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Amanda Wilde: Reproductive Science Center of the San Francisco Bay Area is on the forefront of one of the most exciting and fascinating technologies in the field of fertility, egg freezing. Today, we'll get answers to our questions about how freezing eggs works with nursing supervisor Chelsea Spencer.

This is Fertile Edge, a podcast by Reproductive Science Center of the San Francisco Bay Area. I'm Amanda Wilde. Chelsea, welcome. Thank you for being here.

Chelsea Spencer: Thank you so much for having me. I'm excited.

Amanda Wilde: It is amazing. In the words of Dr. Hinkley, in another Fertile Edge podcast, life can be stopped and then restarted at a point in the future, and a healthy child can result. And she also encouraged patients not to be afraid of freezing eggs. Why would I consider freezing eggs? What are the advantages and what position might I be in that this would be a great choice for me?

Chelsea Spencer: Yeah, I totally agree with what Dr. Hinkley said and passed along. That's actually one of the reasons why I chose to personally freeze my eggs. I had a few life instances that were pretty unexpected come up from about 2017 through 2019, and it just made me realize that I knew I wanted to be a mother down the road, but I was not ready for it in that moment. So when my 30th birthday rolled around in 2020, I was like, "I think I'm going to give myself this gift of this kind of insurance plan for down the road, knowing that this was something I wanted, but not right now."

Amanda Wilde: It's sort of like banking it for later then. It is banking it for later then.

Chelsea Spencer: Yes. Yeah, it is. So, you know, I went through the process and have a good set of eggs on ice, cold and frozen right now that I can utilize down the road if needed. I think that's something that, for me personally, provided some comfort because I knew that something I wanted. But just where I was at with my life and partner and work, I just knew I wasn't ready for it in that moment, but I wanted to still give myself the best opportunity for a family down the road.

Amanda Wilde: Well, how does it work? Let's really dig into the procedures, the timeline, and the costs. So, starting with the timeline and the procedures, how does it work in terms of visiting your doctor, scans, recovery process? What is the procedure itself?

Chelsea Spencer: Yeah. I think the first initial step that I would encourage any woman to take that's considering egg freezing is to get a fert check, that's what we call it. And that looks at a few different hormone levels and kind of helps guide you with where your fertility is at, what your ovarian reserve looks like in regards to how many eggs you have.

Based on that information, I'm a huge proponent that knowledge is power. You can kind of determine how quickly do I need to move into a fertility preservation cycle? Is this something that I have a few years to save up for? Is it something I should really look at doing right this minute? And kind of help plan for yourself and your future.

So, I did that actually, I think it was like 2018 originally. And based off of those results, I knew I had a few years before I really had to start thinking about it. So, when 2020 rolled around and I repeated it, I knew I was ready to proceed with that and I had plenty of time to kind of save up for the cycle and go into it. So with that information, it also helps create your treatment plan and opens that conversation with your physician too about those next steps.

Amanda Wilde: And I assume scoping out the situation and getting that baseline information, sort of like you said, you kind of walked away and then came back to it, it sort of helped solidify your desire to do this.

Chelsea Spencer: Yes. Yeah, it was helpful. Just again, like that knowledge was power for me. Like I knew, "Okay, I have a good five plus years to really dive in and think about this." I started on the younger side normally than most do, just being exposed to the field. But that was important to me. I knew it was something I needed to save up for financially, prepare for mentally, physically as much as possible. So, I really started the process early in order to prepare myself as best as possible.

Amanda Wilde: So, let's talk about that timeline. Can you outline for us kind of what procedures you followed and what order and what the timeline was for that?

Chelsea Spencer: Yeah. So once I repeated that hormone testing in 2020, I knew I was ready to move forward at that point. So, I had a few conversations with my physician and my case manager. They really helped guide me through the process.

Generally, it takes roughly like a month to two months to really prep for everything. The cycle itself is about two to three weeks. Month number one is a lot of pre-cycle items, so getting blood work done, additional ultrasounds to kind of determine that we're on the right track with treatment and our protocol and calendar for that specific person.

And then with the next menstrual cycle, you really just get ready to go forward at that point. So, there's generally a small amount of birth control pills or additional medications to help kind of leading up into the cycle and then, you go in from there. And with that, there's multiple appointments, multiple blood draws, about 12 or so days of nightly injections and then, your egg retrieval, and that's really the Reader's Digest version of it . But your medications could change on a daily basis. You may be coming in on daily basis, so there really is that commitment during that 12 to 14 plus days of being here, making sure that works with your schedule and making yourself the main focus.

Amanda Wilde: And then, how are the eggs harvested?

Chelsea Spencer: So through the egg retrieval process, you will come in once you're triggered, which is at the end of your stimulation injectable medications, you give one last one. And then, exactly 36 hours later is your retrieval. At your retrieval, eggs are harvested. It's through a surgery, and they are then collected. You get to know how many were collected that day before you go home. And then, you'll get a followup call the next morning, letting you know how many were mature and are now frozen for future use. So, they are cryopreserved at that point.

Amanda Wilde: And the recovery process from that procedure, what was that like?

Chelsea Spencer: it was not too bad in my opinion. I know every individual and body is different, and I totally respect that. I went home the day of that retrieval and had a very chill day, so kind of laid on the couch, warm heating pad, Tylenol and Advil kind of around-the-clock just to make sure I was doing okay with any cramping. And then, just really watched Netflix and hung out and didn't do too much. Each day after that, I felt a little bit more like myself, so less bloated, less crampy. And it took probably about seven or so days after the retrieval to be 100% where I was like, "Okay, I don't even remember doing this."

Amanda Wilde: It's a big commitment as you described. You might be going to the doctor every day before you will be doing injections. And then, you go through this procedure and there's a little bit of recovery time. Then, there's the cost, which we have not hit on. How is the cost covered? I don't even know if this is something you see covered by insurance. And you mentioned saving up. So, can you talk a little bit about the cost for this procedure?

Chelsea Spencer: Yeah, it changes every year. But when I went through it, it was about $12,000, to $15,000, I would say out-of-pocket, including medications. There are some insurances that do cover egg freezing, so I would always encourage you to look at your fertility benefits before jumping into this to see what you do have.

For me, with my insurance, it didn't make sense for me to go through insurance, so I paid for it out of pocket. And that's why I knew I was going to be doing that. So, I wanted to take that extra time to save, and so did that.

And yeah, I didn't feel like there was any like surprises financially. I knew the medication cost is a big chunk of it as well. But our case managers work really well to make sure that you have what you need upfront so you're not paying as you go with medications.

Amanda Wilde: Did you have any side effects from any of this?

Chelsea Spencer: The main side effect that I had was fatigue and bloating, very similar to my kind of natural menstrual cycle period symptoms, but definitely exemplified, so more than what I would feel during a normal month. With the bloating, I kind of joke with my patients even like, "Pull out your stretchy pants because you're going to need them." definitely are aware of your ovaries and know that they're enlarged. But it shouldn't be to the point where you're very, very uncomfortable. I mean, you're aware of them. You might have some discomfort, but it shouldn't be anything where you're in extreme pain.

Amanda Wilde: And it sounds like no long-term side effects.

Chelsea Spencer: No, no long-term side effects. Usually after the retrieval, like I said, it takes about sometimes seven to 10 days to kind of start feeling more naturally like yourself again, where that feeling of fatigue and bloating have kind of resolved as well.

I should also mention that my fatigue stemmed from getting a puppy around the same time. So, there was a lack of sleep on both parts with the hormones and the puppy. So, would not recommend that for anyone going through the process.

Amanda Wilde: Good practice though for having a baby.

Chelsea Spencer: Yes.

Amanda Wilde: Will the procedure impact future fertility at all?

Chelsea Spencer: No, it will not. So each month, women have a dedicated amount of eggs for that month in that cycle. And so with the month that you're going through this process, we're really stimulating the body to create as many as possible for that month. So, it's not like you're robbing from your future fertility to go through this process today in the present.

Amanda Wilde: And as people may recall, you are born with all the eggs you will have. But that sort of leads to the other side of that equation, how long are the eggs good for once you've frozen them?

Chelsea Spencer: Yeah. No, that's a great question. That's one I get a lot. The eggs are good for an indefinite amount of time. They'll just remain cryopreserved, frozen until you're ready to use them. I had mine shipped off to a long-term storage facility because that was the easiest way to kind of hold onto them and keep the process going. And whenever I want to use them down the road, I just have them sent right back to my clinic and we go forward with the thawing process and insemination and creating embryos at that point.

Amanda Wilde: Now, what happens if you go through all this but you change your mind?

Chelsea Spencer: Yeah, you can change your mind really at any point in the process. Whether you are two days into your injections and you're like, "This isn't for me," it's totally fine at that point to stop. We're all here to help support any patient that's going through this process. Or if you end up being naturally pregnant down the road and not needing your eggs, there's options for discarding them, donating them for practice for new staff in our embryology lab or discarding them in general. If you don't want to keep them and you don't feel like there's a use for them or you don't want your genetics out there, you can just discard them as well.

Amanda Wilde: Yeah. I understand some people are taking older eggs and using them now, so that it's kind peculiar to think, "Oh, you're an egg that's 27 years old and now you're being born."

Chelsea Spencer: Yes. Yeah. I think there was recently an article about that. I don't remember if it was an egg or an embryo. But, yeah, they're good to be frozen for however long is needed. And then when the time is right for you and your partner or yourself and a sperm donor, whatever works for you and your family planning needs, you can have them thawed and then create embryos at that point to be transferred.

Amanda Wilde: So, you have all this personal experience with freezing eggs, but you also work with people who do that. Is there anything else you want to add as we wrap this up from your experience with a lot of different women freezing their eggs?

Chelsea Spencer: Yeah, I mean, I would just say at the end of the day, doing the fert check, I know through our office, you get scheduled for it and you get a consultation with one of our physicians to review your results is really the first step in knowledge and knowing what your body looks like down the road, so you can plan for yourself.

I think as women and patients in general, to me, that's always going to be something that's really important, is just for people to understand their body to the best of their ability. I would say not to be scared of egg freezing. I think the price tag can be scary, and just not knowing the whole process in general can be scary, not knowing what to expect. So, reach out to your friends or those that have been going through the process to get their feedback to you, but know that each body is individual and different. I'm always willing to help my friends and family and whoever with questions because I'm very passionate about the field and, specifically, this part of it.

Amanda Wilde: So if you're curious, there's lots of tools and resources to access. Thank you so much, Chelsea, for insights into egg freezing and how we can use this technology to ultimately create the family we want in a safe and healthy way. Really appreciate your time.

Chelsea Spencer: Oh, thank you. No, this was fun.

Amanda Wilde: Chelsea Spencer is a nursing supervisor at Reproductive Science Center of the San Francisco Bay Area. For more information about freezing embryos, please visit rscbayarea.com/treatment/fertilitypreservation.

And if you found this podcast helpful, please share it on your social channels and check out the full podcast library for topics of interest to you. This is Fertile Edge by Reproductive Science Center of the San Francisco Bay Area. I'm Amanda Wilde, and we'll talk again next time.