And so we begin again.
Anyone who knows me knows that this is not something I look forward to. I hate needles. I used to run away from the doctor when I was a kid. No joke. Much to my mother's embarrassment (sorry, mom!), I would hide behind doors and under tables when I knew a shot was in my future. I've been known to get really light headed and to even pass out from shots in adulthood. Look, we all have our kryptonite and for whatever reason needles just give me the heebie-jeebies. So, deciding to do this again, deciding to sign up for 23+ more shots and 5+ more blood draws was not a decision that was made lightly. But looking at how many of my close friends have struggled with fertility, and knowing that once the window closes you can't open it again, made the decision clear to me. So, here we are, again.
After my first cycle, my doctor advised me to wait 4-6 months before doing another retrieval. Because my decision to freeze my eggs is what he refers to as "highly elective" (we can get into my thoughts on the use of "highly elective" later) he felt it was more important to let my body reset for a few months before undergoing the process again. Every doctor has their own ideas, treatment plans and of course there are an unlimited number of personal factors to be considered in terms of timing and frequency of cycles. I have friends who have gone from one directly into the next with no break and had successful outcomes. I'm not entirely convinced anyone actually knows the best timing, or if there is a "best" timing. I think my doctor also wanted me to have time to reflect on the first cycle and to think about my priorities heading into the second cycle.
I had two options: I could proceed with the second cycle the same way I had with the first: retrieve the eggs and immediately send them to the "ski house in Aspen" to wait until I'm ready to use them. Or, alternatively, a second option: I could go to a sperm bank and fertilize the eggs with donor sperm. There are no guarantees that I find my person, and in two to three years when I'm ready to consider having a child, I may decide to do it on my own (as so many other incredible women have done).
There are some pros to fertilizing the eggs now with donor sperm. It would eliminate some of the unknowns in terms of how many viable embryos I really have stored. Right now, with just eggs in the freezer, I have no idea if any of them will even survive thawing or fertilization and I have no idea if the eggs are even good quality. Those unknowns are frankly a bit unsettling. It's a bit like gambling at Vegas. Do I gamble with my 15 eggs, plus however many I'm fortunate enough to get out of this retrieval, on the roughly 13.67% live birth success rate (for eggs retrieved at age 37), or do I fertilize the next set and have 15 frozen eggs and a known quantity of viable embryos from this cycle?
From the 15 I currently have happily living in cryopreservation, I could end up with 10 embryos or I could end up with none when I fertilize them in the future. I've seen it happen to plenty of people close to me - a promising number of eggs retrieved but after fertilization and genetic testing none of them pass. There's no way for me to know until that time, when I make the decision to move forward with starting a family, how many viable embryos I actually have. And, by that time, it will be much harder for me to undergo a successful retrieval cycle.
To be clear, only half of the onus is on me, the other half is on the lucky sperm that will be fertilizing these eggs. I think it's important to remember that having a baby does take two people and 30% of the time the fertility issue is actually from the male side.
So, if I fertilize the second batch, I will have a known quantity, but it will also mean that if, or hopefully when, I do find my person, I wouldn't be able to use those eggs to have children with him. So while I would have a better idea of how many embryos I have, and what my odds of having a child by IVF are - perhaps giving myself more peace of mind right now - I would be limiting the number of eggs I have to use with my future partner - if there is one.
As if the decision to freeze your eggs could ever just be simple. So many things to consider, and so many unknown variables. But, like with anything, I think you just have to trust your gut. Fertilizing the eggs now with donor sperm feels a bit like giving up hope on what I really want - to find a partner in crime and to start a family together. I'm not quite ready to let go of that possibility just yet. Maybe I should be. Let's be honest, based on the number of failed Bumble and Hinge dates I've been on in the last few years, I should probably just accept the inevitable. But, I'm an eternal optimist and romantic. I firmly blame that on the Hallmark channel. So, after weighing the pros and cons, the right decision for me is to do another cycle, exactly like last time and to, hopefully add more eggs to the ones I already have on ice.
We re-ran all of my preliminary tests since it had been about a year since we'd looked at my AMH and antral follicle count numbers (we can get into what that all means at a later time). I also had to go get another annual exam with my physician before they'd clear me for anesthesia, which honestly seemed silly since they put me under in November - but who am I to argue. I then started the 21 day birth control pill regimen that my doctor utilizes heading into a cycle. This helps to regulate my hormones and to ensure that all of my follicles are on the same timeline since we want to have as many of them grow together as possible.
The day after the last pill, I went into the clinic to have an ultrasound and blood work done. This is referred to as a "suppression check." They look at all of the follicles to make sure they're all at the same stage, and to do a rough count of how many are in there. They also look at estrogen levels in your blood to make sure they haven't started to climb again. As long as both look good, the green light is given to start the medication course.
My numbers all looked good. Blood work came back where they wanted it and my suppression check showed 14 follicles on the left side and 22 on the right. In comparison, when I had my suppression check done prior to my last cycle, I had 7 follicles on the left and 16 on the right. What that means for the results of this retrieval, I don't know. Only time will tell. Ultimately, more is not necessarily better if they don't grow, or don't grow together.
Egg freezing is after all a team sport.
And then, you wait.