Oh hey. Ya miss me? As of the writing of this initial draft, I’ll be starting day one of my injections TONIGHT. Cue JLo’s iconic hit. Just kidding. I’ll probably be making a Spotify playlist later that are equal parts Whitney, Kendrick, and “Autumn Jazz” to get me through this. But I digress. Let me catch ya’ll up…
So after I chose the red pill (Matrix reference, sup Morpheus) or rather, said yes to this whole egg freeze business, I was entered into “the system” and assigned to a class. I imagined the pre pandemic days of meeting in person and making new friends, all of us bonding over this shared experience, but instead I woke early on a Saturday, bit into a croissant, and logged onto an anonymous Zoom type platform where cameras were discouraged and it was emphasized that we only use initials. Maybe I was joining a cult. Who knows. But on the other side of the screen was a cheery coordinator, let’s call her Trinity, who walked us through a two-hour, 40+ page power point presentation on ALL THINGS EGG FREEZING, what to expect, and aptly called “Oocyte Preservation.” We were the January 2023 class. All ten of us black squares.
After Trinity introduced herself and asked that we mute ourselves (I quickly realized this was not an interactive presentation, boo) she quickly launched into the issue at hand. She delivered brand new information that I didn’t welcome - the fact that due to the various natures of our cycles we were never guaranteed what doctor we’d see when having to come in for monitoring. Greeeaat (sarcasm). Something to think about when choosing where you go. Do you want a big hospital system or a small boutique firm? After flipping through slides with faces of the Fertility Team, we then launched into what’s known as “Cycle Monitoring” or what I like to call “Look and See.”
Because we are the January 2023 class, that means we were on high alert for our November and December periods. Once our periods drop, we call a number that I named The Period Hotline. From there, our designated coordinators would schedule us in for our Cycle Monitoring come January. Unfortunately for me my November period became my December period and dropped 10 days too late (or early). After my coordinator rambled on about how this was not good for scheduling (c’mon, I didn’t tell Aunt Flo to pay a visit when she did), that I may have to wait for the March or April 2023 class (no thank you), she got me into late December. Phew. Crisis averted. But back to the Cycle Monitoring.
Basically the average number of days for an egg freeze “cycle” is 10-12 days. So everyone who’s FTFO (which you are allowed to do, I did) that this is a big deal, at least it’ll all be over in 10-12 days + heal up time. Trinity explained that on Day 1 of our period we were to call the hotline and we’d come in on Day 2. Day 2 = meds. Meds = injections! Towards the end of these 10-12 days the doc will ascertain that it’s “go time” or rather, time to schedule the egg retrieval. The docs will have been monitoring us up until this point with blood work and ultrasounds and when the eggs are plentiful and before our estrogen drops to start ovulation, they’ll literally have us give ourselves even more injections… this time called a “the trigger shot.”
But no, she doesn’t stop here. As I was trying to hold onto every word, remembering what it was like to be a student in a lecture hall, it also suddenly felt like I was in med or nursing school. Trinity broke down all the body parts, meds, and how to administer our injections (shudder). I was typing furiously on my computer taking detailed notes and feeling overwhelmed. Pull this. Inject that. Mix this. I felt like I was Sydney Bristow getting a rundown on an imminent mission by Marshall and still needed Vaughn to give me my counter detail. If you can’t tell, comparing components to this to TV shows is a coping mechanism.
Trinity talked Gonadotropins, Antagonists (who knew meds had character arcs), and Triggers.
Gonadotropins - these tell the ovaries to mature multiple follicles simultaneously. Normally (health lesson folks!) at the top of one’s period our follicle stimulating hormone (FSH) and luteinizing hormone (LH) are released from our brains and stimulate the growth of 15-20 eggs in the ovary. Each egg has its own shell called the follicle. Did I learn this in Catholic School? Nope. Do I know now? Sure do! So why the Gonadotropin you ask? Well basically (again, not a medical professional, summarizing my very basic understanding, do thine own research!) during a menstrual cycle usually one follicle overpowers all the others and forces them to die. Very Game of Thrones up in there. And when that happens, this dominant follicle continues to mature and produces estrogen. Because of this follicle’s estrogen producing power trip around day 14 of an average menstrual cycle, this causes the follicle to release its egg from the ovary and is then captured by the fallopian tube. “Go long!” If and when this egg is NOT fertilized (sup sperm) it dissolves inside the uterus, which in turn breaks down and sheds and then hello period! All that to say, the Gonadotropin prevents a dominant egg from forming. All eggs are equal and will keep their happy buts inside the ovary. And the point of the monitoring is to make sure estrogen doesn’t happen and cause all those eggs to “drop” from their shells. Which brings me to —
Antagonists - another drug I’ll be injecting later on in this 10-12 day “cycle”. From what I understand basically these will help prevent premature ovulation aka the eggs dropping from their shells and the ovary. Then, after Looking and Seeing or rather “monitoring,” for many days, the doctor will say the time is neigh and have us give ourselves a —
Trigger Shot - This is LH in shot form, manually pulling the trigger on the maturing of all our “equal eggs” or what Trinity keeps calling our oocytes.
Ok, got all that? After Trin made me believe I was in fact in medical school with all her nuanced slides and choice of medical terms (ER fandom did not save me that day), we then went on to watch a video on how to mix our meds and inject ourselves. Now, I’m a very literal person and the actress playing “Willing Egg Freeze Participant” did not impress me. I had SO MANY questions after that video but we were told to hold our Qs until after the slideshow. Did we get a break by the way during this whole two hours? No, no we did not.
After the “video,” yes I’m using quotes, we were then told what to expect on the day of “retrieval” — and now it just sounds like I’ve joined a sci fi movie but anyways… In all, we’ll get 36-48 hours heads up before we “go under.” The entire procedure will take a whopping 5-10 minutes and we’d “come to” about an hour after that. Then a slide show with a “celebrate” emoji appeared but here’s a screenshot of what Trinity told us the procedure would look like:
Sexy. I know. After all that, and with ten slides left, Trinity then told us all about the actual freeze or “Oocyte Preservation.” Again, do your research, but where I’m going, after the eggos are evaluated by an embryologist, they’ll be preserved in liquid nitrogen. And apparently one can store them that way indefinitely. I’m sensing a Crichton novel in all of this.
The only major side effect Trinity kept emphasizing was something known as OHSS or Severe Ovarian Hyperstimulation (don’t ask me why the acronym is in that order). Basically OHSS occurs when way too many eggs are produced which can cause fallopian tubes to twist. Really really trying NOT to think about that bit because it’s scary. I’ll let you look that one up for yourself.
Yeah, so after all of those slides and hours I had many a question but seemed to be the only one asking them from behind mere initials on a black screen. While Trinity was very forthcoming with her answers (mine were mostly about how the hell we’re supposed to be scientists now expected to mix our own meds!) she reminded me that we all had dedicated coordinators to further assist us. Sigh.
All this to say, there are small boutique firms out there who will give you more personalized, one on one care. I was overwhelmed but wanted to rip the bandaid off on this whole operation and not spend more time researching alternative places to do this. The science and stats were there. My doctor is well known and referred to me by my surgeon who I like and trust. Do I wish there was more actual face time in all this? Yes. But I can’t ignore the fact that there’s a pandemic still out there.
So after FTFO out on my dear cousin who did all this in the summer and who had the patience to calm me down over this whole med mixing business, I took deep breaths and awaited my period. As stated above, it came too damn early.
Also - because of my endo and below average test results - The Good Doctor is also having me take extra meds (an estrogen patch and some pills, yippee) to help “boost” these injections. Apparently I need all the help I can get (face palm emoji). So if you find yourself in a similar scenario, know you’re not alone.
My period arrived early. I went in. They took my blood. And they said on Day 19 of the December period to start wearing the patch. My mom saw it when I went home for Christmas and said they’re the same ones she used to help with her hot flashes. Eh? And then — I waited…. for my next period — the “January” one. For when that one came, it’d be time to get thee back home and start this whole egg freeze cycle. And oh, on Christmas Day, it delivered or so I thought…
Toodles!