Decision Time

Having received the unexpected news that I had Diminished Ovarian Reserve, I realised I did not have a lot of time to wait around for Mr Right to present himself and for things to happen naturally, or equivocate over freezing what measly few eggs I had left. In retrospect, this actually made my decision easier. Had my numbers been OK I might have gone back and forth on the right time to kick start the egg freezing process but my poor prognosis reinforced that I needed to do it sooner rather than later. 

I obviously had lots of questions which I had thought about in advance, which my Dr was able to answer with complete empathy and understanding (I realise my default tone is sarcasm but this is genuine - Dr Davis was very good!):

Q: How many is a good amount to freeze?

This largely depends on age - the older you are the more eggs (oocytes) you want to freeze to maximise your chances. 10 eggs at 32 is very different to 10 eggs at 38. There is a super depressing calculator available online based on research conducted by Fox and Goldman which indicates your percentage of achieving a live birth based on your age and number of eggs frozen. 

I was told that 12-15 would be a good number given my age and general health. This was also consistent with friends in their early to mid 30s who had been through the process and had frozen 13-22 each.

Q: What are the side effects of the hormone injections?

These vary and may include normal period symptoms (on steroids), feeling more emotional, and bloating / a full feeling. 

Q: How many people have died from fear of self-injecting hormones?

None, as far as we can tell.

Q: Is there any difference in freezing oocytes versus embryos?

I was historically told that it was better to freeze embryos than eggs as they froze better but it turns out this was back when they used to "slow freeze" eggs and embryos. Now they are "flash frozen" using vitrification (liquid nitrogen) there is only a 5ish% difference in success rate between freezing oocytes versus embryos. 

One option I have is to freeze some oocytes and some embryos so I have both options. One relevant factor is that you cannot test quality of an oocyte - only embryos - as oocytes are a single cell, so if you only freeze oocytes you will have no idea if they're viable until you try and use them. 

Q: What's the loss rate for freezing and each stage thereafter?

The "inverted pyramid of IVF" basically means you lose some of your supply each step of the way. Fox and Goldman (makers of the sad calculator mentioned above) estimate that 85-95% survive freezing/thawing, then 70% of those survive fertilisation, then 40-50% of what's left make it to blastocysts, anywhere from 13% (over 44) to 57% (under 35) test normal for chromosomes, 70-75% then survive implantation, then 60% achieve a live birth. Hence the sad calculator. 

Q: Where on earth did all my follicles go?

It is a mystery! And I am furious. When I find out where to submit my complaint you better believe they're getting a strongly worded letter.

Q: Does it make a difference that I've been on the pill?

Nope that actually makes it easier for us to know when to start. They'll tell me when to stop taking it and we'll count from then. Yay some good news!

Q: Is there anything we can do to try and boost numbers?

Be less stressed. Too late. 

Q: Once they're frozen can they be transported?

Yes! My clinic is experienced at shipping eggs out and sperm in so nothing is off the table in that respect! If I leave the Island I can ship the eggs elsewhere or come back for implantation if I need them. 

Q: What happens if I meet someone?

Pigs might fly. But also, we can pursue IVF the way other couples do. 

Q: What are my options if I don’t?

The clinic has connections with a number of sperm banks in the US. I will get wine, girlfriends, and we'll pick a donor. Make it a party!