Wednesday, October 29, 2014

Reflections on egg-freezing

A barely audible whimper sends a warning that naptime is coming to an end. Tip-toeing in the room, I find a wide-awake He-Beat laying on his belly, nursing his pacifier, while his sister still fast asleep. Upon seeing me, he proceeds to sit-up and then lifts his arms high over his head, signaling that he wants to be picked up. After a kiss and a quick diaper change, we leave his sister to finish her nap in peace and head downstairs to begin our Saturday ritual.

Once his feet make contact, He-Beat toddles over to the broom closet. Once I open it, he reaches inside for the red dust pan while I grab for the broom. Situating him in the middle of the kitchen floor, we begin our usual rhythm of sweeping, with him following the broom and reaching out at moments to help me push it. As I turn a corner, I have a flash of myself from a few years ago, sweeping this same floor. But that woman pushing the broom is in the thick of fertility treatments, suffering from the grief of failure after failure. As I move the broom across the kitchen floor, I remember thinking how far away motherhood seemed. And it is as I'm in the middle of that thought, feeling the shadows of that grief wash over me, that He-Beat greets me with a happy shriek, pushing the red dustpan towards me. Seeing this little boy in that moment causes me to drop the broom and scoop him up into my arms. Instead of pushing away, he allows me a sweet moment to hold him, taking in the intoxicating smell of him and to kiss his head that he rests on my chest. Somehow, we survived the nightmare. Somehow, it became okay.

I'm a bit late to the party on this one, but there's been a lot of press recently about egg freezing. Pamela has been running a very informative series about this issue, talking about the push for marketing this procedure as a form of "fertility preservation." On the heels of Apple and Facebook's announcement to offer egg-freezing as part of their benefits package, her articles in WIRED and FORTUNE magazine combined with thoughtful work from others,  has sent a strong message that this procedure isn't the silver bullet to balancing career with family building.

Like many, I agree that egg-freezing is an amazing technology that gives those about to undergo life-saving treatments, such as chemotherapy for cancer patients which would otherwise eliminate their ability to conceive, a chance to spare that. But the way egg-freezing is now being marketed turns my stomach, for a couple of different reasons. The first being that it assumes that egg quality is the only factor for infertility. For me, like many others, this wasn't the case. After two rounds of IVF, it was concluded that my embryo quality wasn't the issue. Instead, I was told I had issues with implantation, an area that we still know so little about. Yet what is being promised with egg-freezing is that by using younger (and assumed healthy) eggs, any issues with infertility would be eliminated. Never mind that biology, not just reproduction, is far more complex and that egg quality is truly only one factor in this equation.

The second issue is harder to explain as it's an emotional one. It goes without saying that I love the Beats with my whole being and there is not a single moment of my journey to bring them into this world that I would trade. These kids are amazing miracles and I would go to hell and back for them 100 times over. But just like anyone else with a life-changing illness, I would not wish the hell I went through on anyone. If someone told me 10 yrs ago that I had the option of getting my babies and never having to go through IVF if I simply started trying earlier, I would have done that. To know there was a way to prevent having to walk through this hell. With egg-freezing being marketed to women who are otherwise healthy, I feel they are unknowingly choosing to walk through hell. Even if they research it and make what they think is an educated choice.

The truth is infertility has been successfully suppressed in society. From the assumption that relaxing is a cure for infertility, to general misunderstandings about fertility treatments, to even outlandish suggestions that adoption is a guarantee way to ensure a future pregnancy, society perpetuates the myth that infertility is rare and something we can easily overcome. The scary truth is that this is far from the case. Not only is infertility a life-changing medical condition, but an emotionally traumatic one. Between the financial stress and the hardship of treatments, there's also the emotional rollercoaster fueled by hope and grief. A rollercoaster that many who live through have ridden many times, often to the point of developing some form of depression, anxiety and even PTSD.

What otherwise healthy women may not understand is that by electing to go through egg-freezing, they are buying multiple passes for this rollercoaster. What they are signing on for is periods of anxiety, fear, uncertainty and, when failure comes, grief from loss. And with a 2-12% success rate, the likelihood of this grief is almost certain.

I remember those days of grief all too well. Of waking up daily to a feeling that my heart had been ripped out of my chest. To having moments where, if I wasn't numb, it hurt to breathe. Where it felt like I had ceased to live and instead was watching the world go by me. To even having moments where I prayed I didn't have to wake up in the morning. What fueled a lot of this was being told that I had brought this on myself. That by waiting until I was 31 yrs old to expand my family, I had eliminated my chances. Or that I had done something in my life to deserve this pain. Worst yet was the guilt I felt for putting Grey through this hell. Even when he made it clear time and again that he would not leave me because of infertility and loss, I still felt I was robbing him of the happiness he deserved.

The painful reality of life is that with choices, there are things we must sacrifice. As someone who is still very career-driven, I am one of the first to champion women reaching for the stars and changing the world. After all, I've had the opportunity to work with side-by-side with women who are changing the way we think life and the world around us, all while inspiring so many who follow in their footsteps. The idea that we are somehow weaker or well intelligent simply because of our gender is truly dated. But Biology is still something we don't understand, even with the advances that have been made. We can't cheat fertility any more than we can cheat death.

I recognize that what I'm saying here will anger some. That some will point to examples in pop culture or share stories they've heard about women who had children well into their 40s. That my words will be seen as simply a scare tactic to dissuade so many promising young women from reaching for their dreams. This is not my intent. But it would be remiss of me to not speak out about the false-hope these companies are marketing. To question the ethics of the doctors and business who are advertising egg-freezing to healthy young women. To not share with all of you my story in hopes that it would spare someone from having to go down this road. Eliminating the fear of her never getting to hold her child in a moment of sweetness or having to wonder if it would ever be okay.

11 comments:

  1. I don't think egg freezing is the answer to IF either, and hope that people that go into it are well informed that they are not exempt from any other problems besides egg quality. I worries me that women may be waiting even later than the mid -late 30s with this option, and possibly holing out until 40s thinking this is the cure all, but only then finding out what we all learned years ago and it takes a long time to research your own IF and take charge of fertility. I have a friend of 36 who still doesn't feel ready with her career and self employment, yet she believes it will happen when she wants it to, even though she knows my story. I hope it does work out for her, but I had to caution her based on my own past. I appreciate that some companies are covering egg freezing or other IF interventions, but I the reason is to work more, I disapprove. I lived and my husband worked in Silicon Valley for 8 years and I have seen the "perks" of companies there, that provide so many services you never have to leave the work place, gyms, salons, car repairs, daycare...I just don't value that lifestyle of living to work! But I do support women succeeding in the workplace! Tricky balance when were the only ones who can birth a child in between juggli a career.

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  2. "If someone told me 10 yrs ago that I had the option of getting my babies and never having to go through IVF if I simply started trying earlier, I would have done that." - this! Yes! If only I had known that at 32 I'd have trouble (and still be having trouble at 34), oh how different my choices would have been... -Polly

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  3. The whole egg freezing thing with Facebook and Apple is hard for me. On one hand, I think the publicity it's bringing to the idea of career and motherhood is important. It's making people stop and talk about this. It's making women honestly think about their fertile years. It's bringing attention to the fact that, despite what Hollywood ofter purports, motherhood in your late thirties and forties isn't as easy as it would appear. I think the attention and the discussion are good.

    However, this idea that one round of IVF and freezing some eggs gives you 10-20 years back is just crazy. A, most doctors will tell you that they're not too sure about quality after 10 years even with vitrification. B, the doctors will probably treat most of these women with a moderate protocol... no one wants OHSS. But 8 eggs is NOT a guaranteed chance at a baby for any woman at any age. And C, this is all assuming that infertility is directly related to egg quality, as you mentioned, and thus connected to age. For me, and a lot of others, it IS about egg quality, but that has nothing to do with age. I was 26 when I started infertility treatments. Allison was 23. Kim was 24. All three of us suffer from crappy eggs to one degree or another, but the logic that those who are pro egg freezing offer says that we are all still at the golden age to freeze. As two of the three chose egg donors thus far, I think that logic might be just a little flawed.

    Great post! Thanks for sharing!

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  4. I know this is controversial idea, and I agree that there is some gray areas about the motivations of employers funding egg freezing as a way to allow women to focus on their careers. However, as someone with DOR who's in the middle of a DE cycle, I really wish someone had offered to freeze my eggs when I was in my early twenties. Then maybe, just maybe, I'd be having a child with my genetics. I didn't put off having children for my career, I put off having children because I hadn't found the right person to have children with. This wouldn't have solved my IF problems either--freezing my eggs wouldn't have given my husband sperm. But it might have fixed something.

    I have two friends who have frozen their eggs on their own dime because they desperately want to have children but aren't married. One is recently divorced, in part because her husband announced that he no longer wanted children. Neither are wealthy, but this is a way for them to preserve their fertility. I am 100% certain that they understand the risks and they know it's not a guarantee, but it's better than waiting 5-10 years (they're both already in their mid-30s) and rolling the dice when it's well known, at least in my social circle, that your fertility declines rapidly in your 30s.

    I get frustrated because I feel like all the commentary is about women who are deliberately choosing to put off having children for their career. Most of the women I know didn't have children earlier because they didn't have someone to have children with. And most of the women I know who don't have children don't have an extra $15,000 to pay for egg freezing on their own and having an employer pay for it would probably be quite welcome.

    I feel like the lone voice out there, but if I had been able to have a daughter with my genes, I would have encouraged her to freeze her eggs just so she wouldn't have to go through what I have gone through because it's not fun. It's very expensive and it's very soul sucking. I think taking money out of the equation isn't such a horrible thing.

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  5. I agree 100% with your POV. So few understand that egg freezing is very new and untested, and I worry that women who freeze their eggs to buy themselves more time will be devastated when it doesn't work. After all, the general public still thinks that IVF = 100% success rate for a take-home baby which we all know is untrue.

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  6. As someone whose infertility issues WERE related to egg quality, this is an interesting thought exercise for me. Thinking back to when I was in my 20s and starting my career, at the time I was fairly confident that I didn't want kids at all. So even if egg freezing had been offered to me for free back then, my lack of desire for kids, plus knowing that I'd have to inject myself with needles (huge needle phobia!) would probably have put me off enough that I wouldn't have done it. In a way, this probably would have made things even worse for me psychologically down the road once I changed my mind, started TTC, and realized I couldn't. Like, I had this option and I didn't take it, and now look at me. Also, like Maddie said above, I didn't delay kids for my career, I just didn't think about wanting them until I was with someone I wanted to have them with, and by that point I was already 35. I think if you're consciously putting off kids for your career then it's great to have that option, but a lot of us (most even?) aren't here because of that. We're here due to other circumstances.

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  7. I am so thrilled that you have joined the discussion on this issue. There are good things about egg freezing, but there are very disturbing things about the way it is being promoted too. One of the concerns I have is that women are unnecessarily (perhaps) exposing themselves to mega doses of hormones (as all of us who have tried IVF or medicated IUIs have) that bring risks. Yet I fear that those risks aren't raised with the young women who are the targets of those marketing egg freezing, and suspect that Apple and Fb and others who offer this to their staff are either unaware of the risks, or don't think that they matter.

    I hate that women have to make a choice - their careers, or becoming mothers - at any phase of their lives, and also that women who are trying to make their careers might be judged by others who are in different circumstances. We are all put in an impossible position - we're under pressure to find partners asap, or to achieve in our careers, or to put our careers on hold or sacrifice them completely to have children at the right time, or now - in the case of employers offering egg freezing - to put having children off to devote time to careers and companies, and risk never being able to have them.

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  8. I don't have much more to add in the way of comments, but I did want to say this was a great post, and I'm so glad you tackled the subject!

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  9. Echoing all the others here. A big thank you, Cristy, for adding your voice and experience to this complex topic. Appreciate all the added perspective from your blog readers, and thank you, too, for sharing the links to my pieces.

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  10. I completely agree, Christy. What you said about buying passed to this roller coaster is so powerful. I fel the same way.

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