No yolk, I froze my eggs

Disclaimer:

I originally created a doc two years about my egg freezing experience. It got re-shared a few times, so I figured it might be helpful to make it public. I wrote the long doc to share what my experience was like because it’s an intimidating process and I relied on a lot of anecdotes about the process from friends and friends and mad Googling. So many people I know are considering the process, so I hope this helps provide some clarity into what it’s like.

The content in this doc is not intended to be a substitute for professional medical advice, diagnosis, or treatment. This is based on my personal experience going through Spring Fertility/Progyny, and your experience may vary significantly. Please seek the advice of your doctor or other qualified health providers with any questions you have about egg freezing. This is strictly my opinion/experience, and shouldn’t be construed as anything but that.

Also, apologies for any grammar or spelling errors below!

The Why

I decided to freeze my eggs because I want to choose my own timeline to have a family. I have a supportive partner but we’re not ready for kids, I want to focus on my career, and I recognize my body’s ability to have a kid has its limits. I’ve had a decent number of friends have miscarriages in the last few years and I know I definitely want kids, so I want to have a backup plan. I’m lucky enough to work at a company where we have fertility benefits through Progyny, so my medical costs for egg-freezing are essentially my medical insurance’s out-of-pocket maximums (~$2,200). Given all of the above, I figured, why not?

Also, I never turn down an opportunity to utilize egg puns.

How does Progyny work?

Note that this is my experience with Progyny, through my company’s benefits. Your company’s medical benefits may vary and how Progyny works may change.

My company provides a certain number of Smart Cycles to employees per lifetime. Progyny’s fertility treatments are each assigned a Smart Cycle value. Egg freezing is worth 1/2 a Smart Cycle.

To get started, I called Progyny to have my initial consultation. Progyny assigns you a Patient Care Advocate (PCA), that answers all your questions about the egg freezing process. I have a wonderful PCA who happens to also be a fertility nurse practitioner, who outlined every single step, talked me through expectations, costs/coverage (it depends on what medical insurance you have), and answered all the random questions I have. She also messages me from time to time to check in. With Progyny, you have to get preauthorization to get started, so I’d contact Progyny right away if you’re interested.

Finding a Provider

After you have the initial call with Progyny, they’ll ask you to find a in-network provider via the Progyny Provider Director. Some other websites Progyny provided to review for providers were Fertility IQ, HealthGrades.com, RateMDs.com, Vitals.com.

I highly recommend doing this as soon as you make the decision to get started. I was surprised to find so little availability with providers in the area. It was essentially take this date in 3 weeks, or this date in 2 months! If you’re in SF, apparently egg freezing services were in high demand.

I found my provider, Spring Fertility and Dr. Klatsky through a recommendation from a friend. So far my experience has been fantastic. Here’s an interview with Dr. Klatsky that talks about the egg freezing procedure. I’ve been able to get appointments starting at 7am for blood draws and ultrasounds, which has been helpful for getting it done before work.

Once you find your provider, let your PCA know. They’ll preauthorize the visit once you have the provider appt scheduled. There’s a bunch of other paperwork and forms you have to fill out, and that varies a lots, so check with your PCA about that.

Consultations and the process

I had a 1:1 initial consultation with Dr. Klatsky, where he went over a deck about how the process works, fertility rates/age charts, risks/benefits, and more. I had a consultation with a Cycle Coordinator from Spring, who guided me through all the forms, any additional questions, and my cycle calendar. The following week, I also had a group class with a nurse who taught us about the medications and the injection process. I was also assigned a nurse from Spring who would be available to continue to ask questions.

I took these times to ask any and all questions. Any followup questions I had, I would email my nurse. Dr. Klatsky, my nurse, and my Cycle Coordinator were all very patient with answering questions, and trust me, I had many many questions.

Essentially the process is this (This was my process and I’m not a medical professional so BIG disclaimer here that this may not be your experience):

• Initially, after your consultation, you’ll go in for a bunch of blood draws for a genetic screening and do a baseline ultrasound.
• PS these are NOT the same kind of ultrasounds that you see on tv where they wave a wand on your belly. These are kind of like a gyno exam. I was very surprised. They really get in there.
• The baseline ultrasound is to examine your ovaries and make a prediction of how many eggs my body could produce. My doctor pointed out this area that had a bunch of black dots (like “chips on chocolate chip cookies”), and apparently those are where the eggs grow (I could be getting the science behind this wrong, but that’s the basic gist).

Left: Here’s a picture I found on Google that shows the follicles. Right: Image result for chocolate chip cookies. Same same.

• Your body normally produces one egg per month. You’ll inject hormones every night that stimulate the ovaries to produce multiple eggs (I’ve been taking Gonal F and Menopur)
• You’ll also take injections that prevent premature ovulation (I’ll be taking Cetrotide). These will be in the morning
• You’ll go in every few days (1–3 days for me) to take blood tests to measure response to the medications, have vaginal ultrasounds, etc. to measure progress.
• When the follicles are ready, you’ll get an injection to help the eggs mature and tell them to git
• Egg retrieval is done under sedation.
• Eggs harvested from your ovaries are frozen unfertilized and stored for later use.

Shots! Shots! Shots! Shots!

The worst part (so far) of egg freezing has been the shots. I’m not scared of needles, but I definitely don’t look forward to the injections that I get every night (and after a period of time, you get them in the AM too).

Evening Shots

Essentially every night, I have to inject two medications (Menopur and Gonal F) into my body. The first time is pretty nerve-wracking because 1) they are very expensive medications; 2) injecting your own body/having your partner inject medications into you is a very new thing for me. Note, your injection process and dosage might be quite different. This is just my personal take on the medications.

Gonal F is easy. You get this pen thing that you twist to adjust the dosage, and you inject yourself. The needle is relatively small and you don’t really bleed much. After the first time, it’s pretty straightforward.

Left: Here’s an image of the Gonal F needle I found on Google Images. Right: These are the shots from my early 20s. Oh my have times changed.

Here’s a link to the video my doctor told me to watch for my injections. It goes through the process step by step.

Menopur is like a science experiment. You have to take liquid from one bottle, and then mix it with another bottle, and because my dosage was two bottles, I had to then take the mixed liquids and mix it with the second bottle. My partner and I messed up on this and had to start over. I was never good at chemistry/this why I work in marketing.

Left: Here’s another Google image I found of Menopur. Note the annoying little bottles you have to mix. Right: Here’s approx what a Menopur needle looks like

Not only does Menopur suck to mix, but it is the shot of the devil. *shakes fist at sky* The needle is relatively small, but it burns when injected and burns for a few minutes after. Okay, it’s not that bad, but it is stingy/unpleasant for a minute or so, much like a papercut you accidentally dip in hot sauce.

Here’s a link to the video my doctor told me to watch for my injections of Menopur. It goes through the process step by step.

Morning Shots

Good morning Centrotide!

Starting a few days in, when your eggs are growing and the doctor’s like — yo eggs you gotta stay in her body — you start the Centrotide shots. The Centrotide shots are also like a science experiment — you have to mix the solution with the powder and then inject it. It’s really not that bad — about halfway between the Menopur and Gonal F. It’s just annoying to have to do it first thing in the AM before work.

Nothing wakes you up like a morning injection, I’ll tell ya!

Here’s a link to the video my doctor told me to watch for my injections of Centrotide. It goes through the process step by step.

Some heads up:

• Shots are less painful if you pinch the area that you’re targeting, and while still pinching, insert the needle.
• Count your meds when they get delivered. Make sure to store them properly.
• Also, make sure you have enough alcohol wipes and gauze pads. They came with my medication delivery, but they didn’t deliver enough. I ended up buying some from Walgreens to make sure I had enough on hand.
• Make sure to keep track of the dosages you have. I didn’t realize until the day before I ran out that the pharmacy doesn’t give enough meds for the entire process because the process length might vary. I only noticed because had to get a refill of Menopur and decided to count my dosages left. Since Gonal F gets stored in the fridge, I didn’t even notice I only had one dosage left.

Is it all that it’s cracked up to be? A compilation of side effects (so far)

• I let my manager know that I was going to be undergoing a medical procedure over 2 weeks and I would need to work from home. I highly recommend working from home when you feel awful. I worked in the office some of those days and felt awful — I didn’t have the energy to engage in small talk/walk around.
• The morning after I started my first shot, I woke up feeling entire body aches, kind of like when you have a bad cold. That was not fun.
• I feel pretty tired, especially in the morning. I usually run on 7 hours of sleep per night but I’m craving more sleep. It’s kind of like waking up after you’ve had a really intense workout the day before.
• Day 5: I started feeling a lot of bloating. Stretchy pants = the best.
• Day 6: I woke up and felt like I had been tackled by a linebacker. My entire body is very sore, I feel tired and have very little energy.

Lifestyle modifications

Here are the lifestyle modifications my doctor gave me:

• Food: Eat whatever, but balanced is best. Given the feeling of bloatedness, I’ve been eating significantly lighter/not feeling hungry most of the time, tbh.
• Alcohol: Fine in moderation, ~2 drinks daily. I don’t really drink so this was easy).
• Exercise: Fine to exercise until 1 week pre/post retrieval, but then nothing strenuous. No jumping but walking, yoga, etc. is okay. I did runs and some hikes up until 5–6 days in and now I feel so tired I don’t really have a desire to do so,
• Caffeine: In moderation, max ~2 cups daily.
• Travel: Best if limited, as you’ll have doctor’s visits every few days and they depend on how each appointment goes. I didn’t have any travel lined up and didn’t feel like dealing with flying with needles. You’ll need to work with your doctor to make sure it works.
• Ibuprofen (Advil, Aleve, Motrin, Naproxen): Should not be taken for one week before retrieval. Tylenol is okay to take for pain management as needed.

Leading up to the day, the retrieval and the after-process

I’m writing about this a few months later, so my memories are slightly fuzzy about the details.

Moving towards the retrieval

Although the process was supposed to only take 1.5ish weeks, it ended up being longer because my eggs grew at different speeds, and the doctor wanted to make sure that the bulk of the eggs got to the right size before retrieval. Apparently taking birth control up to 2 weeks before the process starts helps make the growth of eggs more uniform, but this isn’t always the case.

I’ve heard from friends that it took a few days longer than expected as well, and not to worry about it. I was really annoyed and frustrated at my body and just wanted to be done, but it’s completely normal. I had to order a couple of refills of my meds, and luckily the delivery pharmacy that Progyny orders through delivers the same day and refills orders via text. That made it a lot less stressful when I would realize I was running short on shots.

As you get closer to the retrieval date (depending on the size of the eggs), the doctor adjusts some of the medications. The trigger shot is at a very precise time (I think there was like a half-hour to hour margin of error), and you find out a day or two ahead of time. I don’t remember the shot being super bad, but I think I was already very used to getting shots. I could not have been more ecstatic. I was also told to not eat or drink anything after midnight before the procedure.

The procedure

The procedure itself was very painless as I completely conked out under sedation. I woke up and was like, I’m done? I was surprised by how quickly it went, and although I felt some discomfort initially, it wasn’t bad. The doctor explained that I might feel some pain and discomfort for the next few days, to get a heating pad to help with discomfort, and to call if there were any questions. I was told not to take anything other than Advil/Tylenol, so I could tell if the pain got too bad.

The after-effects (*cue sad trombone sound)

CAVEAT: I had two friends go through the procedure, and they felt as if they were having a bad period the next day, and no additional pain at all. I also had a friend develop the same symptoms as me (Ovarian HyperStimulation Syndrome). According to my doctor, OHSS is rare (3–6% of women get it). However, I wanted to include this because I wish I had known what could happen/what was happening to my body, which I only found out after going to see the doctor.

Not the picture you want sliding into people’s DMs

I initially felt fine the few hours after the procedures. However, as the day wore on, I started feeling extremely sharp pains in the abdomen area and pain in the shoulder blade area. I couldn’t lay down without feeling SUPER sharp pains in my clavicle/shoulder blades. I ended up sleeping sitting up because of the pain, and it got so progressively worse throughout the night that I was crying and in tears. My stomach swelled up to the point I looked like I was very pregnant. I felt like my stomach was completely stretched to the max, and I couldn’t breathe or breath out without excruciating pain. I was physically drained. I called the doctor’s office at 7am and scheduled an urgent visit for 10am (the earliest time they could get me in).

It turns out I developed this condition called “ovarian hyperstimulation syndrome” or OHSS. OHSS happens when your ovaries become really big and painful (as I mentioned previously, some of my eggs grew at different speeds and the big ones got REALLY big). After they retrieve the eggs, the empty follicles fill up with fluid. The ovaries are really swollen already, and this makes them even larger. The fluid leaks into the abdominal cavity, which causes bloating. The fluid irritates the diaphragm, which manifests via sharp shoulder pain. When you lay down, the fluid moves up and irritates it more (which is why I couldn’t lay down without pain). The doctor performed a vaginal ultrasound and pointed out my swollen ovaries and blood/fluid in the diaphragm area.

It turns out, there was nothing that could be done other than taking Advil/Tylenol and letting the body slowly heal. I wouldn’t de-swell until my ovaries let go of the fluid with my period, so I was praying for my period.

• It took about 3–4 days for me to be able to walk across my apartment without being out of breath, in pain, and for the major swelling to go down-ish
• It was extremely painful to laugh, yawn, sneeze, cough.
• It took about 7 days for me to be able to walk longer distances without being out of breath or in pain. Even then I had to walk at a very slow pace.
• It took about 7–8 days for the swelling to go down so I looked somewhat normal. I got my period 7 days after the procedure and then had another period a week later (super fun!). It took getting two periods to completely de-swell.
• I wasn’t able to sleep fully laying down without pain/discomfort (was propped up by pillows) until about 2.5 weeks later. I did get used to sleeping sitting up, but it definitely weirded out my partner to wake up in the middle of the night and groggily be confused by why I was sleeping sitting up
• I didn’t feel completely normal until about a month and a half later.

I had additional complications, which added to the process of healing. I developed an infection from the surgery, which I had to take antibiotics for 2 additional weeks. I was slowly getting better and then started getting really sharp pains that I dismissed as my body just needing time to heal. It wasn’t until I talked to a friend that I realized it wasn’t normal and saw the doctor. My advice is to LISTEN TO YOUR BODY. If it doesn’t feel right, please go see a doctor — I should have seen the doctor sooner. Apparently, the infection had been there, but the other pain had masked it. ¯\_(ツ)_/¯

Despite all of this, I still think the doctors at Spring were wonderful. I think I went through an edge, edge case, and the doctors at Spring showed so much concern, actively followed up to make sure I was okay after developing OHSS, and were generally wonderfully empathetic.

Here’s another good blog post on going through OHSS.

What I would do differently

I wish I had known how to properly prepare for the procedure. My doctor said that there would be discomfort, but you never know how your body would react, so I wish he had given me a list of things to have on hand for even edge cases like OHSS. Once again, this is for the rare chance you develop OHSS.

Here are some things I found helpful to deal with the OHSS recovery process and would highly recommend having on hand just in case. Some of them I bought after I started experiencing symptoms and found advice via Googling and various egg freezing/fertility message boards.

• DO NOT LAY DOWN after your procedure. Make sure you sleep sitting up. When you get out of the procedure, you’ll feel fine but tired and want to nap. If you do, nap sitting up. If you lay down, it increases your chance of the fluid leaking into your abdomen and irritating your diaphragm. If you sleep sitting up, it starts draining slowly and reduces the pain. Have LOTS of pillows on hand to make sure you’re sleeping at like a 100-degree angle.
• Don’t lift or carry anything heavy. It only makes things worse
• Take time off work. My doctor told me I’d be back at work in a day or two. It’s the luck of the draw, so it’s better to take some time off just in case. If you must work, work from home. It’s not worth it to push yourself.
• Ideally, have someone around to help you. It’s really tough to deal with alone. Even a friend to talk to/vent. It can be emotionally challenging.

Things to get:

• Advil or Tylenol. Or both. Your doctor will give you advice on how to take them together but essentially each one lasts a certain amount of time and taking them at staggered times helps manage the pain.
• Heating pad. OMG this was SO NEEDED to help deal with pain and help me sleep. It helps with the discomfort when the pain went away.
• Anti-Gas pills. Necessary to help deal with gas/bloating. Super hot.
• Coconut water, Pedialyte, Gatorade. Helps not be dehydrated and the electrolytes help with the swelling
• Salty foods. Soup, saltine, beef jerky — all of the sodium helps draw the fluid that’s in your abdomen area back into your veins.
• Dandelion root tea. Helps deal with bloating and fluid retention
• Stretch, comfy clothes
• Menstrual pads. You can’t use tampons and will have some leaking for a few days after.
• Prunes/prune juice. A fun side effect of sedation is constipation. Whee! Don’t worry, you can pull the whole “you know what I went through to have you! Be grateful!” thing with your kid.

Ending thoughts

Despite all the complications and the feeling bleh for a while, I’m glad I went through the procedure. I ended up with 12 viable eggs out of 18 (on the lower end, but I’m turning 34 this year) and I’m happy with the result.

However, due to the risk of OHSS, I don’t think I would do it a second time. I’m also pretty sure my partner doesn’t want me ranting about the burden that women have to bear with egg freezing, having children, and making only 80 cents on the dollar again. This procedure would have made a grown man cry, for real.

Anyway, good luck! You got this!