People are always shocked when I tell them my age—they go on about how I look over a decade younger. These ‘compliments’ are almost always followed by lots of questions about my beauty routine. Having always looked younger on the outside, I also assumed that I must be ‘younger’ on the inside too.

“Women with working ovaries are most fertile before the age of 30, after which their fertility starts to decrease, and after 35 it declines more significantly,’ explains Fertility Consultant and Co-Founder of The Fertility & Gynaecology Academy, Dr Amin Gorgy.

I never worried about my fertility levels until my late 30’s, when my cycle became irregular for the first time, so I decided to get an extensive check-up of my reproductive system. The results spurred me on to freeze my eggs—a process that involves stimulating the ovaries to grow as many eggs as possible to maturity all at the same time, so that they can be extracted and frozen and then thawed, fertilised and implanted at a later date.

While it may sound simple, it can be anything but. However, it is a wonder of modern medicine that I’m grateful I was able to make use of. With that said, there are some things I wish I’d known before I started my egg freezing journey.

Know the stats

Egg freezing is often touted as an insurance policy, guaranteeing that if you can’t get pregnant naturally you can simply use your younger, frozen eggs instead. But the stats tell a different story.

Not every egg you freeze will become an embryo, not every embryo that you transfer will result in a pregnancy, and not every pregnancy will go full term and result in a live birth. In fact, the most up to date UK figures from the Human Fertilisation and Embryology Authority (HFEA) show that in 2016, 1,204 eggs were thawed, and out of these, 590 eggs (49%) were successfully fertilised—of the 590 eggs fertilised, 179 (30%) were transferred back to a patient, and out of the embryos transferred, 22 resulted in a pregnancy, for a total of only 13% of the original number of eggs thawed.

While freezing your eggs gives you more options and is a back-up plan of sorts, it’s not a guarantee of having children. With that said, freezing and thawing methods have greatly improved over the last few years, and this can only bode well for future stats.

Understanding AMH levels

When my AMH levels came in at much lower than the average for my age, I felt crushed. AMH levels correspond to the number of eggs you have waiting in the wings: higher AMH levels mean more eggs, and a lower AMH means fewer eggs that could one day be fertilised and/or extracted to freeze.

But this misunderstood test is not a crystal ball to your fertility. “AMH levels depend on the number of the potential follicles in the ovaries. This indicates the ovarian reserve and helps us decide on the necessary dose for ovarian stimulation for egg freezing and IVF,” explains Gorgy.

The real value of the test is how it helps predict your response to fertility treatment, allowing doctors to tailor medication accordingly. What it can’t do is help predict your chances of getting pregnant naturally. This is because, as studies have shown, AMH levels are not a true marker of fertility. In fact, Black women may naturally have lower AMH levels when they're young, but experience less of a reduction in AMH with advancing age, versus white women.

The test also doesn’t account for egg quality which "is probably more important and depends on your age, as woman under 35 have a much better chance of getting pregnant than those who are over 35 with the same ovarian reserve," adds Gorgy.

In relation to egg freezing, the quality of your eggs is also incredibly important, as poor-quality eggs are less likely to mature enough to be frozen, let alone make it to the fertilisation, implantation or baby stage. All of this means that your AMH isn’t necessarily something to fret over.

Take time off

The egg freezing process is intense and typically takes around 14-16 days to complete (though in some cases people can be done in just a week). There are frequent visits to the clinic for blood tests, check-ups and daily hormonal injections of follicle stimulation hormone (FSH).

“When released by the pituitary gland during a normal cycle, this hormone stimulates the production of one egg. But by injecting additional FSH, we’re able to stimulate your ovaries to produce multiple eggs,” explains Dr Gorgy. Later in the process, I started injecting luteinising hormone (LH) too, which also encourages the ovaries to produce more eggs. After that, gonadotropin-releasing hormone (GnRH) is administered to prevent ovulation starting too early, and then finally, when the eggs have reached maturity, human chorionic gonadotropin (hCG) is injected to trigger ovulation.

Needless to say, with all the hormones racing around my body, I felt exhausted by week two. I had food cravings, was irritable, and started to experience low mood, though thankfully I didn’t experience nausea or vomiting. “This isn’t unusual as the main side effects of this process are psychological. Some people get anxious about scans and test results, others find attending the clinic every two days stressful. The high level of hormones can also make you feel tired and sometimes moody,” shares Dr Gorgy.

I think this was compounded by working throughout the process. Ideally, I would have taken the latter part of the process off, and then taken a week off post-egg retrieval to recover emotionally and physically.

Hidden costs

Egg freezing is not cheap, and there are hidden costs that you won’t find on clinic websites. You’ll likely see amounts online ranging between £3000 to £4000 for one round (and you'll want or need to do up to three), but these do not usually include the costs of blood tests, and never include the cost of the hormones you inject. You should factor in an extra £2000 for all of these costs, and remember that you will have to pay for storage too, which is around £300 per year on average.

Finding a clinic

“Clinics should be accredited by HFEA which can be checked on the HFEA website, and doctors need to be registered with the General Medical Council,” says Dr Gorgy. “They should also have plenty of experience with freezing eggs, and a good survival rate and live birth rate. Asking for their success rate stats is particularly important, as otherwise you have no indication whether your frozen eggs will be used effectively in the future,” shares Gorgy.

Check Google reviews and ask around too—word of mouth can be invaluable when picking a clinic and doctor. And don’t forget to factor in location: with multiple visits a week for up to 16 days, it’s important to choose a clinic that is relatively easy for you to get to.

Three years later...

It’s safe to say that freezing my eggs was a pivotal moment in my life. Not freezing them at a younger age made me feel like time was not on my side—had I frozen them at 30, I would have had to use them by 40, as the law only allowed for 10 years of storage until 2022, when it was amended to allow freezing for up to 55 years. Plus, it did take a lot out of me physically, which perhaps wouldn’t have been the case if I were younger.
 
But what really threw me was the psychological aspect of egg freezing—i.e. thinking about what kind of future I wanted, how important being a mother is to me, and whether I would be a solo parent if I didn’t find a partner by a certain time. Forcing myself to get some clarity on my future felt, at times, like something I really didn’t have much control over. But over time, I realised that there are elements of planning for possible parenthood that I could take control of—finances, health, dating life etc. I still haven’t figured it all out, but while I work on the above, I’m thankful that I have younger, healthy eggs on ice that could offer a final chance at becoming a mum, if I exhaust all others with no success.