Is It Time For The Wellness World To Consider Egg Freezing?
"Maybe you can squeeze onto the couch," said the girl with clipboard. Every chair was taken at the Fertility 101 info-session. I guess I expected something more like an any Ivy league alumni meet-up—pencil skirts and sleek ponytails, people with that professional shine. After all, aren't these the "ambitious" ladder-climbers for whom egg freezing and the possibility to postpone motherhood is a "careerist dream"? If I'd stumbled into this room accidentally I wouldn't have been able to peg the issue that brought them all together. The woman beside me looked fresh off of a college lacrosse team, snapping a hairband around her wrist, chipped nail polish. Beside her, a woman with salt and pepper hair twirling the strings on her reading glasses. One woman sipped from a MacDonald's soda straw and, another in a floral skirt clutched her Juice Press bottle. In a white-walled room on the 14th floor of a Madison Ave office building we all cocked our heads to the left to read the y-axis of a graph projected on the wall. "Predicted Probability of Birth."
In case you've never walked past a playground, here's a newsflash: the age of first time mothers is rising—steadily, and interest in preserving fertility is growing right along with it. In the 70s, the mean age of first-time mothers was 21.4. By 2000 that age was up to 26.3. While there's no magical number at which women's fertility plunges (despite what you've heard, it's not 35, 38, or 40—each woman works on her own timeline and may struggle with infertility at 22 or conceive naturally at 44) we know that fertility diminishes over time, and that working with younger eggs gives women a higher chance of getting pregnant later in life.
Egg-freezing has been around since the 1980s. The process has been refined over the decades but the basics remain the same. Artificial hormones are used to stimulate the ovaries to release a large number of eggs at once, which are surgically removed and frozen. To make a baby, those eggs are thawed, inseminated, and re-implanted, where biology takes back the reins. It's not a holistic-friendly procedure: it's Western medicine with a capital W.
Biology doesn't care on which side of the Eastern/Western medicine divide you fall. Whether your healer is a shaman or a psychiatrist, your body is subject to the same laws of time. As the women of the wellness world consider if, how, and when they want to have children, those hearing the ticking the clock might be tempted to ask themselves if egg freezing offers more reward than risk. The number of women taking advantage of in-vitro fertilization has doubled in just 10 years. Are some of them the women who swore off synthetic hormone birth control to be better in touch with their cycles? Are they the women who eat organic, and treat headaches with magnesium? Do they have crystals lining their bathroom window sills? Yes, of the thousands in that group, some are the women of wellness.
Is Everyone Freezing Their Eggs?
With Facebook, Google, and Apple now covering the cost of egg freezing for their employees and Bachelorette contestants instagramming their clinic visits, the procedure has officially gone mainstream. That's where Extend Fertility comes in. The brainchild of Dr. Joshua Klein and his co-founders, Extend Fertility is rebranding egg freezing for a younger, growing, demographic of women. With 76,000 women projected to freeze their eggs in 2018, several more specialty clinics are following suit.
Unlike traditional IVF clinics, whose clientele is actively trying to get pregnant and struggling with infertility, Extend Fertility hopes to catch women early on the path to motherhood who aren't ready to have children now, but want to preserve the option. Dr. Klein recognized a sensitive difference between the two types of client. "Being a young, healthy woman who's not infertile and not dealing with something considered an illness is a lot different experientially from being one of the couples struggling with fertility. The packaging of one service would not fit best in a model designed for another type of person." Lisa Besserman, a 32-year-old tech startup founder is one of Extend Fertility's potential clients, “I would feel very bad to be in the same room as a woman trying desperately to get pregnant,” she told The Cut.
To make the clinic an upbeat environment where millennials feel like they belong, the Extend Fertility staff trained with Danny Meyer’s Union Square Hospitality Group, built private consultation rooms with floor to ceiling windows, decorated counter spaces with purple orchids. Another way they're making millennials comfortable? They've slashed the price. Extend Fertility made headlines by halving the cost of traditional egg harvesting with an “all-inclusive” price of $5,000. How can they provide the service for a fraction of the price? Through specialization. They don't offer in-vitro fertilization. They're the first clinic in the nation to focus in on egg freezing alone. While the difference in price is substantial, the claim of totally inclusivity is a reach. In addition to the $5,000 clients pay to Extend Fertility, the hormone injections necessary for extraction commonly run another $2,000-5,000 and aren't covered by insurance. Then there's the matter of egg storage, which Extend Fertility can arrange for $350-450 per year. And of course, the only way to utilize frozen eggs is in the eventual use of in-vitro fertilization. That process can run upwards of $5,000 per cycle. Even at half the base price, egg freezing is still expensive.
Aren't these the ambitious ladder-climbers for whom egg freezing and the possibility to postpone motherhood is a careerist dream?
No problem for the careerist looking to make partner, right? There's a prevailing stereotype about the women undergoing egg freezing that Dr. Klein says calls a misconception. "From what we're seeing and in the published literature it's clear that by far the number one reason why women are considering freezing their eggs is relationship status. Career is on the list, but nowhere near first." Klein doesn't see patients who are procrastinating pregnancy, they're often women who wish they had the circumstances in place to have children now. "People call egg freezing in this context 'elective' and I think that name has a judgement that's baked into it that is inaccurate or unfair. It makes it sound like this is getting Botox—something frivolous." Elective implies women have the option each and every day to get pregnant. That's not the case for individuals who want to build a family but haven't yet found the right partner. Dr Klein's patients but they don't feel they can "elect" to get pregnant today.
What Does Egg Freezing Really Offer?
Egg freezing represents a significant investment, not just money, but of time and emotion. Extend Fertility streamlines the process, but even pared down to the essentials, the egg-harvesting process requires at least 10 trips to clinic, a week of self-administered hormone injections, and a surgical procedure administered under general anesthesia. And an egg is only one in a long list of requisite ingredients. What else is needed? Healthy sperm (half of all fertility problems stem from the father) and a healthy womb. You can buy yourself a few extra years of egg viability, but what about the other fertility factors? You can freeze today, but you can't know what your needs will be when you thaw tomorrow. Additionally, some eggs can be lost in the thawing process. Predictions exist based on age, egg quality and the number of eggs frozen. So how much can egg freezing really help you down the line?
The best data indicates that women 35-40 years-old have a 78-82% chance of getting pregnant naturally within a year. Dr. Klein is happy to confirm, "Most women in their late 30s will not have trouble getting pregnant." But he's also sensitive to the flip side of the equation. "If you say 70 or 80 percent of women will get pregnant within a year of trying, that's the same thing as saying 20-30 percent will not, and when it comes to something like being able to have children, making a proactive investment in to prevent a 1 in 3, or a 1 in 4 chance of a game-changing-ly bad thing, a lot of women sign up for that pretty quickly." Those are attractive figures, even to women who go to lengths to lead natural lives.
"With Facebook, Google, and Apple now covering the cost of the egg freezing for their employees, and Bachelorette contestants instagramming their clinic visits, egg freezing has gone mainstream."
Dr. Klein readily admits something you might not expect from a fertility doctor. "Many, if not most women who freeze their eggs probably won't use them. That's reality. It doesn't make me feel badly and I wouldn't feel shy to say that because we want people to have their families the way the want to." What does Dr. Klein see as Extend Fertility's primary offering? Peace of mind. "Women who don't use their eggs typically don't regret freezing them, because it was still a good decision at the time, and there's a present benefit, too. It's a little bit life-changing for those women now, because it takes a little bit of the edge off the anxiety and pressure. You live a better life now whether or not you use your eggs later."
How Can You Extend Your Fertility Naturally?
While the ticking of the clock can cause some wellness women to consider undergoing egg freezing, many in the community don't advocate for it. Dr. Eden Fromberg practiced as a traditional Ob-GYN for years before being certified in Integrative Holistic Medicine. She's appreciates why so many young women would want to buy a few more years of fertility through egg freezing but warns, "I have women who take the drugs for egg harvesting and their hair falls out, their cycle goes to 40 days and doesn’t just bounce back. That can happen just from one treatment." She says there's a lot the holistic world has to offer. What does she recommend? First and foremost: Take a deep breath. "There are so many other ways to approach fertility: movement of your body, yoga, hands-on therapies, nutrition." In particular, she's seen success with the use of myofascial release, "There are ways to release tissue in the kidney that frees up the way blood vessels wrap around the fallopian tubes which have a certain rhythmic pulse. These blood vessels that can be strangling the fallopian tubes can be released."
Doula Lindsay Bliss says many of her clients have been pleased with the results of with acupuncture and the Arvigo techniques of Maya abdominal therapy. "This therapy helps to balance the body by correcting the position of organs that may have shifted and restrict the flow of blood, lymph, nerve and chi energy and releases stagnant physical and emotional energy from the abdomen."
Taking a step back, if the primary product offered by egg freezing is peace of mind, aren't there ways to get that through holistic methods? Meditation and mindfulness offer ways to quell our fears and accept our state, to withhold judgement and get in touch with our abundance. And they typically come with a smaller price tag. Dr. Fromberg feels, "There are so many other things to try before you resort to drugs and surgery."
What Is Your Fertility Timeline?
If you're concerned about your future family, empower yourself by learning more about your personal fertility. Two tests can help you gauge your timeline. Anti-mullerian hormone (or AMH) is produced in the ovarian follicals. A blood test measuring your levels of AMH will indicate how many eggs you have to work with. A high AMH number, indicating you have a large supply, may suggest you have a longer fertility timeline. A lower AMH number, indicated a smaller supply of eggs, may mean you have less time to work with. You can request an AMH test anytime you have bloodwork done, you don't need to visit a fertility clinic to get a sense of where you stand.
Another way to measure your fertility is through a transvaginal ultrasound. In black and white, your doctor can see how many activated follicals are in your ovaries, and use that number to estimate the size of your reserve.
You can look elsewhere for clues: Your family tree. What age was your mother at her first birth, and how many children did she have? What about the rest of the women in your family? While the circumstances around childbirth are complex, and every woman's body is unique, you may share inherited fertility traits with the women around you.
Can Holistic Treatments Support The Egg Freezing Process?
The egg harvesting process can take 10 days or longer and while some patients report no adverse symptoms, others, especially those whose bodies require higher hormone doses, can feel uncomfortable. Dr. Fromberg says, "Fertility drugs can really do a number on you. You can feel giddy, and flighty, and emotional, and tearful. It can affect your relationships. All these organs are very emotional." She recommends avoiding stimulants, "They make it harder for us to navigate our emotions."
To keep yourself stable, she suggests eating grounding foods regularly. "Vegetarians and vegans may need a higher protein diet: hemp seed butters, eggs, or grass-fed meat if you're a meat-eater." She recommends herbs and supplements, too. "Take burdock, dandelion root, B vitamins, and minerals," says Dr. Fromberg. Breathing exercises to regulate the autonomic nerve system can also keep you calm and balanced. Another great way to stabilize your body? Keep moving. "It doesn’t need to feel serious or meditative. Just go dancing."
"People call egg freezing in this context 'elective' and I think that name has a judgement that's baked into that. It makes it sound like this is getting Botox—something frivolous."
Bliss says this is a time for self-care. You should be able to keep up with your regular routine, but you will need to be home each night to administer your injections. Treat yourself to whatever replenishes you. Take an essential oil bath. Reread a comforting book. Invite over loved ones.
So, Should You Put Your Eggs On Ice?
It's expensive, it's emotional, and you're likely to never use the eggs you freeze. Is egg freezing a racket? Dr. Marcy Darnovsky, a social scientist and executive director of The Center for Genetics and Society, thinks so. She told the Daily Beast, “You can only speculate, but I think that this is a very lucrative industry, especially in U.S. where we don’t have insurance coverage and people are paying out of pocket." I asked Dr. Klein why he works in fertility. The Harvard-trained doctor said, "In the Bible, Abraham and Sarah and Isaac and Rebecca, they were all infertile. In the jewish world family building is such a priority, there's this deep-seated idea that having children isn't something you should take for granted, and that people suffer greatly when they're having difficulty having children." He says cutting the base cost of the egg freezing procedure will probably mean slimmer profit margins than other more expensive clinics make, but he's okay with that.
What most sticks with Dr. Fromberg is an issue the wellness world may take to heart. “What I’m seeing is how we’re disconnecting from the rhythms of our own bodies. How the culture is encouraging and reinforcing those disconnects." She asks how much this whole process typically costs. I run through the numbers: $5,000 up front, $3,000 as the midpoint for hormones, $2,000 for 5 years of storage. So about $10,000.
"We think we need to buy back the things that are our birthright because we’ve become afraid of them." Said Dr. Fromberg. "Even our own ability to become pregnant and give birth to our own children, we need to buy it back. We can’t buy our bodies back, it doesn’t work that way."
"What if you spent that amount of money living a more connected life?" She asked. "You take better care of yourself. You spend the money on better food, better vacations, better movement practices, better yoga teachers. What if you spent the money on that?" I tell her what Dr. Klein said, that lacking a partner was the main reason women came to his practice. "Spend that money on a really great therapist or go on the vacation to the place where you’ll meet that person. I can see there being so many more ways to spend that money."
If you're trying to answer the question for yourself, maybe it comes down to: What could $10,000 do for you?
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