SART Fertility Experts - Elective Fertility Preservation

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Our experts are members of SART, the Society for Assisted Reproductive Technology, an organization dedicated to ensuring you receive quality fertility care. Hello and welcome to this episode of the SART Fertility Experts podcast. My guest today is Ellen.

Ellen is here to talk about her experience with elective egg freezing. This is also called oocyte cryopreservation. Ellen, thank you so much for joining me today.

Thank you for having me. So Ellen, you decided to freeze your eggs a few years ago, long before you were ready to start having a family. Can you talk a little bit about the decision to do that? So at the time, I was a fellow in a field that was a field that comes out of OBGYN or obstetrics and gynecology.

And during my obstetrics and gynecology training, we trained with fertility specialists. And I was really struck by how once you became a certain age, it would be very difficult to have a family. Because of my training and because of my job, I had not met a future partner or any partner.

And I started thinking, wow, if I don't meet them soon, I may not be able to have children. And I think that the fertility doctors tend to say, hey, whenever you can, you should start thinking about it because fertility drops significantly as you age. And so I was lucky because where I worked or where I was training, they actually would give you 50% off to do IVF.

And my parents were willing to pay for that for me. So I was, I think, a first year in my fellowship, and I started the process of egg freezing. At the time, though, this was quite a long time ago.

So this is over nine, actually, 10 years ago. At the time when I started this process, it was still experimental. And I had to sign the IRB form.

And so the IRB is this governing body that makes sure that scientific studies are not going to harm patients and that they're ethical. And so I actually had to sign a form because it was experimental, the vitrification of eggs. And so because it was experimental, I actually decided to make what I like to call a fertility bank.

And I knew that they don't always know what kind of eggs that they get. And so you don't know what you're going to get until embryos are made. And embryos also at the time tended to be freeze easier and unfreeze easier.

So before I froze the eggs, I did two cycles of IVF and froze embryos. I picked sperm out from a donor site online and picked attributes that I wanted. And I did two cycles of IVF and made embryos.

And then my first cycle wasn't very good. And so the second cycle was great and made a lot of embryos. And so I did a third cycle, just exactly like the second cycle, but for eggs.

So then I ended up having 13 embryos and 9 eggs frozen at that time. And then I went on my way. And I dated a lot.

It actually seemed freeing to me to have that fertility bank because then when I went on dates, the person that I was with didn't necessarily have to be my husband because I had to have kids very soon. So that was great. And that gave me a lot of freedom.

So Ellen, it sounds like you benefited a lot from being perhaps in a medical environment because you were able to hear about the benefits of egg freezing. It was available to you, accessible to you. It was something that was offered next door or something like that, or something available readily to you.

So you benefited from being in an environment that supported it and in many ways. And so that probably helped you along quite a bit. Absolutely.

But also, this was before egg freezing was really becoming a thing. It was really me. I just kept thinking about, wow, what if I miss my chance? And what if I don't get married? And I was already 33.

And I was like, I can miss it. I think I want to do this. And then not a lot of people did it.

At the time where I was training, they mainly did it for people who had to undergo cancer therapy. That's who they were doing it for. But they were willing to let me do it.

I had to speak to a social worker and a bunch of different people. So for our listeners, you're in the medical field, but you had a lot of years of training ahead of you before you would feel ready to potentially start a family. And so by freezing eggs and embryos, it gave you a little freedom and flexibility to finish your training, it sounds like.

Absolutely. Yeah. I would not have been able to, I don't know how I would have handled children during my training.

And I did seven years of training after medical school. So it was a long road. Well, you are very smart to be thinking ahead like this.

And I think, unfortunately, a lot of women in professions that do require advanced training like this or many years of long hours don't always realize that they may benefit from egg freezing. So you were a bit of a trailblazer by going ahead and doing this when you were just 33 years old. Can you talk a little bit about what that process was like? Because obviously you were still going to work every day.

You really, I assume, couldn't take time off to do that. Right. Yeah.

Well, during my training, we had some months where we were doing research. And research meant we sort of had our own time to be working on our research projects. And so I had a little bit of flexibility there.

Also, because I was working in an obstetrics and gynecology field, I was right around all the people who did ultrasounds and things. And it required a lot. I had to administer shots to myself.

Sometimes it was five a day. And I had to go for multiple transvaginal ultrasounds in the mornings. And then I had to take, I had to go and then it's a procedure to have the eggs removed.

And so you have to be put under anesthesia. And then I needed to have somebody with me that day. And so I could go home and some people I know could get, you can get sick actually from having these shots and stuff where you overstimulate and things like that, which it didn't happen to me.

And I actually had very little pain ever with any of these procedures. But it could, I knew that there was a potential for bad things to happen, especially because I just know that area of the body so well. So it was a little bit nerve-wracking.

And it was a little bit lonely actually, you know, because it was just me doing this by myself, having to administer these things. I think I thought a lot about how like, if I had been married and this was, I was going through this, I'd have somebody else helping me. And that wasn't what was happening.

But at the same time, it was still, it still felt like I was doing this out of love. And it felt like I could definitely have a potential child. And so that was the thing that kept me going, knowing that like, if I do this now, hopefully that even if I get older, I'll be able to have children.

Wow, what a story. That is amazing. So let's just talk a little bit about that.

So all this monitoring, you mentioned that there are some potential complications with doing this treatment. So the monitoring, the seeing you for multiple visits, that's really to make sure that you don't have too big a response to the medication, you know, your doctors need to be able to adjust your doses of medication if needed. So it does really require frequent short visits, usually for ultrasounds and lab work on during the process.

And I think that is a commitment that anyone who wants to freeze their eggs has to be willing to make. But usually on those days with monitoring, you can go to work afterwards. And I think that's something our listeners should know, during the egg freezing process, you're not missing work for two weeks, you are going to be missing work the day of your egg retrieval, your procedure, and that requires anesthesia.

And you will need someone to drive you home afterwards, typically. So and then how quickly did you get back to work? Do you remember? Yeah, I think both times I was back, like either the next day or the day after. So it might have been like, or the three times I did it, it might have been close to the weekend.

So then I had the weekend to recover. But I really, it took like a day for me to recover. I know that that's not always the case.

But for me, it was the case. Well, it sounds like you did really well. And that actually sounds like a pretty typical experience for most people, you know, and the timing of egg retrieval really depends on how you respond to stimulation.

So it's not something that can be planned necessarily for a particular day of the week. You really are at the mercy of how your ovaries respond to stimulation. And I'm sure you learned that during the course of this process.

Yeah, I actually could like probably pinpoint when it was what day it was going to be knowing how my body reacted after the first or second time. So fast forward, you completed your training, you had obviously decided to keep those eggs and embryos in storage for a few years. Um, and when you were when you decided to freeze, how were you counseled about that? Do we did they explain to you anything about the duration of time the embryos and eggs could be stored? Um, they did not.

Okay. I mean, that it was a specific time period. And they said at least 10 years they could be stored for.

Right? Right. And that's typically what will counsel our patients is that they can be stored indefinitely until you're ready to use them. Not all patients will end up needing to use their eggs and embryos and it just like it was for you.

It was, you know, a backup plan in case you needed them. So there they were. And so you, you did have to keep them in storage.

I think, you know, advice to our patients, if you do end up freezing eggs and embryos, it's really important to maintain communication with a program and the lab where they're stored. So they know where to reach you. Um, usually you will have to pay for monthly storage fees or yearly storage fees for eggs and embryos.

And that's just something to keep in mind that you are going to be responsible for, um, the, the, um, keeping eggs and embryos and liquid nitrogen is does there is a cost associated with doing that. So it's really important to make sure that you, um, maintain your, your contact with the clinic where your, um, eggs or embryos are in order to do that. And if you move to make sure you let your clinic know your new address, so they can find you.

Um, also very important, which many people now in our society are very mobile and moving around for career and, and everything like that. So, um, so Ellen, can you talk about, um, the next part of the process when, how, how did you come back to this? So when I, I finished my studies, I moved to a new town. Um, and I established myself there.

I decided that I was ready to try to become a mother. And so I still was apprehensive as to what I had in storage in the, in the different place that I lived before. And so I decided, well, I'm 39.

I might as well try first just to see if I have any eggs left in me before I go and use my bank account. So I did another IVF fresh cycle and I failed that cycle. So, I only made, I think one embryo that was good and they, were good enough to put in.

And, it caused a chemical pregnancy. I live in Massachusetts. And so in Massachusetts, fertility treatment is covered once you do, IUIs, which is where they use sperm and inject it into your uterus at the time that you're fertile to see if they can get you pregnant.

And so you have to do six of those in order to then get IVF. So, I paid out of pocket for that first IVF and then I said, okay, well, I'll do the IUIs so I can use insurance to see. And on the first IUI that I did, and I used the same sperm as my embryos.

That's the key. Another thing, I still had sperm from that time. So I use the same sperm as my embryos.

I had an IUI and I was pregnant and I got pregnant and I had one daughter who's now three and a half. So, and I think that was probably my last good egg. So I delivered her at age 40, and she was healthy and everything was great.

And then when she turned a year, I decided I wanted to have a sibling for her. And so I, again, was like, oh, I'll just do IUIs because it worked the first time it should work again. But at this point I was 41 years old and I ended up doing eight IUIs and another fresh IVF, which all failed.

So then I said, well, I should go back to where my eggs and embryos are and see if any of those are going to work. And so all my embryos at the time that were frozen, were frozen at day three. And I think that's because at the time they didn't look terrific.

And so they wanted to freeze at three. So they'd have something to freeze, but they then unfroze them and grew them out and they ended up, unfreezing six and four grew. So I went and I had a frozen transfer of two embryos and there was a long discussion as to whether we should have put both of them in or not, because they both looked gorgeous.

So they somehow corrected themselves once they grew. They both looked very, very good. And so the chance of twins was very high.

I didn't realize at the time that it was as high as it was, by the look of those embryos. I ended up, getting sick right after I had the transfer, from getting cellulitis from the shots or from the transfer. And so I think that probably if I was meant to have twins, one of them got knocked off during that, that episode, but I ended up having one very healthy girl who just turned one today.

So I have two daughters from ART basically. It's amazing. What a great story, Ellen.

Congratulations on the birth of both of your daughters and the birthday of your youngest today. What a great, what a great story that is. You did mention an interesting point.

So for our patients who are thinking about using embryos or eggs that freeze, when we think about the number to transfer, we try to think about the age you were when you created those eggs and embryos. And so even though you were 41 years old, typically we would transfer the number that would be recommended for a 33 year old, which was the age when you originally froze those, which was, which was one, right. And then one would be recommended.

Right. Right. And, and you know, the person who was transferring them trained me and she was actually the most conservative, of all of them in that, that department.

We really did have a long discussion because she's like, we can refreeze one. She's like, but at the same time, you're a busy surgeon and we're going to have, like, if it doesn't work, you know, then you have to keep coming back. And I was very lucky because I, you know, had this transfer and then within three weeks COVID hit.

Um, I wouldn't have been able to go back for a long time. So it would have prolonged having a baby. She said, what would you do if you have twins? I said, I'd rather have twins than no child.

She's like, what if one splits? And then we had discussed it about that because I was not going to carry triplets. So, she liked my answers and went for it and I'm glad she did because I only had a singleton, but, I think the chances were quite high. Cause when I looked at them, they were like, I think I saw the pictures of those embryos too.

And you lost the blood out of the color of your, out of your face. And I was like, Oh, they were very nice embryos, Ellen. And I was happy for you.

So, I think, the key to all of this for our listeners is good counseling, listen to your doctor, listen to what they're saying to you. They've seen lots of patients like you before, and, they really want to help, and they want to make sure that you have a good outcome. We're trying to help you have a healthy pregnancy and not put you or your baby at risk for any complications.

So, any decision to proceed with a cycle, using frozen eggs and embryos definitely needs a lot of careful counseling. So it sounds like you got it. And it sounds like you so fortunately had a really excellent outcome, using your frozen eggs.

So it was nine years in the freezer. Wow. That's amazing.

Well, you know, we hear a lot about women freezing their eggs nowadays,  for various reasons. I think there you're absolutely right. It's a very popular option.

Many women are coming to us to freeze their eggs, but we don't get to hear about too many people using those frozen eggs. It's, it's few and far between, I would say probably our cancer patients. Some of them have been coming back to use their eggs after, completing chemotherapy and getting clearance from their oncologist.

But I haven't seen too many other patients who've had success like you have, you know, because they needed to delay childbearing to finish their training. So I am so happy that you took the time to share your story today with our listeners and to really talk about the ins and outs of the process with everyone. Is there anything else you'd like to add or any other thoughts about egg freezing that you'd like our patients to know? Well, I really think that if you're thinking about it, just do it.

Even if you think that you don't even want to have children when you're older, things change and you don't know how you're going to feel. I never thought I would have children on my own without a partner. And yet I did.

And it's the best thing I ever did in my life. Way more important than even all the medical training I went through or anything else, which I am proud of. But my two daughters are the thing I'm most proud of in life.

Thank you so much, Ellen. It's been a pleasure speaking with you today. Thank you for sharing your story with all of us.

This has been today's episode of SART Fertility Experts featuring egg freezing. My guest today was Ellen. Thank you so much for sharing your story with us.

Thank you for having me. Thank you, Ellen. Take care.

Bye-bye. Bye. Thank you for listening to SART Fertility Experts, your resource for information on IVF.

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