Everything Egg Freezing Part 7: Wrap Up, Q&A
This post is LONG overdue- thanks to the holidays and a busy work schedule- but at long last here we are at our final egg freezing blog post! To wrap up my egg freezing experience, I wanted to take some time to answer the very thoughtful questions that have been posed via instagram and in person to the best of my abilities. Thank you, as always, for taking the time to read this, and a special thank you to those of you who submitted these wonderful questions.
Egg Freezing Q&A:
Q: Will this affect egg count moving forward, does it reduce my remaining eggs more than a normal ovulation cycle?
A: I wondered about this too in the beginning! The short answer is no, this is not going to decrease your overall egg count (ovarian reserve) more than an ordinary ovulation cycle. The goal of the process is to simultaneously mature all of the follicles (pre-eggs, if you will) that are already going to be present and eventually “die off,” with one going on to release a mature egg during ovulation. Your future fertility is not affected by freezing eggs.
Q: Cost?
A: The approximate out-of-pocket cost for egg freezing is ~$10,000, not including medications. IVF is about $15,000 (going on to create embryos and attempt to implant them).
I was fortunate to have my insurance plan cover the procedure after my deductible was met (about $7500 covered), but I did have to pay out of pocket for the medications, which cost about $5500. IVF is expensive and it is an extreme privilege to have been able to do this. It came from months and months of saving since I became a full-fledged doctor several years ago, and I was not in the financial position to do this until recently. Different insurances will offer different coverage options. Everything would have been covered for me if I had been diagnosed with infertility and was going through the full IVF cycle (which results in a pregnancy), so it’s definitely worth investigating coverage and avoiding complete discouragement even if you can’t afford to pay out of pocket for the procedure.
You also will have to pay to keep your eggs frozen. My first year of freezing was included in the cycle, but I will have to pay yearly thereafter.
Q: At what point should someone seriously consider doing this? Are there health indicators beyond age?
A: If you may want to have children in the future and can afford egg freezing, I think it’s great to investigate options sooner rather than later. While egg freezing and embryo freezing are not guarantees of future successful pregnancies, they do increase your odds, and your ovarian reserve is higher in your late 20s and early 30s than your mid to late 30s. That being said, mid-30s has been proven to have the highest return on investment for egg freezing. In other words, we are more likely to actually use our eggs when we freeze them in our mid 30s than we are if we freeze them in our 20s or early 30s.
Another reason to consider this process is if you have a history of gynecologic conditions like irregular periods, PCOS, endometriosis, etc. It’s good to know your options should you need to utilize them in the future. Some folks with breast cancer or other cancers will elect to freeze eggs before undergoing chemotherapy. If you are actively trying to conceive and are unable to for 6 months or more, please start a fertility workup with your primary care doctor for both you and your partner, if applicable.
Q: What to look for in a fertility clinic, doc? Best places they practiced? Success rates?
A: I personally don’t know much about Reproductive Endocrinology (REI) fellowships, where fertility specialists train after residency, and how they rank. I do know that by the time an OBGYN doc makes it to an REI fellowship, they have proven their abilities many times over and are very qualified to be providing this level of care. My search was made much easier by my friend, Dr. Arlene Go, who is completing an REI fellowship. She was so gracious and willing to run through the main clinics in Denver with me, giving me pros and cons. I ultimately made my choice by layering her experience, overall projected costs, and ease of scheduling, given my relative lack of flexibility with scheduling as a physician myself. If I had gone solely on friends’ recommendations from personal experience, I would have selected a different clinic. There is much to consider and you might have different priorities than I do (easier ability to work around a small office’s scheduling practices, not as focused on viewing all of your individual results, less worried about cost, etc). It’s worth doing some research before you dive in. Many offices offer free consultations to see if you are a good fit before you commit.
Q: How painful is the prep?
A: It was not as bad as I was expecting in some ways and worse than I was expecting in others. I am not afraid of needles, so the injections were not bad, but the medication did burn sometimes (my mom and I nicknamed my injections based on which burned the most and which burned the least) and I bruised quite a bit over the two weeks. The hormone surge was actually not as bad as I expected. I only became very tired and bloated during the last few days of my injections before the retrieval. The recovery, for me personally, was worse than the prep (see previous post).
Q: Any difference if LGBTQ+ identifying?
A: While I am certainly not an expert in reproductive endocrinology, it stands to reason that there are at least a few areas that could be different. Two partners who are both able to freeze eggs may both elect to do so or not, which could impact cost and could improve odds of pregnancy in the future. Transgender men sometimes elect to freeze eggs before receiving gender affirming care via hormone replacement therapy, so that discussion may start a bit sooner than it would for a cisgender woman. Trans men do freeze eggs after starting hormone therapy as well, so if you’re reading this after you’ve started, it’s still possible and I’d encourage you to investigate your options if you’re interested. I’d always recommend working with both your primary care doctor and a fertility specialist to discuss your options.
Q: What issues would cause insurance to pay for part/all?
A: Typically, insurance will cover for “medical necessity.” How that is interpreted and how much is covered is variable based on your plan. If I had diminished ovarian reserve and needed to freeze my eggs or do IVF expeditiously, it would have probably all been covered after I had met my deductible.
Q: What happens if the eggs aren’t used?
A: If the eggs are not used, they can either be donated or destroyed. There was an extra cost associated with donation at the clinic I used, which was about $3000, specifically if I died and the eggs needed to be donated or destroyed. I’m not sure if that cost still applies if I was to donate them tomorrow. I could not justify paying that much extra in an already very expensive time in life, so I elected to have mine destroyed if something happens to me. This is a fairly morbid response to a very practical question - sorry!
Q: What am I most worried or happy about?
A: I was most worried that I would get very few or no eggs from the procedure. There is no guarantee, so you could potentially pay a lot of money, spend a lot of time, and put your body through a lot for no results. I am also worried from time to time that my eggs will not be usable/viable after they are thawed. When this comes up, I try to send protective energy to the eggs as they sit where they’re stored. It helps me to focus my anxious energy toward positive thoughts and intentions. I am happy I did it and happy for the learning experience and the journey. I am happy to have a handful of healthy eggs on ice if I do need them someday. I am happy and grateful to know my priorities in life and to have been able to share my experience with all of you.
Thank you for your wonderful and thoughtful questions. I welcome any feedback or questions in the comments below! More blog posts to come on some personal and general topics, so stay tuned!
