Deciding to Take Control of My Fertility Timeline

Olympian Alexi Pappas recently spoke out about her choice to buy herself time to have a family and freeze her eggs. Maybe it is her willingness to be transparent about the subject that allows others to have a platform for the conversation and, as she mentions in this article, to form a community. After all, the process of fertility treatment and egg freezing can be a lonely journey. 

I also chose to freeze my eggs and am still in the recovery process as the procedure was just last week. I, like Alexi, told very few people about my decision and kept it within a close circle of friends and family. Yet, I feel like any choice to have children or not, should be shared and celebrated.

I went back to school to get my PhD at 30 years old. I have been a postdoctoral fellow for the past two years and I will be starting a faculty position in the fall. My career path, which I would not trade, has not lent itself to a traditional timeline of dating, marriage, and family planning. Therefore, I want to share a little about my decision and maybe provide insight to those who may be curious about the process. 

The process for me began in February. I have a wonderful gynecologist who is single, 40, and knew her entire life that she did want children. However, she is well aware that that is not everyone’s choice. Her words to me were “You are single and 35, how do you feel about kids?” I believe my answer was “I think I would like the option,” and without pause, she replied, “You should freeze your eggs.” 

Now, for those who don’t know, without insurance, egg-freezing can cost between $10,000-$25,000 and a lot of the time requires more than one round or cycle of treatment. There was no way I would be able to justify spending this amount of money for the chance of having a child one day. Luckily, I talked to my health insurance and was informed that I could add on a fertility policy at no extra cost (an employer perk) and that insurance would cover everything from genetic testing, medications, the procedure and anesthesia, and the first year of cryopreservation- basically, egg rent. I encourage anyone who may be curious about the process to talk to their insurance, employer and/or a reproductive endocrinologist. It seems that there are many more options for coverage than I had expected. 

Alexi mentioned several things she wished she had known before the process, but I would like to reiterate and expand upon some of those things. The process itself is incredibly daunting but, everything new feels hard at first until it doesn’t. It is very doable. Clinics may slightly differ in their protocols but mine included 10 days of a birth control pill, three days of no medication, and then 10 days of injections (one injection in the morning and one in the evening). Protocols may also be tailored depending on blood hormone levels throughout the process. For instance, I had to add a third injection on day three of injections and continue that until the day before retrieval. Medications were mailed to my door (super convenient!) but I had to be home to sign for them (not convenient at all!) as some medications are ~$4000 and insurance will not cover them if they go missing. Two of my medications had to be refrigerated and the week leading into retrieval required doctor’s visits for ultrasounds and blood draws every other day. Do not plan on traveling during this time. 

It is much harder to give yourself injections than I had thought. The needles are not bad but some of the medications burn. Ice before and after. Intensely. All the injections were administered into my lower stomach and towards day 10, I was pretty bruised, tender, and further, bloated from all the hormones.

The retrieval process itself was easy. I was under twilight anesthesia, a combination of fentanyl and propofol, and do not remember any part of the procedure itself. Really, I just got a much-needed nap. 

The aforementioned injections and retrieval were much more manageable when compared to the recovery. 

After, I was sore with lower abdominal and pelvic pain. I was told it would feel like menstrual cramps, but I felt more pressure and achiness in my pelvic floor and I had referred pain in my hip flexors. I was sore when walking but this pain was very manageable with Tylenol and later Ibuprofen. This lasted roughly 48 hours. The worst part is the bloating. I was fairly warned but not prepared. As of today, 10 days post-retrieval, I am still carrying an extra 8-10 pounds of water retention. It is miserable. Again, I was warned but I thought it was an exaggerative warning – as in this can happen not this will happen. 

To make matters worse, exercise is not an option the week going into retrieval nor two weeks post-procedure as you can increase the risk of ovarian torsion. Again, as athletes, we don’t always obey the “no exercise” demand and I did push workouts a little further into the “no exercise” window pre-retrieval than my physicians advised but stuck to cycling and swimming. I was careful to not flip-turn and kept workouts aerobic. I walked an hour every day. Post-procedure (again 10 days out) I have made sure to walk every day but have not been able to train yet. Even if I didn’t want to wait the full two weeks, the bloating is so uncomfortable that training has not been my top priority. 

I don’t say this to discourage anyone from freezing their eggs, but I do wish to provide transparency. Although I have spoken about the physical demands of the process, there is an incredibly heavy emotional toll throughout any fertility treatment for a myriad of personal reasons. However, like Alexi, I have bought myself time and that is empowering. -Dr. Whitley Atkins