What's Next After Egg Freezing?

Mariana

If you're creating embryos, clearly there's a next step if you want to pursue pregnancy. But if you’re freezing your eggs, once you're done- then what? Do the patients come back and find you, and then have another conversation when they’re ready to conceive?

Dr. Kofinas

Everyone’s situation is different. Maybe you now have a partner, and maybe you want to try naturally first. It depends on age. If you’re 39, it’s different than if you are 44. If you want to try naturally, you should. I think of the egg freezing process as half of the IVF process. 

The big question you need to answer when you come back to thaw your eggs is how many of your eggs do you want to thaw first. What would the considerations be? Different doctors have different opinions on that. My opinion is that you shouldn't thaw all of your eggs at once. What if there's an issue with the thaw? There could be an issue with the media or the lab. This is a human process. They're not machines doing it the same way every single time. Obviously, there's standards, and you fall within a standard error, so that overall the quality is well controlled. But besides cost, I don’t see why you’d want to thaw all of your eggs in one go. Let’s say you thaw half of your eggs and you get 2 or 3 good embryos and you get pregnant, you have your baby, you still have those other eggs- who know what you might need them for in the future. So that’s the first consideration you should think about when you go through the second half of the IVF process. 

The second part is that thawing the eggs is not the difficult part of this process. It doesn’t require a lot of involvement from you. We take the sperm sample and everything happens in the lab. Then we move forward with an embryo transfer. Obviously, we need to evaluate the uterus before the transfer. There's different ways to do an embryo transfer that ranges from really complicated to a natural cycle. So there's been a huge evolution that fits a different patient’s desires, personality, and anxiety levels.

Mariana

Thank you so much, because I have learned so many things that I didn’t know, things that I still had questions about, and just it's so revelatory now. And even knowing that my eggs are frozen, there will be one day that I might have to use them. 

And there have been so many changes from the process that I saw in my first experience when I was 33 to what is happening now, and how doctors are, in the best way possible, just holding our hands and allowing us to be individuals, to not have to fit a one-size-fits-all approach for this very emotional process. Thank you for providing your insight and your guidance. This subject has been and can be so taboo, and it is very personal. But the more information we have, the more we know. There’s a lot of things that I wish I would have known years back, and I'm glad I do now. I hope that we can impart that on anybody else who is thinking of doing this process. 

Dr. Kofinas

Even just from the time I started my career to now, the amount of people willing to speak about this, from a stranger at a party or on the subway has grown dramatically. We see bags with our practice’s logo on it routinely. My staff has been approached by people who tell us that they went to our fertility group 20 years ago, and they then point to their child. Really cool stuff! But I think it’s become less taboo. And the more people talk about it, the more the information will be out there, and the more support networks you’ll be able to create. You don't necessarily have to have a group of friends that are going through it. You can find a support network even online, such as Facebook groups. These things exist, and people use them. 

Mariana

Fertility treatment is more common than we think it is- it doesn't mean that something's wrong with you. I think that is one of the biggest things that we are dismantling now. That fertility treatment is just a natural part of us evolving as humans, as things shift and we have our own individual journeys. This is an option.

Dr. Kofinas

And it's something that you're doing for yourself. And you just want to have that ability to have a flexible future. The future is your decision- whatever you want to do. But if you didn't have this technology, perhaps it wouldn't be quite so empowering in a way. You would just have kids when you're ready, and who's to say that when you're ready, it's going to be feasible, right? So, even if you don't freeze your eggs, fertility doctors are there to guide you as to where your reproductive health is right now. Even OB/GYNs have caught on- a patient will come in, and they’ll have the conversation, “Hey, you're 35. Have you frozen your eggs? Do you have a partner? Have you thought about when you want to start having a baby?” This is where the initial thought enters into a patient's mind. They’ll think, “I saw it on Instagram”, or, “My friend did it a year ago. Thanks for bringing it up. I'm going to go think about it a little more.” It might not happen the first time someone mentions it, or even the second time, but once you keep seeing it all around you, you start to develop this idea in your head, and then at some point it clicks.