Everything Egg Freezing Part 1: Making the Decision
Hello out there! I am starting this blog mid-to-late-cycle in my egg freezing process. Part 1 of this multi-part blog will be the how and why behind me deciding to freeze my eggs. Please come along with me on this journey! We will cover lots of things that have come up for me, from fun things like how to make a smoothie with 50g of protein, to tricky things like how to inject medications to minimize pain and (eek) bruising, to heavier things like coping when you get less than fantastic fertility news. I am generally an open book, and I’m here to share my experience to hopefully make someone else’s experience easier.
Disclaimer: I am always attempting to be as gender neutral as possible when writing and talking about parenthood! Also, I will try to put up a content warning whenever fertility-related things are getting heavier in my posts so that you can skip along if you are not feeling like that kind of content would be good for you to read right now.
First, an introduction. My name is Stephanie Karozos (like “car” and “roses” put together). I am an MD trained in Family Medicine, Integrative Medicine, and Functional Medicine, but most importantly I am a woman in her mid 30s who desperately wants to be a mother someday! I realize that I am privileged in even being able to consider egg freezing and IVF as reproductive options. I acknowledge that not everyone has these options, for both financial and physical reasons. I also realize that it’s undoubtedly easier for me to write about elective egg freezing with a (relatively) normal ovarian reserve than it would be to write about infertility, going through IVF to try to get pregnant, etc etc. I am sending lots and lots of love to anyone going through or who has gone through any part of this process. This is my own personal journey and something I felt comfortable sharing to anyone who is curious to know more. You do not have to be considering egg freezing or IVF to read this! I think the more we all know, the more we can support the folks in our lives who are on this path.
How did I decide I wanted to freeze my eggs?
*CW* infertility in medicine
Well, let’s start with a not so “fun” fact: A couple of years ago, I learned that physicians are twice as likely as the general population to experience infertility. This is thought to be due to occupational stress, abnormal working hours, and occupational toxin exposure. I have personally witnessed many of my friends and colleagues in medicine undergo fertility struggles, and my heart is and has always been with them. While many very happy outcomes have subsequently arrived via IVF or otherwise, I saw firsthand the stress and grief that can come with attempting to conceive. Knowing that I’m a physician in my mid-thirties, I wanted to take a realistic look at my reproductive future and give myself the most peace of mind possible, knowing that my career choice comes with this increased risk of fertility issues.
Another less than “fun” fact: all folks who can become pregnant who are 35 or older are considered to be “advanced maternal age” which does come with some more risks when you’re trying to become pregnant. While I know MANY amazing parents who have conceived after this point, I turned 34 this year and wanted to be as realistic and honest with myself as possible about that. The likelihood that I’ll be a medically “older” parent is…well, 100% at this point. And though I like to think I’m aging like fine wine and only getting better with time, the number of eggs (and high quality ones to boot) that I have is only going to decrease the older I get! I may have no problem getting pregnant and having a baby without IVF in the next few years, but if I do want a 2nd or 3rd child in my late 30s or even early to mid 40s and can’t conceive without IVF, using younger eggs for that process down the line is more likely to result in a healthy pregnancy.
Though egg freezing is definitely not guaranteed to result in a successful pregnancy in the future, it does help my odds, and doing it sooner rather than later to increase my chances of having viable eggs was the best decision for me at this point in my life.
Why eggs and not embryos?
For those of you who aren’t aware, if you’re using IVF to conceive, statistically it takes roughly two embryos to result in one healthy pregnancy and ten eggs for one healthy pregnancy. Eggs do not hold up in the freezing process quite as well as embryos, and genetic testing is not done on eggs, so it’s hard to know if the eggs that are frozen will be able to be used. It costs more to freeze embryos and do genetic testing on them, but there is a higher likelihood that the embryos will result in a successful IVF cycle. I have gone through a divorce and am currently in a very lovely relationship with a great guy. Though I feel great about our relationship, for my peace of mind, I decided to freeze eggs rather than embryos this time around. I also know that I’m not immediately going to try to conceive via IVF and will ideally never need to use my eggs, and it is less complicated for me/my mental and emotional health to just freeze my own eggs only right now.
Who should consider freezing eggs or embryos? When is the best time?
This is a complicated question, and I’d really recommend you speak with a doctor about your options and your personal health journey. A great place to start is to get the basic IVF/egg freezing workup, which involves an ultrasound and some lab work to predict roughly how successful your cycle would be. The initial workup was completely covered by my insurance, so it was very low stakes to start that investigation before I made my decision.
Oddly, I’d draw parallels from this topic to death and dying in medicine, in that they both are not discussed enough, they are difficult conversations to initiate, and the second we start talking about them, the more we can advocate for ourselves and our own individual needs in the present and future. So many factors are at play when it comes to our reproductive outcomes. Things need to be taken into consideration like your age (36 to 39 is when your “return on investment” is highest with egg freezing, according to this study), occupation, financial health, and physical health. I’d also recommend checking your insurance benefits to see what is covered to better understand the anticipated cost. I was pleasantly surprised to learn that the procedure (at least as it stands right now) is covered, however the medications were not - and they were pricey. I also discovered that if I ever need to use IVF in the future, the medications and procedure would all be covered. Increasingly more employers are also offering to cover egg freezing and IVF, particularly in the tech industry, so it’s worthwhile doing your homework before you commit.
I’m writing this blog in part to encourage people to start these conversations sooner, so that they can ensure their unique needs and goals are met as much as possible. I’m definitely not writing this to convince anyone to follow exactly what I did. My situation is as unique as the next person’s! I learned a lot and want to share things that I think are interesting for anyone to know, things I wished I had known, things that have been surprising, and things that I think will be helpful for someone contemplating this decision.
Personally, I found myself worrying about my reproductive future to the point that it was limiting my ability to enjoy the present. I had a window that I could steal away from Aspen and stay in Denver (you need to be close enough to your clinic to get ultrasounds and labs every other day-ish) while working part-time remotely with support from my coworkers and employer, and I was feeling strong and healthy in my body and mind. Last year, I considered going through this and was far too stressed due to a recent move and job change and difficulty sleeping. I think it would have been so distressing to go through it under those conditions.
So that’s how I got here! I’m now mid-cycle, so I’ll be posting more soon! Be expecting more on my overall health and initial workup, a list of things I wish I had known before I started, how I prepared my body (this is really for the Functional Medicine enthusiasts out there), foods I’ve been focusing on to support myself through this process, how the medications have felt, how it’s been going and more!
If you have anything you’d like me to cover, DM me on instagram @stephkaroz or leave a comment!
Stephanie Karozos, MD
