Let’s Talk Egg Freezing & Fertility in Your 30’s
This is a guest post from my good friend and amazing writer Michelle, who recently went through the egg freezing journey.
Phew. I’ve made it. “It” being one of the most important and complex decisions I will likely make in my life: I froze my eggs at 32 years old.
If you’re here, you know Jetset Christina. She’s joyfully open about sharing her experiences in the hopes of inspiring others to get on that plane, dream big dreams, and take what life has to offer! She’s committed to giving you the stories that are most helpful for you and isn’t afraid to get real. Well, today we’re about to get real. The topic? Fertility and egg freezing – and why, we, as the fabulous women we are – need to think about our fertility now.
A little intro on me
Hi! I’m Michelle. Like many of you, I’m just like every other woman simply trying to live her best life. I live in the Bay Area with my long-term boyfriend, our dog, trying not to lose our minds in our one-bedroom apartment in this COVID world. I’m in my early 30’s, an executive for a busy startup, yoga instructor, runner, reader, and (of course!) an avid traveler.
On a more personal level, I like to dig into tougher parts, ask hard questions, spark genuine conversations. So today, I want to break the taboo that our fertility is only a concern when trying to conceive. I hope to encourage you to consider what makes your fertility journey unique to you as you consider your own ambitions, relationships or partnerships, careers, and your own unique biology. Most of all, I hope to offer something useful from sharing my personal fertility journey story, with small and tangible steps you can start taking in your own life.
These are the steps I wish I knew as I was going through the process. Steps I will forever be grateful I took.
Here’s what we’ll cover:
Fertility is not a simple subject, so for the sake of focus, we’ll be covering 3 main things:
1. Why it’s critical to think about your unique fertility journey now.
2. Where to even begin wrapping your head around the terminology.
3. What steps you can take to determine if egg freezing is right for you.
After taking the steps below, I did end up deciding to freeze my eggs. This was a highly personal decision, and will be for you, too. I’m not here to convince you to freeze your eggs, but I am here to share what went into my decision and how that could help you.
Here’s the bottom line: Knowledge is power. Each woman has her own unique journey, with her own sense of timing, and her own body.
I only hope this helps provide you with a guide to know yourself better.
Let’s dive in.
My motivations: why I thought it was too early until it was nearly too late
For me, minding my “biological clock” was not exactly top-of-mind. When it came to my fertility, I thought: “I’m young, so why do I need to worry?” I eventually wanted to get married and build a family, but I wasn’t going to force or rush anything. Plus, throughout my 20’s and early 30’s, there were plenty of reasons not to think about my fertility: I was having fun (or not having fun) dating, experiencing some relationships that ran their course, letting my current relationship evolve without any added pressure, focusing on my career, and so forth.
Fertility, in my mind, was only something I needed to worry about when it was the right time. I didn’t see any urgency behind it. We see celebrities and friends having kids later. We hear stories of surprise babies later in life (we don’t consider there could be potentially very expensive fertility treatments behind those later-in-life babies!). We’re told “there’s still plenty of time!!” And, of course, my favorite line I told myself: “It will happen when it will happen”.
Stressing too much about it could jinx it, I thought.
I find that many women also share this superstition – as if our fertility is so out of our control that we’d rather close our eyes, cross our fingers, and hope for the best. And, you know what? I don’t blame us. There’s always so much pressure from ourselves and others. It’s intimidating, and we’re taught from a young age that our bodies should work as it’s meant to when it’s meant to. We even spend the majority of our lives trying not getting pregnant, as if getting pregnant was so easy, and will continue to be easy even as we age. And when it doesn’t come easily, we don’t talk about it much.
So, I’m not surprised that fertility and egg freezing are still relatively new topics. And, truth be told, there is a lot about our fertility that isn’t in our control. But here’s what we can do: do what we can to learn about our bodies, and increase our chances of giving ourselves the best possible outcome.
It took me some struggle to get around to considering my fertility. And some wise warnings from someone I love very much. My uncle – who was like a father to me – had no biological kids of his own, sadly, due to trying to start a few years too late despite wanting them so badly. He didn’t want me to go through the same heartache. So, ever since my 28th birthday, he not-so-subtly bugged me to at least think about my fertility. But I resisted persistent pressure from relatives and continued to shrug those comments off.
As life would have it, my uncle died this summer after a 2-year battle with cancer. I was devastated. As I was picking up the pieces in the months after, I remembered his voice urging me to put my hopes and dreams for a family first. Loss and grief have their way of making you pause to reflect on what’s really important in life. Ok, ok – I’ll keep my promise, I thought.
So, on a whim in early September 2020, I decided to take a fast, easy, take-at-home Modern Fertility Hormone Test (yes, those exist now! And it is so easy!). I was thinking: well, it didn’t hurt to do one just in case.
I didn’t expect any results out of the ordinary. But once I got those results back less than 2 weeks later, it felt like a slap in the face: my results were abnormal.
I found out what I couldn’t quite process at the time: that my fertility window was potentially closing faster than expected. I must have read and re-read my results 50 times over. What?!? How is this possible? I’m young, there isn’t any indication of infertility in my family, my periods are regular, I stay active and healthy –– what is going on?!
Needless to say, I didn’t take this news well. There were a lot of tears; I was in total shock, if not outright temporary denial. Without even knowing it, I was gambling with my hopes and dreams of a future family with every day that passed. And the scariest thought: I would have continued to wait had I not taken that test.
After the initial shock subsided, I scrambled to figure out next steps and my options. Once I opened up about my results, I revealed my struggles with a few girlfriends who shared their own stories, and urged me not to procrastinate:
“We just went through 3 rounds of IVF, and it’s heartbreaking. I wish I had frozen my eggs earlier, then this would be so much easier.”
“I wish I had known this was an option. I procrastinated, and now it’s too late for me, but not for you. If you can freeze, freeze now.”
“It’s worth every penny to have more choices. If you can afford it, please freeze your eggs.”
Some of these women had their own “miracle babies” after years of treatment; some were still trying. But all of them were young – ranging from 30 to 37 years old max. So, with their collective wisdom, newfound knowledge, and a promise I made to my uncle guiding me, I took immediate action to learn more.
What I learned, I’ve laid out below.
The basics: what is “fertility”?
When you get to know your own body and fertility, there are several basics you need to consider. There is a lot to know that can take multiple blogs to cover. For the sake of simplicity, I’ve covered basic points only as related to ovarian reserve and egg freezing.
1. Your “fertility”, at its simplest, is discussed in terms of the quantity of your eggs and the quality of your eggs.
2. Fertility hormone tests (like the at-home one I took with Modern Fertility) have gotten good at predicting how your hormones impact your egg quantity.
3. There is no current test to determine overall quality of your eggs; our best guess is your current age. It is assumed that the younger you are, the higher quality your eggs are.
4. Any successful pregnancy is possible with just 1 egg.
Key terms to know (not exhaustive, but a good place to start):
- Ovarian reserve: the number of eggs you likely have left. You are born with all of your eggs and lose about 1,000 immature eggs each month after hitting puberty, but each woman loses her eggs at different rates. Your reserve is key to understanding your egg freezing and IVF outcomes.
- Anti-mullerian hormone (AMH): the hormone that predicts your current ovarian reserve and considered the best blood marker for ovarian reserve. AMH may impact how many eggs are retrieved per egg retrieval cycle.
- Follicle: a fluid-filled sac in your ovaries that have the potential to release an egg for fertilization.
- Follicle-stimulating hormone (FSH): the hormone made out of your pituitary gland that stimulates your ovaries to grow follicles. Medications during treatment include ones that focus on elevating your FSH to stimulate egg production.
- Antral follicle count (AFC): the baseline number of follicles your body has before egg freezing treatment. Your AFC, correlated with your AMH, may impact how many eggs are retrieved per cycle for egg freezing.
- Estradiol (E2): estrogen created by your ovaries to support overall reproductive health.
- Egg freezing: Also known as mature oocyte cryopreservation or fertility preservation, it is a method to help save a woman’s ability to get pregnant in the future. Eggs are harvested from your ovaries, then frozen unfertilized upon retrieval. You undergo the same injections you would for in-vitro fertilization (IVF); the only difference is that following egg retrieval, they are frozen before they are fertilized and thawed at a later date.
To help apply what all of these mean, I will share my results from Modern Fertility. For the sake of simplicity, I will focus only on our ovarian reserve hormones: AMH, FSH, and E2.
What my first fertility test results told me:
1. My AMH was slightly low for my age at 0.58 ng/ML, so my AMH level (i.e. potential quantity) is more comparable to a woman who is older.
2. My FSH levels are high, meaning my pituitary gland is likely putting forth more effort to stimulate follicles to keep up.
3. My E2 was normal – my reproductive health was normal.
Modern Fertility’s nurses will call you to go over what they found and what this could mean for egg freezing. Here’s what they summarized. Note that there are never absolute statements, it’s all about probabilities.
Low AMH + High FSH = my egg quantity was running low. This means my window (in terms of number of eggs) was potentially closing faster than the average woman my age.
Remember: we can only assume that my eggs are still high-quality because of my younger age.
My low AMH means that I may retrieve less eggs during egg freezing. This may result in having to complete multiple treatment cycles to get the ideal number of mature eggs to increase my chances of a live birth.
A woman’s unique set of hormone levels play a large part in your medical protocol for egg freezing.
This is worth repeating! We are working with probabilities. Having abnormal data points does not mean you are infertile. After all, a successful pregnancy is possible with just 1 egg.
Taking all of this into account, it boils down to: the younger you are, the higher the chances you have of not only a larger ovarian reserve, but also of a reserve of higher quality. This is important because more eggs of higher quality result in higher chances of a successful pregnancy. That’s why women who get their eggs frozen when they are younger need to freeze less eggs – compared to a woman who is older – to achieve the same probability of a live birth rate.
Ah! So how does this affect my planning?
If you decide to start younger, this may result in a lot of saved money and time while increasing your chances of a live pregnancy. Some say that the “ideal range” is somewhere between 27 and 34 years old, with most agreeing that before 36 is best. In reality, there is no magic year where a woman should absolutely freeze her eggs – it depends on the woman, her hormones, where she is in her life, and when she’s ready.
Check out Spring’s egg freezing outcome estimator calculator to have a better idea of how your age at retrieval impacts your probabilities of a live birth.
THE NEXT 5 STEPS TO DETERMINE IF EGG FREEZING IS FOR YOU:
Talk to your primary care physician.
After my conversations with Modern Fertility, I contacted my primary care doctor for a second opinion of my results. It’s useful to do this because they have a holistic picture of your health. She gave a similar assessment, though recommended I get an ultrasound to confirm. At this point, I asked her for a list of recommended fertility clinics. Your PCP should have this on-hand. Or, you may also use this link to search for clinics near you.
Make a shortlist.
When it comes to choosing a fertility clinic, do your research as no clinic is the same. Here were a few factors I considered:
- Longevity – how long they’re likely to stay around. This is important as there are newer startups in the space, whereas some have been around for some time. Your eggs are precious and you want them in good hands in case you decide to freeze (and store) your eggs. I considered stages of funding, recent news articles, customer reviews, and number of locations.
- Live birth rates – look at live birth rates and number of customers who have trusted them (and saw success!) to-date.
- Locations – choose a fertility clinic geographically near you. If you decide to move forward with egg freezing, you will be in and out of many (and at times, very early!) appointments leading up to retrieval. Also, ask where your treatment appointments will be, where your retrieval will be, and where your eggs will be stored. They may be in the same space; they also may not be.
Book an initial consultation.
Once you choose a couple (or one leading) clinic, book an initial consultation. A consultation should include a baseline ultrasound to get your AFC count, a physician consult, and a physical exam. At mine, I also decided to take another blood fertility hormone test. From your ultrasound, note your Antral Follicle Count (AFC). Your AFC is that last critical data point that is not covered with blood hormone tests. This will give you an even clearer idea of your reserve and it is correlated directly to your AMH. Note that a consultation will cost around $450 depending on the clinic.
Choose a clinic to build a plan for you.
In my case, I chose the clinic I had my initial consultation with: Spring Fertility. They were openly communicative, knowledgeable, customer-service oriented, conveniently located in the Bay Area, and didn’t pressure me to make any quick decisions.
Assess your plan and the costs.
Take time to review your plan and your treatment cost. Your treatment cycle is 3-4 weeks long. Ask questions about each phase or stage of treatment – you will need to know this to schedule around your travel, work calendars, etc. Discuss best-case scenarios and worst-case scenarios with your physician.
Of course, there are also personal factors to consider when deciding whether or not to freeze your eggs.
The tough stuff: asking yourself (and/or your partner) the right questions
What questions should you ask yourself when deciding to freeze your eggs? Like any big life decision, it’s a mix of head, heart, and trusting yourself to determine what’s best knowing what you know. Egg freezing is not a lightweight investment, and there are a few personal factors to consider. Here are some questions to get you started:
- When do I (and/or my partner) want to begin trying for kids?
- How many children do I (and/or my partner) ideally want?
- Does it matter to us if our kids are biological?
- Do I have a unique medical situation where egg freezing may be more beneficial (i.e. endometriosis)?
- What is my current financial situation?
- How many treatment cycles, if any, can I (or we) afford?
- How many treatment cycles, if any, am I (or we) willing to go through?
- Does my medical insurance cover any treatments?
- Do my workplace benefits cover any treatments?
- Can I wait to make my decision on egg freezing?
- If so, for how much longer and how big do I see the risk being?
So, for me, I knew:
1. We weren’t going to be ready for at least a couple more years.
2. We wanted at least 2 kids biologically, and this was very important to us.
3. So, practically speaking given my age, kid #1 may be easier to conceive, but kid #2 may be more challenging as we got older.
4. Financially, we were prepared to do up to 1 cycle and could discuss a second cycle if absolutely necessary.
5. My medical insurance did not cover this,
6. But my workplace benefit did cover up to $5,000.
7. Given my results of low AMH, low AFC, and high FSH, I was not willing to risk the wait.
8. I knew the younger I did this, the more money and potential heartbreak I may save myself and my partner in the long run.
With all of these factors in mind, I made the challenging, but practical, decision to freeze my eggs. My whole decision-making journey started in September; I made my decision in November, then proceeded with treatment in December. My retrieval date was January 1, 2021 – and I’m back into my normal routine, just a few days later.
Ok, friends – you’re now armed with an idea of your unique history and dreams, your blood hormone fertility tests, your ultrasound results, and your potential treatment plan. You have sufficient information to help make a more sound decision about what’s right for you –– if you want to consider freezing your eggs.
What are the costs of freezing your eggs?
I wanted to dedicate a separate section to this because it’s one of the top questions I get about egg freezing, and rightly so. I will be honest: it is expensive and it is not a guarantee. Many women consider egg freezing an insurance, but it’s not quite, because it doesn’t promise a payout like insurance does. Instead, I encourage women to look at egg freezing like another option to tap into – should you run out of all other (natural) options in the future and need to try your “younger” eggs.
For me, it was worth giving myself this option. But more importantly, our financial situation allowed us to afford it. I also acknowledge this may not be immediately financially accessible to everyone (I wish it was!). So, please make this one of your primary factors when considering egg freezing.
So, what are the true costs of egg freezing?
Most will pay somewhere between $15,000 – $20,000 per cycle, with some women opting for two cycles. Note that costs will vary from person to person because every person’s clinic, medical protocol, and number of cycles will be unique.
- [Optional] At-home fertility test – the Modern Fertility Hormone Test : $159*
- Initial consult with Spring Fertility: $450
- One cycle with Spring: $8,750
- Vitamins to support treatment: $100
- Medications: $4,400
My Grand Total: $13,859
A few critical notes:
- There is also an annual fee for egg storage. At Spring, that is $650, but they waive the costs for your first year.
- There may also be a few more optional fees in there you want to keep an eye on, like genetic testing.
- This does not include the cost of having to resort to using your frozen eggs in the future. Costs for future IVF, for instance, are not taken into consideration here.
*Note: Modern Fertility is a good starting point because it’s less expensive and way more convenient (what’s easier than being at home?). You can also get this same fertility panel test done at a nearby clinic, which could cost anywhere from $800 – $1,500.
Can you tell me more about the actual process & procedure?
I am more than happy to answer any questions about what the actual experience is like, but every woman’s experience is so unique to her own body (and this blog is getting quite long!). There are also so many wonderful resources out there for you to read that I’ve included below for generally what to expect – if and once you do make the decision to move forward.
There were few common questions I did get, though, which I will quickly answer below. The long and the short of it was that it was an incredibly humbling, emotional experience with ups, downs and everything in between.
Do you have to inject yourself? Is it painful?
Yes, you have to give yourself injections (the needles are tiny, though pain tolerance varies from woman to woman!).
What about the procedure? Does it hurt?
No, the procedure itself was not painful and was over in 30 minutes. It is a surgery, but is considered “minimally invasive” and is an outpatient procedure (i.e. you do not stay overnight).
Are you put under anesthesia during egg retrieval?
Yes, you are put under anesthesia during the procedure itself.
Are there side effects to freezing your eggs?
Side effects, if any, and recovery side effects, if any, vary from woman to woman.
What’s important is that you take care of yourself throughout the whole process. Practice self compassion, practice lots of self-care, because your body is doing its best and working very hard!
Here is some additional reading I found helpful if you’re interested:
- What is Freezing Your Eggs Really Like?
- Everything You Need to Know About Egg Freezing: Extend Fertility
- Getting to Know Your Medications: Spring Fertility
- What to Know about Egg Freezing: MedicalNewsToday
Thanks for reading my fertility journey!
After all is said and done, I mainly feel relieved, grateful that we tackled this, and eager to help others by sharing my story. I feel better knowing I gave myself (and my partner) the gift of another option in case we may run into fertility challenges later down the road. And, I kept my promise to my late uncle, and hope that wherever he is now – he’s proud.
I sincerely hope this helps you think more about what’s important for you and your own fertility. It’s tough stuff! I’m here for you, please feel free to ask any questions or share any feedback in the comments.