Like many millennials, my husband and I have chosen to delay starting our family despite being in a stable relationship. This decision isn’t unique to us; it’s becoming increasingly common among young Filipinos for a variety of reasons, including economic pressures, health concerns, and personal circumstances. A study by the Philippine Statistical Research and Training Institute, commissioned by the Commission on Population and Development (CPD), highlights this trend. It found that from around 2017, Filipinos began to delay or deprioritize having children due to financial constraints and insufficient income.
The impact of this shift is evident in the national birth statistics. From a peak of 1,700,618 registered live births in 2017, the numbers fell to 1,668,120 in 2018 and further dipped during the COVID-19 pandemic, reaching lows of 1,528,684 in 2020 and 1,364,739 in 2021. The Philippine Statistics Authority’s 2022 National Demographic and Health Survey echoed these findings, showing a decline in the total fertility rate from 2.7 to 1.9 over five years. So be at ease, you’re not alone in your decision.
For us, the pandemic felt like it robbed us of precious years we could have spent exploring the world together. Now, as we try to make up for lost time and I go through my 30s, we’ve decided to embrace egg freezing as a way to keep our options open for the future. If you’re considering delaying parenthood but want to preserve your reproductive potential, egg freezing could be a viable choice. Here’s a breakdown of what the process will be like and details about my own treatment, aiming to provide insight and perhaps guidance for your own path.
How Does Egg Freezing Work?
Egg freezing, scientifically known as oocyte cryopreservation, is a method to preserve a woman’s fertility by saving her eggs at a younger age. Here’s a simplified breakdown of the process:
Natural Cycle vs. Enhanced Cycle
Normally, a woman’s body develops multiple eggs each cycle, but typically only one matures and is released. Egg freezing aims to increase the number of mature eggs available by using hormone injections.
Stimulation Phase
The process starts with daily injections that stimulate the ovaries to produce multiple eggs. These hormones, like FSH and LH, encourage the ovaries to develop several eggs at once.
Monitoring
The development of the eggs is monitored through regular blood tests and ultrasound scans. This helps determine the best time to retrieve the eggs, ensuring they are mature enough for freezing.
Retrieval Process
The retrieval is done under sedation using a needle guided by ultrasound, which collects the eggs from the ovaries. This procedure is quick, typically taking about 20 to 30 minutes.
After Retrieval: Your Options
Once your eggs are retrieved, you have several options on how to proceed, each with its own set of advantages and considerations:
Egg Freezing:
The eggs can be frozen as is and stored for future use. They are rapidly cooled to prevent damage, in a process called vitrification.
Pros:
- Flexibility: Freezing eggs as they are retrieved preserves them without the need to commit to a current partner or donor sperm. This can be particularly appealing for those who are not ready to start a family but wish to preserve their fertility.
- Vitrification: This fast-freezing process prevents ice crystals from damaging the eggs, maintaining their viability for future use.
Cons:
- Uncertainty: Not all frozen eggs will survive the thawing process when they are eventually used, and not every surviving egg will successfully fertilize.
- Delayed Testing: You won’t know the quality or viability of the eggs until you decide to use them, which could mean uncertainty about your chances of success in future fertility treatments.
Fertilization and Embryo Freezing:
If ready to consider pregnancy, you can have the eggs fertilized with sperm to create embryos, which are then frozen for later use.
Pros:
- Increased Success Rates: Freezing embryos, rather than eggs, typically results in higher success rates for future pregnancies. Embryos are more stable to freeze and thaw than eggs.
- Preimplantation Testing: Embryos can be genetically screened before freezing to check for chromosomal abnormalities and, if desired, the gender. This can be important for those at risk of genetic disorders or who have specific family planning goals.
- Immediate Feedback: You can learn a lot about your fertility from how many of your eggs fertilize and develop into healthy embryos.
Cons:
- Commitment Required: This process requires sperm, meaning you need to be ready to choose a donor or involve a partner, which may not be suitable for everyone at the time of egg retrieval.
- Ethical Considerations: Deciding what to do with unused embryos can be complex and emotionally challenging.
Immediate IVF:
Instead of freezing, the embryos can be placed into the uterus immediately to try for a pregnancy.
Pros:
- Immediate Attempt at Pregnancy: For those ready to become pregnant, moving directly to embryo transfer increases the immediacy and potential success of becoming pregnant without the intermediate step of freezing.
- Synchronized Preparation: Your body is prepared in advance for implantation, which can optimize the chances of embryo attachment and pregnancy.
Cons:
- Less Flexibility: This option commits you to pregnancy at that specific time, which might not suit everyone’s circumstances or timing.
- Emotional and Physical Demand: IVF cycles can be emotionally and physically taxing, requiring significant commitment and resilience from the patient.
Choosing whether to freeze eggs or embryos involves weighing your current life circumstances, including your age, relationship status, and readiness for parenthood, against your future family planning aspirations. For those facing infertility issues, these decisions might also be influenced by the need for specific treatments or interventions.
Consulting with a fertility specialist is crucial. They can provide detailed insights into the success rates associated with each option and help tailor a plan that best suits your long-term reproductive health and family goals. Egg freezing offers the chance to preserve younger, potentially healthier eggs, thereby providing flexibility and peace of mind for your future family planning needs.
A Breakdown of My Own Journey
Initial Steps and Preparation
Our choice of clinic for this process was Kato Repro Biotech Center (KRBC), a state-of-the-art facility in Makati City. The decision to go with Kato was strongly influenced by a recommendation from my husband’s colleague, who had success with their IVF treatments. KRBC is renowned for integrating a natural approach with advanced technology, a methodology pioneered by Kato Ladies Clinic in Japan, a leader in Assisted Reproductive Technology (ART).
The process began with an online consultation where the medical team and I discussed the entire process of egg freezing and how I could prepare my body for the upcoming treatments. The doctors recommended a regimen of COQ10 and glutathione supplements, which are known to improve egg quality and overall reproductive health. After two months of preparations and careful consideration with my husband, we decided it was time to move forward.
Scheduling and First Clinic Visit
I was instructed to contact the clinic on the first day of my menstrual cycle to schedule the start of the process. Ideally, the treatment should begin on the second day of your period to synchronize optimally with your body’s natural cycle. However, due to personal reasons, I ended up starting on the third day, which the clinic was able to work around, though they stressed that time precision is critical in egg freezing.
During my first visit, the clinic performed comprehensive blood tests and an ultrasound to check my baseline follicle count. The results were promising, showing 19 follicles ready for stimulation, setting a positive tone for the process ahead.
The Medication Regimen
After the initial tests, I was introduced to my medication regimen, which involved several types of injections, including the Gonal-F pen. This device is user-friendly and designed to make self-administration as painless as possible. Although the idea of self-injecting was intimidating at first, it quickly became a routine part of my daily schedule.
The importance of timing with these medications cannot be overstated—doses need to be administered at the same time each day, with no more than a two-hour variation to ensure optimal effectiveness.
Second Visit and SIS Procedure
On my second visit to the clinic, I underwent a Saline Infusion Sonohysterography (SIS) to assess the health of my fallopian tubes and evaluate potential for natural conception. This procedure involved filling the uterus with a saline solution via a catheter to provide a clear ultrasound image. While not particularly painful, the SIS was quite uncomfortable and resulted in mild cramping that subsided after a few hours. This test is crucial for anyone considering natural pregnancy options alongside or following egg freezing.
Challenges and Progress
Throughout the treatment, regular monitoring was essential to track the progress of follicle development and adjust treatments as necessary. Initially, it was hopeful to see 19 follicles during the first scan. However, by my third clinic visit, an ultrasound revealed that only 9 of these follicles were developing into mature eggs suitable for retrieval. This stark contrast between initial expectations and the reality during the process highlighted the unpredictable nature of how one’s body might respond to hormonal stimulation.
This variability is a critical aspect of the egg freezing process. It underscores that while medical technology and treatments are advanced, they cannot always predict or control biological responses. Each person’s body reacts differently to the hormones used in the stimulation process, which can lead to varying results in the number and quality of eggs retrieved.
Day of the Egg Retrieval
On retrieval day, I chose to be sedated, which made the procedure smooth and painless. Unfortunately, of the 9 oocytes we hoped to collect, only 7 were successfully retrieved. Even more disheartening was that just 4 of these were viable for freezing. While this number is lower than ideal—since at least 10 frozen eggs are typically needed to achieve a 50% chance of a live birth—the quality of these eggs is bolstered by the fact that I froze them at a younger age. Freezing eggs between the ages of 28 and 35 is considered optimal because the eggs are typically of higher quality, which can significantly impact future success rates.
Additionally, it’s worth noting that during this first cycle, all my medications were administered at a standard dosage. This is common as the medical team assesses how one’s body reacts to the initial round of medication. It’s a process of trial and error to discover which stimulations work best and how long you should be on them. Our bodies are unique, and the response to hormone treatments can vary widely, which means adjustments are often necessary in subsequent cycles.
For me, retrieving 4 eggs is acceptable for now. If we decide to pursue IVF when I’m older (36 and above), I will undergo the stimulation process again to increase the number of eggs stored, which will then be used in the IVF process. This plan allows for flexibility and the opportunity to improve outcomes with more tailored and possibly different medical treatments based on what we learned from this initial experience.
Understanding the Odds
The realities of egg freezing statistics are sobering. While the survival rate of thawed eggs is high at 95%, the actual rates of fertilization and subsequent pregnancy are 70% and 45%, respectively. This means that many women need to undergo multiple cycles to secure a sufficient number of eggs, aiming for 10-20 frozen eggs to maximize the chances of successful pregnancy.
The Physical and Emotional Toll
In my case, the hormone treatments mimicked menopausal symptoms, complete with migraines, irritability, hot flashes, swelling, and weight gain.
These symptoms were quite intense initially but became more manageable over time. It’s important to recognize that such physical changes are a natural response to the hormonal upheaval your body is going through.
Costs and Considerations
The financial commitment for egg freezing is substantial. My entire process cost approximately PHP 230,000, which included additional tests for my husband and sedation during retrieval. Prices at Kato Repro Biotech Center start around PHP 250,000 but can vary based on your specific treatment needs. If considering transitioning to IVF later, prepare for significantly higher costs, with a minimal stimulation IVF cycle priced around PHP 400,000.
Tips for Managing Treatment
Being proactive about understanding the medications and treatment you are undergoing can significantly ease this journey. Here’s how you can manage the process more effectively:
- Educate Yourself: Learn as much as you can about each medication being prescribed. Know what each drug is for, its side effects, and what signs to look for if things aren’t going right.
- Communicate Openly with Your Doctor: Regular and open communication with your reproductive endocrinologist is crucial. Discuss how you’re feeling, both physically and emotionally. If the side effects become overwhelming, there may be adjustments that can be made to your treatment protocol.
- Adjust Expectations: Recognize that your body’s response to stimulation can vary widely from others’. If your initial cycle doesn’t yield the results you hoped for, your doctor might suggest changes to your medication regimen or offer alternatives for your next steps.
Being well-informed enables you to have detailed discussions with your healthcare provider about optimizing your protocol, especially if initial results are not as expected. This not only helps in managing the physical aspects but also in preparing mentally for the outcomes of each cycle, whether you proceed to another cycle of egg freezing or move towards IVF.
Approaching your treatment with knowledge and preparedness can make a significant difference in your overall experience, helping to manage expectations and better cope with the challenges that come with preserving your fertility.
Final Thoughts
If you are considering egg freezing, it’s essential to approach this journey with open eyes. Understand the physical demands, the emotional rollercoaster, and the financial implications. Set realistic expectations about the outcomes and prepare thoroughly both mentally and physically.
I hope sharing my story helps clear up the process and provides you with the insights needed to make the best decision for your circumstances. Whether you’re looking to preserve your fertility or seeking options for family planning, egg freezing is a profound journey that requires courage, commitment, and careful consideration.