4.0 nanograms per milliliter, but this may be higher or lower depending on age. The astral follicle count and AMH level are good predictors of ovarian reserve and response to fertility medication. A high AMH level and astral follicle count generally indicate good ovarian function. Blood tests may also be used to measure other reproduction hormone levels, such as FSH, LH, estrogen, and progesterone, helping further assess reproductive and ovarian function." (ccrm.engagedmd.com educational videos).
The transvaginal ultrasound is used to evaluate your uterus, fallopian tubes and ovaries. (ccrm.engagedmd.com)
Following this appointment you HAVE another appointment with a nurse. They go over what medications you will be taking, the timeline of process, when you could expect to do the actual retrieval, what restrictions you will have, and how you'd have to pretty much making yourself available for 10 days once you are close to the retrieval. Again I needed to talk to my insurance about where I can send my medications to get covered, and my last pap smear results.
Your medications are sent to pharmacy and because of where mine were sent, I had to call them, and hear ALL the things they were sending me. Anything from the medications, to alcohol swabs, packets, to needles and syringes. I couldn't keep up, just send me what I need. I was also told the nurse would call me and it was very important to call her back. She did, I didn't call back, I can read directions and give shots all the time. I still got my meds :)
Now, my medications came - and HOLY MOLY so many medications and boxes. I had to organize them. 
THEN you wait again for your period. They told me to start ovulation tests 10 days after I got my period which ended up being 12/19. I had to pee in a cup again every morning. Luckily I had some red solo cups - easier for sure. Dip the thing in pee, and wait. For the tests I bought, I could take a picture of them and it would tell me when I was in my "surge". This means that in the next 24-48 hours I will likely be ovulating. Four tests later and I was in my surge (1/1). The two lines were the same color.
You call the office when you have the surge, mine happened to be one New Years Day, but the office has people monitoring the voicemails. I was instructed to start taking Estrace 10 days after the surge (1/10), by mouth twice daily. This hormone is normally produced by the ovaries after ovulation. It is given to help stimulate the eggs to grow.
Then the day after that (1/11), continue with the Estrace and then start a cetrotide injection into abdomen daily. They have this nice treatment calendar. When I had been looking at it before I started it, there was CD1, CD 2, and I kept being like "WHAT DOES THIS MEAN???" The nurse told me "cycle day 1". Makes sense.
Cetrotide is a gonadotropin medication). It is a natural hormone that helps the ovary to grow several eggs at once over 8 or more days.
Cetrotide - into the abdomen tissue
I started my first medication 1/10, then two meds 1/11. I started the Estrace which is an oral pill. Along with the pill, I took the cetrotide for 4 days (which was only supposed to be 3) which was a shot in the belly. I was supposed to stop taking the cetrotide 1/14, but I took it - whoops. Then you call them when you get your period.
These meds are considered the suppression medications and phase. This phase isn't done for everyone but I did go through it. "During this phase, medication is used to suppress the typical production of hormones in order to prevent the development of a single follicle, preparing the ovaries to grow multiple follicles of a relatively even size in the next phase. The endometrial lining will be thing, and the follicles will be small. If everything is as expected, you'll progress to the stimulation phase in the stimulation phase" (ccrm.engagedmd.com; educational videos.)
Once you start medications you have restrictions:
No intercourse, orgasm or sexual activity
No cardiovascular exercise (keep heart rate under 140)
No heavy lifting (10 pound weight limit)
No caffeine (including coffee, decaf, teas, soda etc) or alcohol
consumption
No nicotine or social drugs
No NSAID pain relievers (Advil, Aleve, aspirin, naproxen, ibuprofen)
STIM ONLY:
No vitamin supplements other than Vitamin D
AVOID activities which may be traumatic to the abdomen or pelvis
AVOID overheating (sauna, hot tubs, excessive sun exposure)
AVOID over-the-counter medications and supplements
I started that day - but it was mid day and just spotting, so I waited until the next day to call (1/15). Then CD2-5 (cycle day 2 to 5) I had another ultrasound and blood work. That ended up being 1/16.
What happens is they call you back once you report your period, and usually you go in the next day. So this is a very "fly by the seat of my pants" schedule. At my appointment (1/16) I had another transvaginal ultrasound. Which I think it's kind of awkward and I am a medical person. I just don't really know where to look. If you've never had one, it's just a probe (like a dildo) that gets stuck up your vagina. They more it around and there is definitely pressure. Plus another blood draw. I did get my vitals taken - my BP was VERY GOOD. 103/74.
Then I leave and wait for a phone call. I was told to start my other medications. Because it was later in the day, I was told to just take them all at once. I started menopur which is an injection into the abdomen. It was easy for me to mix the solutions but I can see why it would be challenging for someone who is not a nurse. They probably gave us videos to watch. Then dexamethasone in pill form. And then of course the last medication was Follistim which also went into the belly. So for the following 10 days or so, it was 2 injections a day. I can't imagine how that would go over with someone who can't stand needles.
This is now considered the stimulation phase. This phase typically takes 8 to 14 days. They start monitoring and assessing the body's response to the medications. Estrogen level is monitored as the follicles develop and mature, they produce more estrogen. "Your estrogen level will reflect the number and maturity of the follicles and the eggs inside." "By the end of stimulation the process, a good response produces 8-20 follicles, each measuring between 12-22 millimeters." Follicle production can vary between women based on ovarian function, medical dosage and the protocols used." There is a chance the the doctors would cancel the retrieval process (at this cycle) if optimal number of follicles don't grow. The likelihood of cancelation is age.
These medications can cause fatigue, headaches, mood swings, nausea. Also temporary weight gain between 2-5 pounds due to potential fluid retention. Oh and bruising from the injections! I also had some stinging for a few minutes after my injections. (again information from ccrm.engagedmd.com in their educational videos).
Menopur and Follistim are gonadotropin medications. They are natural hormones that help the ovary to grow several eggs at once over 8 or more days.
Menopur
Follistim
I started those medications on a Thursday (1/16) (along with my appointment). I had another one 4 days later on Sunday (1/19). They do the same thing, ultrasound and bloodwork. Again another appointment on Wednesday (1/22). And then again another appointment Friday (1/24).
Why so many appointments? They are measuring your follicles and the eggs within. I am ashamed to say that I wasn't extremely familiar with what all happens during the ovulation and menstrual stages. Obviously I had a general idea. I did go to nursing school - but I got REAL invested in knowing everything. I am like that with all things - I love to learn and understand. I honestly thought that follicles were the little wiggly things on the end of fallopian tubes. There you go - showing my dumbness. ANYWAY - follicles are small sacs filled with fluid that hold the egg. During this transvaginal ultrasound they are measure the follicles, and monitoring the amount of eggs that are potential for freezing. The blood work is to see how my hormones are doing for the process. FSH, LH and maybe one other lab.
After my appointment on Wednesday 1/22 they did have me restart the cetrotide to prevent ovulation. However, I had accidentally taken an extra dose of that so I didn't have enough. I called my pharmacy to get that figured out.
Unfortunately, at the Friday (1/24) appointment my follicles weren't quite big enough to go ahead with retrieval on Monday. Instead I continued with medications and had an appointment on Monday. To continue medications I had to get more medications. Now I needed to get these medications fast - essentially I needed them by Sunday. The pharmacy I was using (because my insurance covered from there) was a mail order medication. Because I had needed another dose of the cetrotide (and now two more days worth) kind of complicated things. Through multiple calls and wonderful help from the people at the pharmacy they were able to get my medications overnighted to me so I could have them in time. It was a lot of calls and waiting to hear back.
Now, I had the next appointment on Monday (1/27). Before I left I did request that if I needed to continue medications to be called asap. I was out of them (I didn't want to pay for more than I needed) and would need to call the pharmacy and it would take a lot of work to get them sent.
They set up this portal type thing that allowed me to have a picture of my ovaries and follicles and the measurements. I got the notification before I even was done with lab. I could tell they grew quite a bit so I was crossing my fingers I wouldn't need any more medications. Luckily when they called they told me I was ready for my trigger shots and egg retrieval!
Jan 22
Jan 24
Jan 27
Just incase you were curious about the length of my follicles and wanted to see them grow 😂
You have to give yourself these trigger shots at certain times. The first med was to be given at 10:30 pm. This medication is called Pregnyl, it is a human chorionic gonadotropin, this hormone supports the normal development of an egg and stimulates the release of the egg during ovulation. This medication is a intramuscular injection. One that is like the flu shot - goes into the muscle. I give these all the time, but definitely a little different giving it to yourself. An hour later I had to give myself a shot in the belly which was Lupron. It helps to trigger ovulation. Then I took it again at 1130 am the next morning. That same morning I had to go into the clinic for labs to make sure the trigger shot worked.
"The final stage of the controlled ovarian stimulation process is the trigger injection, which is administered once the largest follicles reach the optimal size. This trigger shot completes the final maturation of the eggs, allowing egg retrieval to be performed 35-37 hours later." corm.engagedmd.com - education videos.
After that 11:30 am shot, I had no more medications until I went in for the actual egg retrieval.
I guess I didn't take a picture of the Lupron - but just like all the other ones, went into the abdomen with a smaller needle.
They asked me to be there at 8:30, I would go back at about 9:30. My mom wanted to be there to drive me, however, things just didn't work out that way. I have the best, most amazing friends who were willing to take and pick me up. I had one drop me off, and then my other friend came and picked me up.
Because I was/am so grateful for my amazing support system and friends I made them both a card with a little humor with a women's egg as decoration. cccInside I said some things but my favorite was "you are egg-cellent"
When I was sent back to get to the pre-op area they went through medications, when you last ate/drank, take your vitals, ask when the trigger medications were and who is the person picking you up. Then you get dressed in your gown and such.
The nurse then came in and put an IV in. Then I waited some more time (I had brought my kindle, so I just read). The doctor who was doing the procedure came in and asked if I had any questions. Then slightly later the anesthesiologist came and talked with me, asking if I have ever had issues before, etc. Shortly after that a nurse came to get me, walked me to the bathroom and then walked me into the "OR". They made sure I was sitting in this indent or hole in the gurney thing. My legs were put in stirrups, my left arm was put on an arm rest and the anesthesiologist started giving me meds, as the nurses took my other arm and put the blood pressure cuff on. I started getting that dizzy/blurry vision. Then I was in the post op area.
Not my picture - it's from the CCRM website,
but this is what the OR looked like
Obviously I wasn't awake during the procedure but they take a transvaginal ultrasound but it has a little "needle" thing that comes out of it. That goes through the vaginal wall and goes into the ovary to retrieve the eggs. They do it on both sides.
"Egg retrieval is a minor surgical procedure performed under anesthesia, that last approximately 10 to 30 minutes. Your medical team will retrieve the eggs using an ultrasound probe and needle. With internal ultrasound guidance, the needle is inserted through the upper vaginal wall, and into each follicle. Fluid from the follicles is removed through gentle suction that draws it into a tube. As seen on the ultrasound, once the needle has been inserted into the follicle, the fluid is removed through gentle suction that draws it into a tube. An embryologist will immediately examine the fluid for eggs under a microscope.A single egg is present in roughly 65% to 90% of optimal follicles. In rare cases, no eggs will be retrieved, or none of the retrieved eggs will be of proper maturity to fertilize. This is more likely when very few follicles are present."
They brought Andrea back. They gave me some water and Tylenol. We waited briefly for the doc to come by and give me an update on how many eggs they were able the retrieve. Unfortunately, they were only able to get 5 eggs (I think typically they want 8-10). I would be called the next day from the embryologist.
I wasn't in any pain, I wasn't even really groggy. Andrea and I left, I was still on restrictions and would be until I got my next period. I was starving so I convinced Andrea to go through the McDonalds drive through, and then she also was okay with us stopping for a target order. We got back to my place, and this sweet friend of mine had bought flowers, pastries and soup for me.
I was home by 11. I relaxed. I started feeling extra warm. I did take my temperature and did have a little bit of a fever. I had to call the clinic anyway so I did mention that. I had thought I had received my antibiotics to start taking that evening when I got all of my medications, however, I guess I didn't. Luckily they were able to get them sent real quick and I went to go pick them up.
Because I was on a weight limit during these medications and after my procedure (until I got my next period). So Naturally I took that as I could go to Vegas for the Mecum Motorcycle Auction. I flew out Thursday morning (the day after my procedure).
I was never in pain, but I did have a lot of cramping. The real deep rooted cramping in my lower abdomen. Of course, this was all to be expected. However, I am used to it lasting maybe a day and it was lasting a few days. But completely tolerable. One of the other restrictions had been no coffee. I WAS SO EXCITED TO HAVE COFFEE. I got it at the airport right away.
I did get a call from the embryologist that they could only freeze 3 eggs. That to me does not seem like that great of a number. The eggs would have to be thawed, and then "mixed" with sperm and then also implanted and actually take. So the odds do not seem that great of success. Now maybe I will meet someone sooner the later and I won't even need to use those eggs. I have a follow up appointment with my doctor and we will have to discuss that and see what the options are.
Overall I am glad that I did it. Do I want to do it again? Not really. Would I? Probably. It's a lot of work, and I can't work during that month. My insurance covers up to 30,000 dollars of infertility treatments per life. I will definitely want to know where I am at with that amount. But if I ever do use the eggs, then it would likely be that it would have to be out of pocket - or at least majority of it would be.
It is a lot. It's not just the medications - that I can handle. It's the appointments. There are so many and it's hard to plan ahead. That makes is very hard to work and switch my shifts. If I could work before I really start the stim medications, and then shortly after my procedure, I would probably do it regardless.
I have a follow up appointment end of February. They say they usually bump it up to sooner once they get results of everything. Time will tell if I go through it again.
I do have to say that I have so much support through all of this. I am grateful that I can afford this, that my job and boss have been supportive and understanding and really encouraging. Mostly, I am grateful that I have this option. That women have this option.
A little more eduction about egg freezing:
Egg freezing from the beginning - what to expect.
"Some interesting statistics:When a female is born, she is born "with all of the potential eggs or oocytes you will ever have, which is generally between one and two million. Overtime, the number of potential eggs in your ovarian reserve declines. By age 18, roughly 200,000 eggs remain. A steeper decline usually begins around age 35 as menopause approaches. By menopause, typically only a few hundred eggs remain. Egg quality also decreased over time. This means that as you get older your chances of getting pregnant decrease even if you still have a high number of eggs in your ovarian reserve. For those under age 30, the average likelihood of achieving pregnancy is 25% per cycle. For those over age 30, that likelihood drops to 20% each cycle, and by age 40, the chance of conception is as high as 10% per cycle. This is because of the natural reduction in quantity of quality of eggs over time. " (ccrm.engagedmd.com education modules)
There are risk factors from the fertility medications. "In some cases, ovarian stimulation can result in a condition knows as OHSS, ovarian hyperstimulation syndrome. Symptoms of OHSS include excessive swelling of the ovaries and build up of fluid in the body, which can occur in mild to severe forms depending on your age, clinical situation, and the medications used. The trigger injection can lead to the early onset of OHSS 1-5 days after egg retrieval. The mild form of OHSS occurs in 5-10% of ovarian stimulation cycles. People with this condition will experience moderate abdominal bloating and discomfort that will resolve without medical treatment over the course of 3-7 days. Fluids may accumulate in the abdomen and pleural space around the lungs resulting in pain, discomfort, and shortness of breath. This fluid buildup also results in thickening and concentration of blood, which can raise the risk of kidney failure and blood clots most commonly in the lungs and legs." (ccrm.engagedmd.com education modules)
There are risk factors for egg retrieval just likely any procedure. low blood pressure, nausea or vomiting, and rare cases death, due to the sedation medication. Because of the small blood vessels covering the ovaries, there is a chance of bleeding. It usually is minor and stop on own, but it can accumulate in the pelvic and abdominal cavity. This could cause you to have to have surgery or hospitalization etc. Due to the enlarged ovaries they may twist around can block blood supply, this is know as ovarian torsion. Infection is also a possibilities and increased with endometriosis. (ccrm.engagedmd.com education modules)
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