Learn About Egg Freezing
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Learn About Egg Freezing

9:08 a.m. MST May 20, 2015
by Megan Finnerty, The Republic | azcentral.com

As children, these women might have passed around rumaki and crudité as their mothers learned to apply fuchsia lipstick at Mary Kay parties….

Instead, at a recent happy hour at Del Frisco’s Grille, the women snacked on flatbreads, cheesesteak, eggrolls and lollipop chicken wings as they learned how to extend their fertility through egg freezing. The deviled egg appetizers — one of Del Frisco’s most popular — would have been too on-the-nose.

With two yellow drink tickets per guest, the “Fertility al Fresco” rooftop event in central Phoenix — the first of its kind in Arizona — was a fairly festive setting for talking about overcoming one’s mortality and fear of irrelevance by stopping one’s biological clock.

Last year, an egg-freezing national network called EggBanxx hosted the first such party in Manhattan. Now, similar events are held almost-monthly in places like Boston, San Francisco and Washington, D.C., and draw between 50 and 200 women per party.

If “Fertility al Fresco” sounds less than common, give it time. It was only in 2012 that the American Society for Reproductive Medicine, the self-regulatory organization for U.S. fertility clinics, removed the “experimental” label from egg freezing.

The parties borrow from the playbooks of Tupperware, Pampered Chef and cosmetic surgery doctors, with their own spin. “Let’s chill,” the invitations read, offering guests an evening of “fun, fertility and freezing.”

To be clear, no eggs were frozen on the restaurant patio. The party is about pitching an idea to future clientele.

The 11 Valley women had heard about the happy hour at a women’s expo the week prior, or had seen ads on their Facebook feeds. The hosts, the Scottsdale-based staff of Boston IVF, didn’t seem disappointed with the turnout. The size lent the evening the intimacy — and intensity — of a group gynecological visit.

“Times have changed,” said nurse practitioner Rekha Matken, who works at Boston IVF. “Women talk more about their infertility issues now than ever before. It’s not that it’s more prevalent, but it’s that we talk about it more openly. They know the biological clock is ticking, and they want to learn about doing something to help.”

In an extra-long purple T-shirt, leggings and sandals, mortgage writer Antaysha Brice, 23, sipped a lemondrop martini and sat on a banquette with her cousin, Frances Ortiz, 25.
Brice, who lives in Maricopa, has been married for 31/2 years and has been trying to get pregnant. She has polycystic ovarian syndrome, often linked to infertility.

“I want to keep my options open,” she said. “I want to know what they are, for anything that ever comes up, or life in general.”

The evening opened with seven true/false fertility-related statements, delivered by publicist Ania Kubicki, who breezily teased the women with such statements as: “The missionary position is the best position for getting pregnant.”

The women called out “False,” prompting Dr. Jesse Hade to quip, “All the positions are the right positions.”

A smiling man in a Prussian blue suit and yellow tie, Hade, a specialist in reproductive endocrinology, obstetrics and gynecology, got serious quickly. “As long as you can have intercourse, you can get pregnant.”

Then Hade was right back to the jokes: “It’s like Lotto, you’ve got to be in it to win it.”
Kubicki moved on to posing open-ended questions like, “How many eggs do women have?” Hade answered that females are born with 1.5 million viable eggs, only about 10,000 of which are still good at age 40.

Next question: “Do you have to have an orgasm to get pregnant?”

“No,” the women called out. Unanimously.

“How long does the uterus function?”

Turns out, pretty much forever.

“How many good eggs does it take to have a baby?”

“One good egg leads to one good kid,” said Hade. “Well, I can’t promise your kid will be good, but it will be fine.”

Collectively, the women aced the quiz.

This is because these women know the subject. They’re members of a generation who’ve heard since childhood that they could become pregnant near-effortlessly starting at menstruation, but only until about age 43.

Hade and Kubicki then launched into a scripted run-through of commonly asked questions, covering the science, finances and emotional choices in what’s called “fertility extension” or sometimes “fertility preservation.”

They said egg freezing and thawing has been around since 1986, but a flash-freezing method called vitrification was perfected only three years ago, dramatically increasing the odds of success.

The process starts with blood tests and a pelvic ultrasound to determine a woman’s “egg reserve,” or how many viable eggs she’s likely to have. Then a woman injects herself with hormones to hyperstimulate her monthly egg release from one or two eggs, as per normal, to between 4-20.

To retrieve the eggs, using an ultrasound guide, a doctor pushes a long needle through the vaginal wall and into the ovary. In the ovary, the doctor pierces as many follicles as have produced eggs that month, sucking them out and into a test tube. Then, the eggs are frozen. How long eggs can stay frozen and still be thawed successfully is an open question.
If a woman decides she wants to try to conceive using them, they’ll be thawed and fertilized. Then the blastocysts (if any develop) are tested for chromosomal abnormalities, and any healthy ones are implanted in her uterus just like in traditional in vitro fertilization.

Hade described this as a “very minimally invasive procedure, using a very small needle.” A few women laughed, thinking he’d made a joke.

In Arizona, the process costs anywhere from $9,500 to $12,000, but these costs can vary, up to $50,000. They’re unlikely to be covered by insurance.

After each answer from Hade, the publicist invited women to ask questions. When they did, Hade told each that her question was great. Typically, this is a bit of live-event politeness. But on this patio, it felt true.

Phoenix attorney Chelsea Sayles, 36, asked about medical conditions that could interfere with a woman’s ovaries being successfully hyperstimulated, such as thyroid and autoimmune disorders.

Hade took several minutes to explain how this was unlikely.

Sayles followed up: “At one point, you mentioned women up to age 34, and then you mentioned women up to 40. Is there a cut-off age? Me, at 36, egg freezing is an issue, obviously. If I’m going to do it, I need to do it soon. Is there an age where you start looking and say, ‘I’m not sure if this is really going to be an option for you.'”

Hade took more than five minutes to respond, running through odds of viable eggs and of healthy embryos. He talked about the difference between one or two rounds of hormones and egg retrievals versus 10 to 15 rounds.

He talked about thaw and success rates, “For every six eggs a woman gets under age 34, one blastocyst will be implanted that will be chromosomally normal and that will have a 35 percent chance of implantation…” He talked about false hope, and counseling, and how much in dollars and time might it be worth to improve a woman’s odds of improving her odds.

It was a non-answer. But Hade wasn’t being evasive.

Rather, he was likely covering for a lack of data. Neither the Centers for Disease Control and Prevention nor the American Society of Reproductive Medicine collects data on egg freezing. The New York University School of Medicine says 2,000 babies have been conceived and carried to term via egg freezing. USC Fertility in Los Angeles says 5,000.

A woman near the snacks raised her hand. “So if you’re giving me extra medication to make me ovulate more, and people already generally annoy me when I’m PMS-ing, will I have to save extra money for bail money because I’m just gonna, like, lose it on somebody?”

“You know, everyone handles the hormones a little bit differently,” Hade replied with an air of understatement. “Every individual is unique … and I think it just depends on what’s going on in your life at that time.”

The presentation was over in about 30 minutes and hits from Billy Joel and Van Halen filled in the quiet. Matken, the registered nurse, approached two women to ask if they had any follow-up questions.

“Two years ago, I was diagnosed with endometriosis and now everything is normal. And I’m not ready at all to have kids in the next few years,” said Christine Woolley, who is married and studying for a doctorate in chemistry. “But I know my diagnosis means …”

“How old are you?” Matken gently interrupted.

“Twenty-eight.”

“So you’re a great age for fertility preservation.”

“But I know the medicine can exacerbate the endometriosis.”

“It can, but it’s unlikely,” Matken said.

Down the banquette, women asked questions about the safety of the procedure. Clinic staffers’ answers were reassuring, but vague.

In America, there’s no mandatory national registry tracking the health of women undergoing these procedures, or of their offspring.

At the bar, Sayles, the attorney, said she’s been in a relationship for about nine months and has mentioned to her boyfriend that she wants children.

Asked why she had come, Sayles replied matter-of-factually: “Because I’m 36, unmarried and I don’t have children.”

While most of the women at the Phoenix party were married, Sayles is in line with the national average. About 88 percent of women who freeze their eggs do so because they haven’t found the right partner while they’re still reasonably fertile, according to a 2013 study published in Fertility and Sterility.

“I’m concerned,” she continued. “I want to have kids and I don’t want my potential opportunity to pass me by. I think about it all the time.”