Egg Reserves

Continued from previous post Taking the Leap into Fertility

The wheels were in motion! To move forward with oocyte vitrification (egg freezing), I was presented with a number of options for referral to a fertility clinic including some local clinics and some overseas. I wasn't attracted to the idea of going abroad. For one thing, it is a drawn out process with many tests, scans, and uncertainties so I didn’t think it was practical to go overseas - not to mention the added costs associated with travel, accommodation etc. What's more, I really didn’t like the idea of having my eggs stored in a foreign country.

So, having weighed up the options at home, I decided to proceed with my Consultant’s preferred clinic. He had informed me that he had sent other patients, friends and family members to this clinic which I took as a good sign. I also really trusted his judgment as he had been my Consultant for 9 years and never took any chances with my health.

The one drawback is that by choosing this particular clinic, I was not eligible for any financial support from my health insurance provider so, I braced for the fact that I would have to foot the entire bill. However, in the grand scheme of things, it seemed like a small price to pay if this would increase my chances of having a family of my own. I appreciate that this might not be the case for everyone, but some clinics have financial assistance schemes so that option can always be explored too.

Before my appointment with the Fertility Consultant, I needed to have a scan on my ovary (to assess the number of antral follicles) and a blood test to assess my AMH level - key factors in the decision making process to determine if I am a suitable candidate for oocyte vitrification.

The AMH level, or Anti-Mullerian Hormone level, is an indicator of a woman’s remaining egg reserve (females are born with all the eggs they will ever have and this egg reserve diminishes with age). Note though that the AMH level tells you nothing about the quality of a woman’s eggs or her ability to actually get pregnant and carry a baby to term.

The ultrasound scan needed to be performed between Days 2 and 8 of my cycle. This was an internal scan, or a trans-vaginal scan. It can feel invasive for some people but, having had many of these as a result of my own medical history, thankfully, this part didn't bother me.

The nurse talked me through the scan as she performed it. She informed me that the ideal number of follicles in the ovary is 6-12. She counted 6 for me. On the low end, yes. But at least I hit on the desired range. I took this as good news.

Alas, this was short lived.

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The day of my appointment with the Fertility Consultant arrived. I wasn’t quite sure what to expect from this appointment. At the very least, I expected to be informed about the process, on both a practical and financial level, and to receive my blood test results.

My appointment was on a Thursday morning and it had been a crazy week leading up to it so I was heading in to the appointment with no reserves. I also learned the hard way that it is so important to have some support for these appointments (a friend, family member, partner). I made the mistake of going alone.

“Your AMH level is very low…even when accounting for the fact that you only have one ovary”. This was the crushing blow that was delivered by the Consultant. It really did feel like a blow. I was devastated to hear that my egg reserve was very low - I was only 34! The tears came thick and fast in the Consultant’s office. I wasn’t sure what to think.

The Consultant advised me that I should attempt egg freezing for this reason alone and do so as soon as possible. She also informed me that I may only get one or two eggs per cycle (if even) and that I may need to do three or four cycles (at a cost of thousands per cycle). Funnily enough, the financial implications were the least of my worries.

This news frightened me. For the first time, I had it in black and white that my dream of a family may not happen. I fully appreciate that this might sound like a dramatic reaction but this was what was going through my head at the time.

I felt a deep sadness. The tears would not stop flowing – which in hindsight was not a bad thing. I was processing this in real time. Although breaking down on the street, on your own, in front of rush hour traffic is a real lesson in vulnerability, I’m not sure I would recommend it.

After the appointment, I was brought into another room to schedule my information session with a nurse and to sign a number of forms. I had no idea what I was signing. I was could barely see through my tears and not a lot of information was getting in after receiving this news. This is another reason why I highly recommend bringing someone with you to the Consultant visit.

It is also recommended that you schedule an appointment with the Fertility Counsellor before you commence egg freezing. I have been engaged in psychotherapy for a number of years so for this reason, I opted out of seeing the Counsellor in the clinic and the Consultant was satisfied with this approach.

From my work in psychotherapy, I finally understand the importance of actually feeling emotions in real time and allowing myself to process what had just happened. I am proud to say I managed this at the time. It was tough for a few days. There were many tears, and when they came, I let them flow. I am extremely grateful for the circle of friends and family around me who are aware of my journey and who were there during this time.

Day by day, I felt lighter again and the hope and positivity soon returned. After all, your AMH level is only an indicator of egg reserves, and is not an indicator of your chances of actually conceiving down the line.

On to the next step!