Egg Freezing: The Beginning

No one wants to be here. The classroom is full of unsmiling women and their partners, all in their thirties and early forties. Practice syringes and medical vials are arranged on the tables in front of us. Our teacher, a friendly nurse named Glynnise, has written the names of our many medicines on the whiteboard: Follistim, Menopur, Ganirelix.

For everyone in the room, this is plan B. You’re either here because you’ve failed at having a baby, or you’ve failed at finding someone to marry you. In the first camp, there are infertile couples who have to go through IVF to have a baby; in the second camp, single professional women who want to freeze eggs or embryos. I alternate between regret — shouldn’t I have had a baby yesterday? — and fear. There are an awful lot of needles on the table.

Still, I am in a better position than many of the women here. I’m not here to have a baby, at least not right now. I’m here because I want to freeze my eggs in case I have trouble conceiving later in life. I’m 33 and expected to respond well to the treatments. Based on what the doctor’s told me, I might produce 20 mature eggs, twice as many as what I’d get at 39. Once the eggs are frozen, I can still try to have a baby the natural way. But if I’m 39 and having trouble getting pregnant, my 33-year-old eggs will be a good fallback option.

Sitting across from me is a blonde woman in her late 30s, with kind eyes and a denim jacket. Next to her is a Chinese woman around my age, with choppy short hair, also wearing a denim jacket. Later I will Google them and discover that the kind-eyed woman is an opera singer who graduated from Harvard, and the Chinese woman is the COO of an Internet company. In the moment, though, they just come off as likable, attractive, professional women. Hardly unlovable or desperate. “Do you feel ready for this?” the woman across from me asks, and we say no, not at all.

Glynnise starts to go over our drug regimen. Every night for two weeks, we’ll inject ourselves in the belly with FSH (follicle-stimulating hormone), and every morning we’ll come in to have our ovaries inspected via ultrasound. Without the FSH intervention, our ovaries would produce only one mature egg every month. The massive doses of FSH allow multiple eggs to grow to maturity.

With a syringe, Glynnise mimes how we’ll inject ourselves. While standing, she pinches a “good, healthy” inch of belly fat with her left hand. With her right, she brings a syringe to her belly. “90 degrees, straight in.” She says to wait until the needle is fully inserted before we start injecting.

After a week of FSH injections, we’ll start injecting a hormone antagonist that prevents us from ovulating before the eggs are surgically collected. When the ultrasound shows that the maximum number of eggs have grown to maturity, we’ll give ourselves a “trigger shot” of HCG (human chorionic gonadotropin). The HCG injection causes the follicles to release the eggs, making them ready for extraction (and freezing!) 36 hours later.

There are several notably unpleasant side effects of our hormonal cocktail, the least of which is temporary weight gain. A woman with Ovarian Hyperstimulation Syndrome (an overdose of the follicle-stimulating hormones) can “barely walk”, will have trouble urinating, and might even find it hard to breathe. That’s because the ovaries get so swollen they start to impinge on your other organs, including the bladder and diaphragm. Then there’s ovarian torsion, which happens when the ovaries twist on themselves. Jogging and other bouncy exercises increase the risk of torsion and are therefore strictly forbidden during IVF.

For the sake of my future potential children, I will also need to give up caffeine (which may reduce fertility), yoga (which twists the ovaries), and high-impact exercise during my two weeks of “stims”. In the week following the egg retrieval, I won’t be allowed to have sex so that my vagina can heal. I rely on daily lattes and weekly yoga classes to stay happy and productive at work. I envision myself falling asleep at my computer, torpid and exhausted after days of injections. I also envision myself being grumpy with my boyfriend.

With the demonstration vials and syringes, we practice measuring and mixing the medications. It’s satisfying, like a high school chemistry class. I learn how to inject an air bubble into a fake vial to make it easier to draw the “medicine” into the needle. I carefully flick my finger at the air bubble in the needle, ensuring that I have exactly the right dose of saline solution in the needle. Then I push the trigger in very gently, until I see a tiny bead of water at the tip of the needle.

I can do this. I don’t know when I’ll get married, or when I’ll start trying to have a baby, or what kind of world my future children will live in. But I can measure medicine and follow instructions and maintain a strict routine. I suspect I will even enjoy doing it, though the side effects sound scary.

Now Glynnise is going over the progesterone injections, which don’t apply to me. They’re for women who plan to use their eggs immediately after IVF. Every night for 90 nights, their partners will inject them with progesterone in the upper buttocks. Since it’s an intramuscular injection, the needle is much longer — 1.5 inches, versus 0.5 inches for the stims. One woman asks, a little angrily, what she should do if she has no partner to give the injections. Glynnise tells her to do it using a full-length mirror, so that she can see her rear. Another woman asks if it’s better to have the injections done quickly or slowly. “It’s not the injections,” says Glynnise. “My patients say that the muscle pains are worse, especially after 90 days straight.”

This is just the beginning. The first of many sacrifices that I’ll have to make. And not nearly as overwhelming as actually having a baby right now. With luck, I’ll be able to have a baby naturally when the time is right, without having to thaw out my eggs or deal with the pain and indignity of progesterone injections.

Afterwards, my tablemates and I exchange e-mail addresses. “I was thinking that I wanted to join a support group for this, but I couldn’t find any,” the kind-eyed woman says. She’s not sure if she wants to go through with the whole thing yet, but she’s thinking about it. The Chinese woman will start her cycle next week, just like me.

On the way back to work, I reward myself with a chocolate chip cookie, thinking that I will have to cut out sugar altogether in order to offset the fertility-drug weight gain. I happily envision two weeks of austerity: kale, bone broth, long walks, and no sugar. I am excited, the way I am with the beginning of any new project. I message my boyfriend,”OK, I have the hang of this.”