NPO After Midnight: Egg Freezing Cycle as a Medical Resident
I am sharing my journey going through a cycle of elective egg freezing as a young woman in medicine with the hopes that it will inspire other women to do the same, if it's something they've been considering.
Remember, I am sharing this as a patient, not a specialist doctor – nothing is medical advice: just my experiences and what I've been told by my fertility team.
Below I'll try to answer all your most frequently asked questions. Let's get into it.
How old are you?
I'm 32, turning 33 in October.
Why are you freezing your eggs? ("You're so young!")
I've wanted kids for as long as I could remember, and as I delved further into my decade-long medical career, one of my recurring fears was that by the time I tried to have kids, I wouldn't be able to for some reason.
In emergency medicine, I see so many young, otherwise healthy people get devastating diagnoses. Furthermore, women in medicine are almost twice as likely to have fertility issues than the average population, which is terrifying.
I live in fear that by the time I get around to having children, I may have unexpected issues (fertility, health, etc.) and I may never have kids. So this is a form of backup, a "just in case."
I also had a failed long-term relationship: I spent ages 22-29 with a man and it didn't work out. I spent the next 2+ years worriedly wondering if I would ever meet someone soon enough to have kids, and even though I have, I decided to take my fertility into my own hands.
Ideally, I (dare I say we?) plan to have a first child at 33 (eeep!) via the natural route, and I hope to use these eggs for a second pregnancy at 35/36.
What's the best age to freeze my eggs?
Good question. The best age is late 20s/early 30s based on the sources I've seen and what my fertility team told me.
I do wish I'd frozen them a few years ago when I first thought about it, but I was too indecisive and time kept moving. But better now than never, I think.
How much does it cost?
The question of the hour. It's expensive, and the estimates vary. When researching online, I found these estimates:
"On average, the process can cost between $10-15k, which includes:
- Ovarian stimulation medications: $3-6k
- Egg retrieval procedure: $5-8k
- Initial consultation and monitoring: $1-2k
Additional costs to consider:
- Annual storage fees: $500–1,000 per year (for storing frozen eggs)
- Pre-cycle testing: $500–1,000 (e.g., bloodwork, ultrasounds)"
This doesn't include the cost of using these eggs for IVF when you're ready to thaw them.
Does insurance cover it?
Mine did, and that's largely why I was so eager to get it done before I graduate from residency in June. Of note, my insurance company initially declined the claim and my fertility team had to appeal, so this was the longest part of the process (about four weeks).
What were your out-of-pocket expenses?
So far, here's what I've spent (my insurance handled a huge chunk of it and I'm so grateful):
- medications: $1,077
- co-pays: $139
- egg retrieval anesthesia: pending (waiting for the bill)
- storage fees: pending (waiting to find out)
I'll update this blog post as those details become clear; so far I think the anesthesia might be another $1,400.
What is the process actually like?
I had no idea what an egg freezing cycle looked like going into this. I was surprised to learn that the period of injections was only approximately 12-14 days, depending on how your body responds.
The prep/lead-up:
For me, it started with a video visit with the fertility doctor, and the following day I went into the office for a physical, initial bloodwork (hormone panel, as well as basics) and an ultrasound.
My doctor recommended starting prenatal vitamins, as well as some supplements (again, not medical advice so I won't go into detail). We set an approximate date for the start time, and my fertility team started the prior authorization for the insurance company.
And then we waited. This was the longest part: about 3-4 weeks, partly because the initial request was denied and they had to appeal. Finally, it was approved, and I was to pick up my meds so that we could start!
The injections:
Exciting – and scary.
We did a "random start" because I have an IUD and I don't get regular periods, and also with my schedule it was hard to find a time that works. I chose to start on Monday of a two-week period when I would be able to go in for all AM appointments. (Otherwise, in most other cases, you go in for your appointment on the first or second day of your period, whenever that is.)
[NOTE: If you have an IUD, like I did, you may be relieved to learn that you can keep it in!]
For the next 12-14 days, I had frequent appointments (transvaginal ultrasound and bloodwork) every morning and they emailed me further instructions around 2pm. The instructions told me exactly which medications to inject, and how much, in the same 2-hour window each night.
Mon (day 1!): AM appointment / 2 injections
Tues: 2 injections
Wed: 2 injections
Thurs: AM appointment / 2 injections
Fri: 2 injections
Sat: AM appointment / 2 injections
Sun: 3 injections
Mon: AM appointment / 3 injections
Tues: AM appointment / 3 injections
Wed: AM appointment / 3 injections
Thurs: AM appointment / 2 injections + TRIGGER! (PO doxycycline)
Fri: AM bloodwork only (+ doxy)
Sat: egg retrieval at 6:45 am (+ doxy)
During these two weeks, my doctor recommended acting like I'm pregnant: no sushi or raw foods, deli meats, litter boxes, etc.; essentially following all those generic pregnancy precautions.
The retrieval & aftermath:
This part was nerve-wracking, because, being in medicine, I know that things can go wrong even during "routine" procedures.
I was told to go in for my procedure at 6:45am; it was to be at a surgery center and a fertility doctor I hadn't met before was going to do the procedure. The procedure was at 8am, and by 9:30am we were basically out of there.
It was done under deep sedation (propofol & fentanyl, I asked), and the procedure itself is about 30 minutes. The whole experience was really pleasant; the team was nice, the anesthesiologist was jovial, and it was very well-orchestrated. I woke up in the PACU and after I could prove that I was able to pee and drink/eat a little, I was essentially discharged.
The days that followed still had some pain, treated with acetaminophen and ibuprofen. The bloating didn't immediately go away, and it took me until the Thursday to make it back to working out. My period ended up coming by Friday, which is a little odd but I'll take it.
Did you get/take time off to do this?
No, I didn't - I didn't really have the opportunity to. I had to choose a time period in my schedule when I would be able to make AM appointments, which in shift-work (EM resident) life is really hard.
My work schedule for these two weeks were:
Mon: OFF
Tues: OFF
Wed: 8am-1pm didactics / 11pm-8 am night shift
Thurs: 11pm-8 am night shift
Fri: 11pm-8 am night shift
Sat: 7pm-7am night shift
Sun: 7pm-7am night shift
Mon: 11pm-8 am night shift
Tues: sleeping day
Wed: 8am-1pm didactics / 2-10pm afternoon shift
Thurs: 3-12am afternoon shift
Fri: 3-12am afternoon shift
Sat/Sun: OFF
I did injections at work during the second week, which was a bit hard but luckily I was always able to slip away for 10 or so minutes each day.
It was really tiring, I won't lie. Downright exhausting. But it was doable. If I could take time off, I would definitely prefer it that way.
What are the side effects?
The main one is bloating, which means the process is working! I felt like I had eaten an entire horse.
For the rest, I apologize if this is TMI (too much information), but here goes:
Pain: the latter half of the 2nd week was tough, because I was incredibly bloated and on the last 3 days I was having some pain (a persistent bilateral lower abdominal ache). I did find myself taking acetaminophen and taking life slowly; certain movements hurt more than others, and I slept on my back.
Mood swings: I don't think they were as bad as I expected, although maybe you should ask my significant other how I seemed to him haha.
Ovarian hyperstimulation syndrome: this is a big one, and the reason why you get regularly bloodwork and ultrasound, so they can monitor this closely. I didn't have an issue with this.
Breast tenderness/cramping/insatiability: definitely felt some of these, and they were similar to my period pains - it was bearable.
Ovarian torsion: a potential issue if your enlarged ovary twists on itself - very rare, and luckily did not happen to me.
Constipation: some women messaged me to warn me about the severe constipation following the egg retrieval and they were not wrong. The first few days were intense, unlike anything I had felt before. But by Tuesday after my retrieval, I was fine without laxatives.
Bruising/scarring: women also reached out to say that they had some bruising in the abdomen where they did the subcutaneous injections, and luckily that wasn't so terrible for me.
Other downsides to the process:
During the three weeks, they don't really recommend exercise or sexual activity, and while understandable, I started to miss my workout routine. Working out has become a form of self-care, so this part was a bit hard/isolating. In general, light exercise can be attempted, but most days I was so tired or cramp-y that I just wanted to lay in bed and complain instead haha.
So how did it go?
Well, let me start by saying that I cried the whole way home. Not from the pain, but because I was told how many eggs they were able to retrieve and it felt like not enough. I wondered to myself, there in the recovery room,
I did ALL this for just that?!
I was crushed. That phrase kept going through my head over and over again as the tears streamed down my face, and I wondered if I could do it all over again.
Now, in retrospect, I know that the numbers, while disappointing, weren't such an outlier. I'm choosing not to share the number publicly, because I don't want other women to feel the way I did if they got fewer eggs or something. If you're curious, I'm happy to share – drop a comment below and I'll message/email you back privately.
For now, I'm deciding whether or not I want to squeeze in another cycle before I graduate in June.
How many eggs should I freeze?
This depends so much on you, your genetics, age, reserve and so much more - it's extremely personal. But it's a natural thing to wonder, and I asked my fertility team the same question.
This is the answer I received:
Final thoughts:
- It wasn't as terrible/hard as I thought it would be, but I'm exceedingly proud of myself for having done it, despite all my initial fears and uncertainties.
- I would have done it even if my insurance didn't pay for it, but I'm eternally grateful it did.
- My family didn't understand why I did it – and that's okay. After trying to explain it a few times, I decided I'd rather just not talk about it, and relied on my friends/significant other for support instead.
- I wrote this blog post to help other women who have been thinking about it: I want you to feel empowered to pursue this option, if it makes sense to you.
Special thanks to the two women who encouraged me to go through this process, I am forever indebted to you.
So there you have it:
All the information about egg freezing that I could squeeze into a single blog post. If I missed anything, let me know in the comments below and I'll do my best to answer those questions too.
