'There's so much more to egg freezing than I thought.'

“Ok Lizzie, we’re going to administer the anesthetic now. You’ll feel a little pinch in 3, 2, 1…”

I felt the familiar, tiny prick of a needle going into my left arm as more doctors appeared in my peripheral vision. I spotted stirrups at the end of the bed, and the last thing I remember feeling is relief that I wouldn’t be conscious when my legs were placed into them.

You might think — after decades of pap smears, internal scans, an IUD insertion (and swift removal) — that I’d be used to the joys of women’s health by now (will we ever be?).

Not quite.

Watch: Manman’s egg freezing journey. Post continues after video.

Video via Mamamia.

Besides, this particular procedure was a first — and hopefully, last — for me. Like a rapidly growing number of women in the West, I was having my eggs retrieved to be frozen.

Before we go any further, I want to acknowledge that I was doing this electively. I’m in a committed relationship, but we weren’t experiencing challenges with fertility or preparing to undergo a health treatment that could impact it.

Reproductive treatments of any kind can be difficult and triggering for a host of completely valid reasons that I would never dismiss. But doing this by choice rather than necessity, with the support of a partner, made the process less emotionally gruelling for me than it is for many.

As for how I ended up there — full of hormones and hope that they’d retrieve enough mature eggs to ease the echo of the ‘ticking clock’ in my mind — apparently, that’s a decision thousands of women can relate to.

The boom of elective egg freezing.

The number of egg freezing cycles performed each year increased by 1000 per cent between 2010 and 2020 — with significantly more growth projected. While those numbers include medically necessary cycles, elective or ‘social’ egg freezing is on the rise too.

“There are a few reasons for this,” Dr Raewyn Teirney, my fertility specialist at IVFAustralia, explains.

“People are delaying starting a family so they can focus on their career, get into a more comfortable financial position, or sometimes they’re simply not ready. Some patients haven’t met the right partner yet and want to potentially give themselves that option down the line.

“It’s those who want to be a bit more proactive about their fertility, without having to rush or be consumed by a fear they’ll run out of time.”

With growing demand comes growing business. The fertility industry is privatised in Australia — which means clinics are for-profit; they set their own prices and market their services. You may have noticed an increase in ‘egg freezing’ ads in your feed lately — some more responsible than others.

While anything that gives women more control over their bodies is a net positive, experts warn against clinics that use unrealistic claims or fear-mongering methods to exploit a sensitive, loaded, and often triggering subject for women.

“Anything that claims absolute success with egg freezing or birth outcomes is a red flag,” explains Lisa Ransome, perinatal and reproductive psychologist at Seeds for Hope Perinatal Psychology.

“Irresponsible marketing can create a sense of urgency and pressure on women, and push them to make decisions about fertility preservation when they may not have the financial means to do so. It’s not accessible for everyone, physically and financially, and can err into preying on vulnerabilities.”

Dr Teirney agrees.

“Be aware of any advertising that promises guarantees or ‘amazing results’,” she warns.

“There are no guarantees that egg freezing will result in a live birth. As the industry grows, there are more people entering the field who aren’t actually experts. Choose your clinic and your doctor wisely.

“A good specialist will have a conversation around the realities and pros and cons of your specific situation to help you decide whether egg freezing is right for you.”

As for my specific situation, having kids has never been ‘top of mind’. My twenties were dedicated to travelling, writing, and building my business. At 33, I’m still not ~ready~, but I’m also aware that I can’t keep my head in the sand on this forever – because, biology (unfortunately).

So my decision-making went something like this: Do I want to be a mum right now? No. Do I know for sure I’ll want to use these eggs at some point in the future? Also no. But do I fear that I’ll regret not doing it if I do have issues when (or if) I do feel ready? That’s a yes.

It may sound simple when mapped out like that, but — like most issues pertaining to reproductive health — there are nuances, complexities, and costs to consider. These can vary significantly depending on what medication you’re prescribed, which clinic you go to, whether you qualify for medicare rebates, and how many rounds you need or decide to do.

Generally, you’re looking at a minimum of $10,000 — plus annual storage fees for as long as you decide to keep your eggs ‘on ice’. There’s also a lot more to the egg freezing process than some marketing may have you believe.

What *actually* happens during egg freezing?

The first step is booking an appointment with a fertility specialist after getting a referral from your GP.

Dr Teirney talked me through exactly what would happen to my body during an egg freeze cycle and the reality of the potential results based on my age. When I decided to go ahead, I was sent down the hall for a (very comprehensive) blood test and an internal ultrasound.

Both had to be completed at a particular phase of my cycle. The blood tests assessed a number of things, including thyroid production, vitamin D and anti-mullerian hormone (AMH) levels. AMH is produced by follicles, and is an indicator of ovarian reserve. It’s a number that can cause a lot of anxiety if not explained properly.

“AMH is an important number for fertility treatments because it determines what type and dose of hormonal stimulant your doctor will prescribe. A low number doesn’t necessarily mean you’ll have difficulty conceiving, and a high number doesn’t necessarily mean you won’t,” explains Michelle Smith, AHPRA registered Chinese medicine practitioner (BHSc), reproductive health educator, and founder of Ova Acupuncture.

“It’s one piece of the puzzle.”

Other pieces include hormone levels and the results of that internal ultrasound.

If you’ve never had one of these, the name basically says it all. The sonographer inserts a wand-like device vaginally to determine the shape and thickness of your uterus and how many follicles can be seen in each ovary. The team at IVFAustralia managed to make me feel comfortable during this, but as you can imagine — it’s not exactly pleasant.

Once the tests had been run, I went back to Dr Teirney to discuss my results and treatment plan. Even as someone doing this electively, sitting in that waiting room was anxiety-inducing. What if I found out something was ‘wrong’? Would it create a sense of panic or force me to rethink my current priorities?

I was lucky. While I did confirm I have polycystic ovaries — something I’d suspected based on past scans that can be problematic if not managed correctly — it meant my AMH levels were high for my age. Everything else was within the healthy range.

During this appointment, Dr Teirney explained the process to me again.

“Egg freezing involves stimulating your follicles to grow into mature eggs and retrieving as many as possible. The stimulation phase typically starts on day two of your cycle, and lasts anywhere from 10-12 days, depending on how your body responds. During this time, our team will be in touch with you daily and you’ll be monitored with blood tests and scans to assess the growth of your follicles.

“Once they reach a certain size, we’ll schedule you for the egg collection or retrieval procedure. You’ll administer the ‘trigger’ shot 36-38 hours before the procedure to help the egg mature inside the follicle before we operate to collect as many follicles as possible.”

Dr Teirney also explained there was no rush to start the process, and I could take my time to decide when — or if — to start.

And I did. Having a high AMH puts me at higher risk for Ovarian Hyperstimulation Syndrome (OHSS), a reaction to stimulants that can increase nausea and discomfort for patients and, in rare cases, be very serious.

To give myself the best chance of a positive experience, I consulted a mix of eastern and western medical specialists, along with friends who had undergone IVF out of necessity, to help me prepare.

How to prepare for egg freezing.

As with any health matter, preparing for an egg freeze cycle is personal. When I spoke to experts in this space, I learned there are often differences between those who do it out of choice and those who do it out of necessity.

“I find that many of my social egg freezing patients are not taking the same preparatory approaches as those that are preparing for IVF due to medical reasons. The stakes seem ‘higher’ for those on the medical IVF path, and the focus is on quality, whereas I find the elective path is more focused on just quantity,” explains Michelle.

“I recommend you prepare for your egg freezing as if you were preparing to conceive. It takes approximately three months to influence egg quality, so I recommend, at minimum, three months of preconception care. This should involve removing alcohol and drugs, taking a prenatal supplement, aiming for eight hours of sleep per night, stress management (acupuncture is great for this), and stopping hormonal birth control.

“I also recommend following a Mediterranean diet or working with a fertility nutritionist like Monique Cormack, who can provide more individualised nutrition plans to support your egg freezing journey.”

While doctors say it’s not necessary to completely stop drinking, they do recommend maintaining a healthy intake in the lead-up to and during your stim cycle.

“General health and wellbeing should always be a priority,” explains Dr Teirney.

“In the lead-up to your stimulus cycle, it helps to re-evaluate your lifestyle. The biggest issue we see is smoking and vaping. If there’s one thing women can do to help their eggs, no matter what age, it’s don’t smoke or vape.

“Reducing alcohol intake can help, as can a healthy Mediterranean diet and regular exercise. A folate-rich diet or supplement is great for egg quality, as is ensuring your iron and vitamin D are at great levels. Things like acupuncture can help ease general stress.”

While it was challenging at first, I enjoyed the ‘excuse’ to cut back on drinking and focus more on my health. Though I experienced a bit of cognitive dissonance at ‘preparing my body for conception’ when I felt far from it, I implemented all of these practices, including a prenatal supplement, for 3–4 months before starting my stim cycle.

And I’m glad I did.

During the stim cycle.

Dr Teirney warned that I should ‘expect to be quite bloated and uncomfortable during the stimulus phase’. She wasn’t wrong.

I started injecting the shots on day two of my cycle as per the nurse’s instructions. I’m generally okay with needles, and the team had shown me the best ‘anti-bruise’ technique. I gave myself a shot at the same time each night. On day five, I went back in for my first blood test.

At this stage, I was feeling a little bloated but mostly okay. My bloods confirmed my estrogen was rising fairly rapidly, and I was told to come back in for another blood test and internal scan the following day. It was also time to start taking the second shot, which prevents ovulation, that night.

My body was responding well, so Dr Teirney dropped my dose to mitigate any risk of OHSS. From day five onward, taking two shots a night, I was definitely feeling the bloat and discomfort she’d warned about. I was also more fatigued and less focused.

“We generally recommend avoiding overly strenuous exercise, slowing down, and eating nourishing, whole foods. It’s also important to avoid saunas, baths, and hot yoga; spiking your temperature quickly can impact your results,” Dr Teirney says.

“I recommend doubling down on mindfulness and stress reduction techniques such as meditation, journalling, and acupuncture,” advises Michelle.

“I also recommend gentle exercise and avoiding HIIT, hot yoga, or any exercise that involves twisting (this is especially relevant where OHSS may be a possibility). Focus on your mental health and book appointments ahead of time, whether that be with your counsellor, psychologist, acupuncturist, or dinner with your close friends.”

My stim cycle ultimately lasted nine days, which is shorter than average and more typical for patients with polycystic ovaries. While some women say they breeze through this phase with little to no effect, others find it emotionally and physically debilitating.

In the last 24-48 hours, I was pretty much couch-bound. By the time I went in for my procedure, I was ready for it all to be over.

The egg collection procedure.

The morning of my surgery, I was greeted by a maternal-feeling nurse who gave me a robe to wear and a heated blanket to keep warm.

I met the doctors who would later be in my peripheral vision one by one: the embryologist, the anesthetist, and Dr. Teirney popped in too. She explained once again what was about to happen.

“The retrieval procedure generally takes about half an hour,” she said.

“We’ll retrieve the eggs under ultrasound vision. A very thin needle is inserted through the vaginal wall and into the ovary to collect as many as possible.”

When offered the choice between sedation and general anesthesia, I quickly opted for the former (I repeat: stirrups). As I was wheeled into the operating theatre, any nerves were overshadowed by a sense of relief that I’d made it to this point. The end was in sight.

Then suddenly, it was here. I woke to a nurse offering me some apple juice, telling me I had done well. They retrieved a high number of eggs, again more common for people with polycystic ovaries, and would know later in the day how many were mature enough to be frozen.

I was kept in the clinic for about half an hour to have some food and water before my partner could take me home to recover. Before I left, Dr Teirney came to check in and gently reminded me that not all of the eggs retrieved would be frozen.

Generally, around 80 per cent of retrieved eggs are mature.

I spent the day in bed while, in the clinic, an embryologist was examining my eggs to assess how many were viable to freeze.

Around midday, I got another call, and it was a good one. They had frozen 96 per cent of the eggs retrieved, which was an amazing result. I was one of the *very* lucky ones.

It took about 7-10 days for the bloating and discomfort to dissipate. The trigger shot causes ovulation, which means patients can expect their period 1-2 weeks after the procedure. Then, hormone levels reset, and the body can return to its natural rhythms.

It’s been just over a month since I had my eggs frozen, and it already feels like forever ago—though not so long ago, it was all-consuming. While I know there are no guarantees that the eggs I’ve frozen will result in a live birth, I do feel a sense of relief that, for now, I’ve done what I can without rushing one of the most consequential decisions a woman can make.

Any decision about fertility and reproductive health is deeply personal and shouldn’t be dictated by fear-mongering marketing. If you’re considering freezing your eggs, consult with a psychologist and specialist you trust, and don’t be afraid to seek multiple opinions. If cost is an issue, some clinics offer payment plans, and you may be eligible for a Medicare rebate.

Fertility psychologist Lisa Ransome says: “Egg freezing provides opportunities for the future, but it doesn’t create certainty. If you have the means to engage in elective egg freezing, then it might be a good option for you. But you do need to be aware of the risks to the process, the limitations to outcomes, the costs that are prohibitive for many, as well as the decision-making in the future should you decide or not to use the eggs you have opted to freeze.

“If you are considering elective egg freezing and are unsure, you can make an appointment with Australian and New Zealand Infertility Counsellors to obtain independent discussion and options for elective egg freezing prior to approaching a fertility clinic.”

After securing the commission, the writer approached IVFAustralia who were able to subsidise some of the services.

Feature Image: Supplied.