“Shall we just pop ‘em on ice?” I ask my friend with a laugh. “Save it all for later?”
“Yeah, probably,” she sighs. “It’s all too much right now.”
Are we talking about leftover bolognese or freshly caught seafood? Yum, but alas, no.
We’re talking about our eggs. The ovarian kind.
Trigger warning: This article discusses fertility, IVF and egg freezing and may be distressing to some readers.
“I would have given anything if someone had said to me ‘Freeze your eggs. Do yourself a favour’,” Aniston revealed in what would become *that* viral interview with Allure.
“So here I am today. That ship has sailed.”
Her words of warning struck a well-worn and often targeted nerve for a lot of women. The idea of missing the baby boat as the sun sets on the possibility of biological motherhood can be unsettling for a number of delicate, complex and individualised reasons.
Even for those of us in the ‘unsure’ camp—like my friend and I. I’m in a long-term relationship and both my partner and I are in our thirties.
Most of our friends have either had babies, are pregnant or are planning to be soon. But for a cocktail of our own reasons—cozzie lives, a love of sleep, a sprinkling of unresolved childhood trauma—we’re simply not there.
And we may never be. But also, I’d like to have the option. Without the pressure, please.
Which is why, despite a wariness of the investor-backed fertility industry, I decided to explore elective egg freezing myself.
What You Should Know About Egg Freezing
When you think of the confronting possibilities that await on the path to ‘popping ‘em on ice’, learning your chances of conception are low is arguably the scariest (followed by discovering some other undiagnosed medical issue).
I’ve barely started the process, but the fear that’s come up for me has already been surprising.
For those playing along at home, egg freezing is the process of stimulating follicle maturation with daily self-administered injections from the start of your cycle through to ovulation; a phase health professionals refer to as the ‘stim cycle’.
Then, prior to your body’s natural ovulation, doctors administer a ‘trigger shot’ to fully mature as many eggs as possible before conducting the ‘retrieval’, a mildly invasive procedure to extract those eggs from the ovaries.
The process is exactly the same as the first phases of IVF treatment. But when you’re freezing eggs electively—i.e., not because my partner and I are currently struggling with pregnancy or a medical reason like undergoing chemotherapy, which can significantly impact ovarian reserve—the emotional stakes can vary.
As my close friend who had to undergo IVF after two traumatic pregnancy losses so accurately put it—there’s different skin in the game.
So when I learned I’m at higher risk for Ovarian Hyperstimulation Syndrome (OHSS), I stopped to think twice about continuing.
“(OHSS) is a complication of the drugs used in IVF treatment,” explains Dr Raewyn Teirney, a fertility specialist with IVF Australia who has been working in Gynaecology and Infertility for more than 20 years.
“It occurs when there’s an excessive response to the stimulation of the ovaries with the hormone injections. The second hormone used as a trigger injection can then raise the hormone levels even further causing a potentially serious condition including abdominal discomfort, shortness of breath, bloating, swelling of the ankles and weight gain.”
How Common Is OHSS?
Dr Teirney stresses OHSS is very rare—occurring in approximately 1% of treatment cycles—and that modern treatments make it much easier to prevent. But in some cases OHSS can be ‘very serious and the women involved may need to go to hospital for assistance’.
The risk of OHSS increases for women with a higher number of follicles, which doctors determine through an internal scan and a blood test to determine your anti-mullerian hormone (AMH) levels. AMH is associated with follicular development and is often referred to in reckless marketing as your ‘egg count’ or ‘egg reserve’, but this can be a dangerous misconception.
“AMH is a can of worms, and I want to be really clear,” says Michelle Smith, AHPRA registered Chinese medicine practitioner (BHSc) and reproductive health educator.
“A low AMH does not mean you have less chance of conceiving without medication, and a high AMH does not mean you have more chance of conceiving without medication. AMH is a marker designed for the IVF space, to be used along with other markers to guide the fertility specialist with dosage of your stim cycle meds.”
It’s one piece of a very large puzzle.
Other key fertility factors include sperm quality, age, diet and lifestyle (improving Vitamin D levels and decreasing alcohol consumption can actually increase AMH levels) the strength of your uterus lining, and more.
As for OHSS, Michelle emphasises that while the symptoms can be severe, with proper medical care the chances of it occurring are low.
What Should I Consider Before Freezing My Eggs?
Whatever your ‘why’ for egg freezing, it’s important to take it seriously.
“People undergoing IVF have a really high awareness of the importance of egg quality, but with elective egg freezing there’s often this misconception that we’re drawing from some sort of utopia that hasn’t been affected by age or alcohol or smoking. When elective egg freezing is empowering people to make informed choices about their future, it’s great. It can be dangerous when marketing uses fear mongering tactics or fosters a flippant attitude of ‘just freeze your eggs’.
“You’re not ‘just’ freezing your eggs. It’s going to have a really significant physical, emotional and financial impact. It’s also really important to be fully aware of the realistic likelihood of pregnancy, and how many cycles you’ll need to budget for to give yourself the best chance. It’s not an insurance policy.”
Lisa Ransome, a reproductive psychologist and infertility counsellor, agrees. “A more accurate analogy is a lottery ticket. What we lack when we hear ‘just’ freeze your eggs is the limitations that apply and how different ages are impacted. Women who freeze in their 20s and early 30s have a fairly good chance of a live birth but with age the chances get fewer and fewer,” she says.
“Egg freezing can be great if you’re well informed and understand the risks and benefits on both sides of the page, but fertility treatments of any kind are never a guarantee. From a mental health perspective, it’s really important to understand this to ensure your expectations aren’t mismatched with reality.
“It’s also important to know your goal for getting your fertility tested. Is it because you’ve had a history of health issues? Or is it just because it’s in vogue to get everything checked now? Are you trying to find out how many more years you can buy before you need to settle down, or make a decision about starting treatment on your own?”
While it may be tempting to approach egg freezing with the nonchalance of leftover bolognese or freshly caught seafood, the professionals advise against it.
“Don’t dismiss it as something you can do in your week off from work. Some people may glide through, but for others it will be more challenging and you won’t know until you’re doing it. If you’re unsure or on the fence, speak to a psychologist or medical professional to help you work out what is right for you.”
Lizzie Mulherin is a freelance writer and travel author with a passion for exploring the grey areas that make us human. When she’s not tirelessly searching for Sydney’s best spicy marg, you’ll spot her spamming Instagram with unsolicited dog content.