Freezing, thawing, and using one's eggs with professional help
February 3, 2014 9:51 AM   Subscribe

Please tell me your experiences, thoughts and advice about egg freezing (the ones you make babies with, not the ones you eat).

I'm a 39-year-old woman (I know, I should have done this a long time ago) who would like to pursue this option. I know that until recently the technology was experimental, and that there aren't that many people out there yet who have had the procedure, much less had a baby with frozen eggs, but I'd love to hear thoughts and advice from anyone who has any to give.

I have found a place that looks reputable and charges less than older clinics (about $7000, with one year of storage included) because it's relatively new. The doctor and director are both credentialed and have published research in the field. I'm scheduling a consultation with their lead doctor today. I am calling my endocrinologist to ask what I should be testing or taking to maximize fertility, and am also seeing my ob-gyn this week.

I have a sense of what the procedure is from my sister, who froze embryos with her boyfriend last year. The first step is an ultrasound that will give them a sense of what kind of prospects I have, egg-wise, and accordingly whether this is worth pursuing. What other questions should I be asking? What should I be thinking about?

Any resources or references in the San Francisco Bay Area would also be much appreciated.
posted by foxy_hedgehog to Health & Fitness (5 answers total) 4 users marked this as a favorite
First step might be a blood test, specifically for follicle-stimulating hormone (FSH) and luteinising hormone. You will also have a sexual health test. They also shouldn't just be looking at eggs during the diagnostic phase - they should be looking at your womb lining, shape of your uterus unless you plan to use a surrogate.

I would look out for places that feel like a meat factory. Trust your instincts - you need to feel comfortable because this is an invasive process. Fertility treatment is a business with a decent mark up and it sells on hope. Do your due diligence. They all employ doctors, of course, many of whom will be published, but how long they spend assessing your scans and tests and how well they do the care and after care differs from place to place. I would ask your ob gyn what he/she thinks about available clinics. Personal recommendations from other customers are not always totally helpful, because if someone has conceived successfully they are more likely to recommend, and the reverse is also true.

When your diagnostics are done, I would ask the doc to take you through as if you were an idiot, what they will do and what your forecast chances of a successful conception are at ages x, y, z. They should have statistical software or tables to go through this based on past data. Be clear on whether the data they refer to is their (i.e the clinic's) data or derived from other sources. Better than average results does not always mean it is a better clinic - some places refuse to take on difficult cases because it will make their stats look bad. Make notes. You should be given a lot of information. Do not be afraid to ask lots of questions. You may not get a lot of time with your actual doctor at the clinic. You'll likely spend more time with the nurses, the ultrasound technician.
posted by MuffinMan at 10:22 AM on February 3, 2014

Since your question was quite open-ended in asking for advice, here goes:

You need to prepare yourself emotionally for the likely possibility that this will not work. If you're going to go this route, always frame it in your mind as a hail-Mary pass -- "probably won't work, but wouldn't hurt to try," rather than, "I'm preserving my chance to carry a child."

I say this because, regardless of what they tell you after your ultrasound, it is anyone's guess as to the likelihood that your eggs are still usable. That is, they may be able to tell you that for sure they can see something on the ultrasound that is discouraging, but if they don't see anything damning there, they still won't be able to say with any kind of certainty that you can get pregnant. The main way you find out if this turned out to be a viable plan is by going through the hell of fertility treatments again and again until they finally succeed, you go broke, or you give up. _Words cannot express_ how hellish that process is for the vast majority of people who undergo it -- it is not something you can understand unless you've been through it yourself. It didn't surprise me to learn that undergoing fertility treatment ranks higher than treatment for a terminal illness in terms of stress.

If I were going to explore the possibility of going through all that hell to produce a child, knowing what I know now about the process, I would want to give myself the best possible chance by using 20-year old eggs, as even then it may not work out. It sounds like you have put a lot of thought into this and have realistic expectations about the process itself, but 40-year-old eggs are _old_ in the scheme of things.

People love to point to those they know that conceived (traditionally or otherwise) post-40, but the reason they can even think to name them is because there are so few of them. In the scheme of things, those people are either using donor eggs or are a statistical outlier.

If you want to go that route, talk to older women (40+ years old) who've gone through the whole process of intense fertility treatment (i.e., not just a little clomid for a month or two, but the big drugs). Harvesting the eggs is the easy part -- the brutal part is on the other end. If you decide after that you still want to go through it all, the #1 factor that would affect your outcome is the quality of the eggs used, so my advice would be to give yourself the best possible shot by starting the process with eggs that are not at or past their expiration date.

Sorry to be so blunt, but while medical professionals love to talk about what is possible, I think the kindest thing to do is make people aware of what is most likely.
posted by ravioli at 11:13 AM on February 3, 2014

I have a sense of what the procedure is from my sister, who froze embryos with her boyfriend last year.

You may already know this, but if not it's extremely important to remember that freezing embryos is a relatively common procedure that many people have used successfully, although pregnancy is by no means guaranteed. Freezing eggs is much newer, much less understood, and much, much harder to get a successful pregnancy from.

A recent analysis of 10 studies containing a total of about 1800 women attempting to become pregnant from frozen eggs showed that 328 were successful. At age 39 the chance of a live birth with frozen eggs was about 5-15% (depending on the freezing technique), although the numbers of women are pretty low so that may not be very accurate, and I believe that's the age at pregnancy, not the age at egg collection. They didn't see any live births after age 44, although again, fairly low numbers of women studied, as this is a relatively new technology.

(Let me know if you want access to the scientific article itself and/or more info about the science. I don't work in assisted reproduction myself but I work with a lot of people who do.)

All that to say, as I'm sure you're aware, keep in mind that the failure rates are very high. The places standing to make thousands of dollars from you are not always going to be truthful with you about the chances of it working (although they absolutely should be, if they're ethical places). It's worth considering using a sperm donor, since embryo freezing has a far higher rate of success. Definitely ask about the rates of success for both methods at the clinics you visit.
posted by randomnity at 11:56 AM on February 3, 2014

Response by poster: Unfortunately I have no sperm donor. I am still holding out hope that I will find a male partner to conceive with. Thanks for all of the responses thus far. I appreciate the honesty.
posted by foxy_hedgehog at 5:18 PM on February 3, 2014

The Bay Area is a good place to be if you're trying to conceive in your late 30s/early 40s. Clinics here are very experienced with people like us. I think ravioli is right that it is hard for many, but it's just not accurate that "there are so few of them". My pregnancy class had 5 of 12 women over 40, including me. Some had assisted reproduction; some did not.

Back to your question: freezing eggs is new. It would be a gamble. You know that, and presumably find the trade offs of involving your potential future partner worth that gamble vs proceeding with donor insemination now. That's your call, but probably worth exploring further with your clinic. It sounds like you have a clinic you want to use, but if you need another option, many people I know loved RSC Bay Area.

Feel free to MeMail me if you want to chat more. I was in your shoes at 39 and am now a very happy 43 year old single parent.
posted by judith at 2:12 AM on February 6, 2014 [1 favorite]

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