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What No One Tells You About Freezing Your Eggs

Achieving pregnancy with ART is more common than we think.

Women's Health

As your Facebook news feed fills with baby announcements and pictures, it's easy to assume that getting pregnant naturally is simple. But achieving pregnancy with ART (Assisted Reproductive Technology) is more common than we think. According to a 2015 report by the U.S. Society of Assisted Reproductive Technology, 1 million babies born in the U.S. between 1987 and 2015 were born through the use of IVF, an egg donor, or a sperm donor. A common misconception is that only women over a certain age use IVF, but women of all ages struggle with fertility challenges. Conditions such as PCOS, endometriosis, or fibroids can cause some women to be unable to get pregnant naturally or be unable to carry to term.

Egg freezing, while relatively new, has opened up avenues for women to explore prolonging their fertility, however, there is still limited knowledge about the process. A recent study conducted with a cross section of reproductive age women reported that "overall, 87.2% reported awareness of egg freezing, yet only 29.8% knew what it really entails." In addition, for many women, egg freezing can be a cost-prohibitive process, making it inaccessible to certain demographics. A recent report found that only 4% of respondents who froze their eggs were African American, 4% Hispanic and 1% Middle Eastern.

Our Biological Clock

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A girl is born with all the eggs she will ever have, approximately two million of them. By the time she begins menstruating, she will have about 400,000 remaining, and from then, about 1,000 die each month. On average, she will have approximately 12% of her reserve at age 30 and only 3% at age 40. This decline continues until she reaches menopause at an average age of 51. Technically, a woman can naturally conceive until she reaches menopause, but it becomes harder with time.

From ages 30–34, a healthy woman trying to get pregnant naturally has about an 86% chance of conceiving in a year and those odds decrease slightly to 78% from ages 35–39. By the time she is well into her 40s, 90% of her eggs will be chromosomally abnormal, making it harder to conceive and increasing her risk of a miscarriage, a Down syndrome pregnancy, or an abnormal pregnancy.

What egg freezing attempts to do is freeze time — that is, keep a woman's eggs at a certain point in time, when they were of higher quality. For example, if a 45-year-old woman were trying to conceive, typically, she is better benefited using the higher quality eggs she froze while at age 35.

My Journey

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From a young age, having children has been one of my greatest life goals. While many girls dream of their wedding day, I'd fast forward to becoming a mother. I've even had the names of my future kids picked out since I was in high school. However, my dreams of motherhood juxtaposed traditional yet progressive ideals and that meant my dream would have to wait until I was in a great place in my career, had secured financial independence, and had a suitable partner to raise children with; a scenario familiar to many ambitious, family-oriented women.

At 28, it seemed I had it all. I had just graduated from a top MBA program, started my post-MBA career at a top management consulting firm, and was newly engaged to who I thought was the love of my life. Life was perfect, until it wasn't. Everything came crashing down when my relationship ended. Before that happened, the plan was to have my first kid at 30 shortly after we were married, the second at 32, and the third at 34. Instead, I was so devastated that I swore off relationships for the next three years to protect myself from another heartbreak. I spent the time focused on my career and traveling.

When I came out of my three-year dating hiatus, I had a moment of panic.

The societal pressures of getting married had started to get to me, and I could no longer ward off the not so gentle nudges from my family that I was getting older. Though I was thriving in other aspects, I felt like I was failing in life because I was nowhere close to being married and having children. During this time, I began to put a lot of pressure on myself to make it work with whomever I was seeing because "time was ticking". It became a roller coaster of finally liking someone, emotionally investing in them, then realizing we were not a great match and having to go back to the drawing board. I no longer enjoyed dating — it felt more like a draining task with a rabid sense of urgency. I'd wonder if every guy sitting across the table from me on a date could potentially become my husband/the father of my children.

But as strongly as I want to be a mother, I am also a hopeful romantic who believes in love and finding "the one" and I was not going to compromise on that.

I knew I had to reset and get back to my normal self. I wanted to date (and have fun doing so), take the time to properly get to know someone, let the relationship blossom, then proceed without the pressure of stressing about the future. Yet, knowing that my fertility doesn't depend on the pace I want to take things in my relationships, when my OB-GYN reminded me during my last annual that I needed to stop procrastinating on freezing my eggs. I recall her scolding me in her own endearing way, "If you're not going to get knocked up, you need to freeze your eggs," and I knew she was right so in July, I started the process.

What You Should Know About Egg Freezing

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More than likely, you've heard of one freezing their eggs freezing being mentioned casually, but many do not know what it really entails. Having just completed my retrieval stage, here are some things I learned about the process:

Freezing your eggs does not guarantee a baby.

While the success rate has been improving, outcomes will vary depending on age, genetics, reproductive history, and other lifestyle factors.

Your initial tests help your doctor assess if you may be a good candidate for egg freezing. After the initial consultation, you will go through robust testing of your fertility factors, reproductive health, STI status and genetics (if selected). You will learn numbers such as your AMH, FSH, and thyroid levels, etc. The results of these tests will help the doctor assess if you should continue with the process, and if so, which medications you will need. I opted for the full panel of tests, including genetic testing and in doing so, I learned more about my body than I ever thought possible. I was tested for every disease and genetic condition imaginable, most I had never heard of.

Freezing your eggs does not deplete your egg supply.

Your normal reproductive cycle won't be affected because only the eggs that will be "lost" anyway through the natural process will be captured. You will continue to have your cycle as normal.

Start the process when you feel most comfortable, but 'the earlier the better'.

On average, 25-year-old eggs are better than 30-year-old eggs and 30-year-old eggs are better than 35-year-old eggs, etc. If you're wondering when is the best time to freeze your eggs, the general rule is now.

Egg retrieval is the first stage of IVF.

In a full IVF cycle, after the oocytes are retrieved, sperm is used to create an embryo in vitro, and then the embryo is implanted. If you successfully freeze your eggs, and when you are ready to use them, you will conclude the second half of the IVF process.

It is not a quick process.

Durations vary, but it took about three months from the time I had my initial tests to the time I had surgery for the retrieval stage. While the injections themselves last 10–12 days, some tests leading up to it can only be done at certain times of the month.

Injections, injections, injections.

I almost changed my mind when I realized how many needles were involved because I am terrified of them. Brace yourself, there's a lot. There are frequent to daily blood draws to test hormone levels and then every night, I injected myself three times in my abdomen between 8–10 PM for 11 days.

My counter was filled with syringes, swabs and more.

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You cannot travel for a period of time.

Throughout the three months, I was only able to squeeze in a week of work travel. As someone who loves to travel, my inability to do so felt suffocating. You have to visit the clinic frequently for blood tests and ultrasounds, hence the travel restriction.

Not everyone in your life will understand your decision.

If you are looking for unanimous support from friends and family, you might not get it. Some people may question your decision or even advise you to just "focus on finding a man instead". Expending your energy on trying to convince someone it is a good idea to freeze your eggs might be the wrong thing. As long as you (and your doctor) know why you're doing it, that's good enough.

That said, you will need support.

If you're a single, independent woman, you might be inclined to think you can do this entirely on your own, but it helps to have a support system, no matter how small. I was blessed to have the support of a couple loved ones and having them to talk to was invaluable. A great example was my best friend FaceTiming with me as I administered the injections the first day. I had called her in tears seriously doubting if I could do it, but she calmly cheered me on.

Even with support, the process will often feel long, lonely and emotional.

There is loneliness in the mere act of pricking yourself with needles every night and clinic visits every morning before the rooster crows. But also, due to the hormone injections, my estrogen level was incredibly high and I was very emotional. I felt proud about freezing my eggs but I also felt some sadness about having to do it at all. I'd cry when I'd see a baby, and even stayed off social media to avoid it. My normal routine was also completely thrown off track; one particularly tough morning, I got up at 4:30 AM to get to the clinic by 6 AM, but it was so packed that I was not seen till 7:30 AM, and I had an important 8 AM meeting with a 1+ hour commute.

I was so overwhelmed that as soon as I stepped into my car, I burst into tears. My weight was also out of control and I lost all the definition in my abs as my ovaries expanded. I had no desire to be social — I wanted to just stay home all day. But don't worry: This part only lasts for a few mentally and physically exhausting weeks.

The egg retrieval is a surgical procedure.

On your retrieval day, you will arrive at the clinic, be hooked onto an IV, then proceed to the operating room. A propofol-based anesthesia will be used to knock you out. Then the surgeon uses an ultrasound probe through your vagina to retrieve the eggs. You don't feel a thing. The surgery takes less than 30 minutes, but plan to be there for three hours. You must have someone accompany you as you will not be able to drive yourself home.

Give yourself time to recover.

Bravo, you made it! But your body just went through a lot. Take time off work if you need to and rest. It takes about a month for you to feel fully back to normal again. After my surgery, I still felt very bloated and had days of painful cramping. I was also nine pounds heavier, due to both the IV fluids and not being able to work out for weeks. You are advised to refrain from working out (or sex) for another 1–2 weeks.

You may need multiple cycles. Doctors advise freezing 6–10 eggs per live birth desired because when you are ready to use your eggs, some eggs may not survive thawing and some will not successfully fertilize into an embryo. Multiply this range by the number of kids you may want to have to get your suggested amount (e.g. 12–20 eggs for two). You will likely be unable to know if you will need more than one cycle until your first cycle is complete.

As women continue to strive towards full equity in every regard, and as the average marrying age increases, the rate of women choosing to freeze their eggs also continues to increase. In the past, egg freezing was thought to be a thing that women did so they can focus on their careers, but that is changing. A recent study found that 85% of women surveyed who had frozen their eggs said they did it because they had not yet found a person with whom to raise a family.

When I'm ready to start a family, I hope to conceive naturally but having my frozen eggs just in case makes me feel relieved, empowered, and less pressured in my dating.

If you're also considering freezing your eggs, I commend you on making this important decision. What you are about to embark on won't be easy, but if all works well, it will be worth it. Though you might feel overwhelmed, you are not alone. You are strong and amazing — you can do it!

Article originally published on Medium.

Featured image by Shutterstock

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ACLU By ACLUSponsored

Over the past four years, we grew accustomed to a regular barrage of blatant, segregationist-style racism from the White House. Donald Trump tweeted that “the Squad," four Democratic Congresswomen who are Black, Latinx, and South Asian, should “go back" to the “corrupt" countries they came from; that same year, he called Elizabeth Warren “Pocahontas," mocking her belief that she might be descended from Native American ancestors.

But as outrageous as the racist comments Trump regularly spewed were, the racially unjust governmental actions his administration took and, in the case of COVID-19, didn't take, impacted millions more — especially Black and Brown people.

To begin to heal and move toward real racial justice, we must address not only the harms of the past four years, but also the harms tracing back to this country's origins. Racism has played an active role in the creation of our systems of education, health care, ownership, and employment, and virtually every other facet of life since this nation's founding.

Our history has shown us that it's not enough to take racist policies off the books if we are going to achieve true justice. Those past policies have structured our society and created deeply-rooted patterns and practices that can only be disrupted and reformed with new policies of similar strength and efficacy. In short, a systemic problem requires a systemic solution. To combat systemic racism, we must pursue systemic equality.

What is Systemic Racism?

A system is a collection of elements that are organized for a common purpose. Racism in America is a system that combines economic, political, and social components. That system specifically disempowers and disenfranchises Black people, while maintaining and expanding implicit and explicit advantages for white people, leading to better opportunities in jobs, education, and housing, and discrimination in the criminal legal system. For example, the country's voting systems empower white voters at the expense of voters of color, resulting in an unequal system of governance in which those communities have little voice and representation, even in policies that directly impact them.

Systemic Equality is a Systemic Solution

In the years ahead, the ACLU will pursue administrative and legislative campaigns targeting the Biden-Harris administration and Congress. We will leverage legal advocacy to dismantle systemic barriers, and will work with our affiliates to change policies nearer to the communities most harmed by these legacies. The goal is to build a nation where every person can achieve their highest potential, unhampered by structural and institutional racism.

To begin, in 2021, we believe the Biden administration and Congress should take the following crucial steps to advance systemic equality:

Voting Rights

The administration must issue an executive order creating a Justice Department lead staff position on voting rights violations in every U.S. Attorney office. We are seeing a flood of unlawful restrictions on voting across the country, and at every level of state and local government. This nationwide problem requires nationwide investigatory and enforcement resources. Even if it requires new training and approval protocols, a new voting rights enforcement program with the participation of all 93 U.S. Attorney offices is the best way to help ensure nationwide enforcement of voting rights laws.

These assistant U.S. attorneys should begin by ensuring that every American in the custody of the Bureau of Prisons who is eligible to vote can vote, and monitor the Census and redistricting process to fight the dilution of voting power in communities of color.

We are also calling on Congress to pass the John Lewis Voting Rights Advancement Act to finally create a fair and equal national voting system, the cause for which John Lewis devoted his life.

Student Debt

Black borrowers pay more than other students for the same degrees, and graduate with an average of $7,400 more in debt than their white peers. In the years following graduation, the debt gap more than triples. Nearly half of Black borrowers will default within 12 years. In other words, for Black Americans, the American dream costs more. Last week, Majority Leader Chuck Schumer and Sen. Elizabeth Warren, along with House Reps. Ayanna Pressley, Maxine Waters, and others, called on President Biden to cancel up to $50,000 in federal student loan debt per borrower.

We couldn't agree more. By forgiving $50,000 of student debt, President Biden can unleash pent up economic potential in Black communities, while relieving them of a burden that forestalls so many hopes and dreams. Black women in particular will benefit from this executive action, as they are proportionately the most indebted group of all Americans.

Postal Banking

In both low and high income majority-Black communities, traditional bank branches are 50 percent more likely to close than in white communities. The result is that nearly 50 percent of Black Americans are unbanked or underbanked, and many pay more than $2,000 in fees associated with subprime financial institutions. Over their lifetime, those fees can add up to as much as two years of annual income for the average Black family.

The U.S. Postal Service can and should meet this crisis by providing competitive, low-cost financial services to help advance economic equality. We call on President Biden to appoint new members to the Postal Board of Governors so that the Post Office can do the work of providing essential services to every American.

Fair Housing

Across the country, millions of people are living in communities of concentrated poverty, including 26 percent of all Black children. The Biden administration should again implement the 2015 Affirmatively Furthering Fair Housing rule, which required localities that receive federal funds for housing to investigate and address barriers to fair housing and patterns or practices that promote bias. In 1980, the average Black person lived in a neighborhood that was 62 percent Black and 31 percent white. By 2010, the average Black person's neighborhood was 48 percent Black and 34 percent white. Reinstating the Obama-era Fair Housing Rule will combat this ongoing segregation and set us on a path to true integration.

Congress should also pass the American Housing and Economic Mobility Act, or a similar measure, to finally redress the legacy of redlining and break down the walls of segregation once and for all.

Broadband Access

To realize broadband's potential to benefit our democracy and connect us to one another, all people in the United States must have equal access and broadband must be made affordable for the most vulnerable. Yet today, 15 percent of American households with school-age children do not have subscriptions to any form of broadband, including one-quarter of Black households (an additional 23 percent of African Americans are “smartphone-only" internet users, meaning they lack traditional home broadband service but do own a smartphone, which is insufficient to attend class, do homework, or apply for a job). The Biden administration, Federal Communications Commission, and Congress must develop and implement plans to increase funding for broadband to expand universal access.

Enhanced, Refundable Child Tax Credits

The United States faces a crisis of child poverty. Seventeen percent of all American children are impoverished — a rate higher than not just peer nations like Canada and the U.K., but Mexico and Russia as well. Currently, more than 50 percent of Black and Latinx children in the U.S. do not qualify for the full benefit, compared to 23 percent of white children, and nearly one in five Black children do not receive any credit at all.

To combat this crisis, President Biden and Congress should enhance the child tax credit and make it fully refundable. If we enhance the child tax credit, we can cut child poverty by 40 percent and instantly lift over 50 percent of Black children out of poverty.

Reparations

We cannot repair harms that we have not fully diagnosed. We must commit to a thorough examination of the impact of the legacy of chattel slavery on racial inequality today. In 2021, Congress must pass H.R. 40, which would establish a commission to study reparations and make recommendations for Black Americans.

The Long View

For the past century, the ACLU has fought for racial justice in legislatures and in courts, including through several landmark Supreme Court cases. While the court has not always ruled in favor of racial justice, incremental wins throughout history have helped to chip away at different forms of racism such as school segregation ( Brown v. Board), racial bias in the criminal legal system (Powell v. Alabama, i.e. the Scottsboro Boys), and marriage inequality (Loving v. Virginia). While these landmark victories initiated necessary reforms, they were only a starting point.

Systemic racism continues to pervade the lives of Black people through voter suppression, lack of financial services, housing discrimination, and other areas. More than anything, doing this work has taught the ACLU that we must fight on every front in order to overcome our country's legacies of racism. That is what our Systemic Equality agenda is all about.

In the weeks ahead, we will both expand on our views of why these campaigns are crucial to systemic equality and signal the path this country must take. We will also dive into our work to build organizing, advocacy, and legal power in the South — a region with a unique history of racial oppression and violence alongside a rich history of antiracist organizing and advocacy. We are committed to four principles throughout this campaign: reconciliation, access, prosperity, and empowerment. We hope that our actions can meet our ambition to, as Dr. King said, lead this nation to live out the true meaning of its creed.

What you can do:
Take the pledge: Systemic Equality Agenda
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