Good for you! Way to take charge of your reproductive potential and plan for your future. It is liberating and exciting to do so, but it can also be difficult and stressful. You need to educate yourself and go in with eyes wide open. So, where to begin? As you start the process of fertility preservation, your first and sometimes most daunting task is to choose a clinic. Not every fertility clinic is created equal.
Here is what you should know…
The embryology piece of egg freezing is a big deal. The process of vitrification (fast freeze method) is what makes egg freezing successful. The human egg is the largest cell in the human body, and it is fragile. Handling it requires TLC from someone with A LOT of technical expertise. In fact, egg freezing was considered experimental by the American Society of Reproductive Medicine (ASRM) until 2012. To date, some 5,000 babies have been born from frozen eggs in the US. It is important that the clinic has an in-house embryology lab and specialist who have a long history of freezing and thawing eggs, as well as data on pregnancy outcomes from frozen eggs. You want to ask who will be freezing your eggs, how much experience do they have, and how many live births have occurred from frozen eggs at that clinic.
Many clinics freeze eggs, but very few have much experience with successfully thawing and warming the eggs to create embryos that result in successful pregnancies. It can be done with technical expertise and still not be successful, so it’s important to trust that you are in the best hands. Reproductive biology is an imperfect process, and there is a lot of attrition that occurs between thawing the egg and making an embryo. This means that not all the eggs will survive the thawing process, not all of the eggs that survive the thaw will fertilize with sperm, and not all of the embryos (fertilized eggs) will become a baby when transferred back into the uterus.
It is also important to talk to your doctor about how many eggs you should freeze. The eggs are the oldest cells in your body, and as you age, so do your eggs. The older you are, the more eggs you should freeze in order to give yourself the highest chance of success in the future. The success rate per embryo is driven by the age at which the eggs were frozen. Freezing your eggs is never a guarantee of a baby, so make sure you have realistic expectations about how they can be used in the future. You may need to do more than one cycle of IVF in order to get enough eggs to freeze and use in the future when you are ready.
In addition to technical expertise, it is also important to find a clinic where you feel comfortable and confident with your clinical team. The IVF egg freezing process is no walk in the park, but feeling well taken care of makes a huge difference and minimizes stress. If you decide to move forward with freezing your eggs, you will have quite a few appointments, and you will have to walk in, undress, and be okay with it. While a medical clinic is not a spa, you want the reception to be personable. Feeling comfortable with your surroundings and clinical team will have a lot to do with how you’ll feel through the process.
Who is going to be walking with you through the egg freezing process? Can you see the same nurse and MD for most of your appointments? Or will you see someone different for each visit? Will the physician be doing your ultrasounds or will it be an ultrasound tech? Who will do the egg retrieval? You also want to ask how you will get your questions answered and how you can communicate with someone any time of day or night if you have questions. Seeing the same people who know you and know your story can make the process a more positive one and will help make the experience of egg freezing easier.
Egg freezing is expensive! Unless you work for a progressive high-tech company that pays for egg freezing for its employees, it’s not likely to be covered by insurance. Cost is oftentimes the limiting factor for most people. When considering preserving fertility, less expensive does not equal better. Some patients are attracted to the fertility start-ups that serve as brokers and offer steep discounts if you go to one of their preferred clinics. These businesses often make money by sending you to a specific clinic, which isn’t necessarily the clinic that provides the best care or the highest success rates. You don’t want suboptimal results in order to save a little bit of money, so be sure research the broker in addition to the clinic. Egg freezing is expensive and a big decision, but don’t let cost be your number-one determinant.
Now that you know the basics of choosing a clinic, your next step is to make an appointment with the clinic you think is the best fit for you. Go to your appointment, learn about your fertility potential, and ask about what that clinic has to offer. Make sure the above criteria are met and that you feel comfortable with the provider, the place, and the process, and then go for it! If something doesn’t feel right, it’s okay to meet with another clinic.
Egg freezing is empowering and life changing, but it’s also hard and extremely personal. You want to make sure that you have a supportive team on your side.
Julie Lamb, MD FACOG
*Director of Fertility Preservation
*Director of the New Center of Excellence for Family Building at Advanced Reproductive Age
*Pacific NW Fertility and IVF Specialists
Julie Lamb, M.D., F.A.C.O.G., has worked with thousands of fertility patients over the last 10 years and she is gifted at combining attentive, personal care with advanced reproductive technology. “Helping build families is an incredible privilege and responsibility. My goal is to help people build families with a safe, compassionate, yet optimized approach.”
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