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Health

https://www.washingtonpost.com/health/

Aging Well

We welcomed our new baby boy 18 months ago. He is here because 10 years ago, when I was 30 and my husband was 32, we underwent IVF to create and then freeze embryos. Back then, we were not ready to be parents. But we knew of the looming risks of infertility, miscarriage and genetic disorders if we waited too long. So we turned to what I called “Preservation IVF” in a <a href="https://www.washingtonpost.com/wp-dyn/content/article/2010/07/02/AR2010070204597.html" title="www.washingtonpost.com">Washington Post story</a>. Our baby is proof that this can work and help so many future couples wanting to delay parenthood.


By freezing embryos, a couple uses their fertility while delaying parenthood


Most people resort to in vitro fertilization when all other options for conceiving a baby have failed. In our case, because our fertility levels at ages 30 and 32 were normal, we could undergo a gentler version of IVF that requires little or no drugs. Instead of pumping myself full of hormone shots to induce, or ramp up, my production of eggs, we used the egg that my body produced each month, which was then retrieved from me and fertilized in the lab with my husband’s sperm. Five or six days later, we had a blastocyst-stage embryo that was then frozen to use when we were ready.

We did this process five times, at intervals spaced around our work and travel schedules, at two different clinics, stored our babies-of-the-future in a freeze and then continued on with our lives.

We viewed creating these embryos as insurance against potential future infertility problems. When we eventually used them, our risk factors for miscarriage and chromosomal abnormalities would be that of a 30-year-old, not those of, say, a 40-year-old (or whatever our age at the time of the actual pregnancy). These differences in risks are dramatic. At age 30, the chance of miscarriage is 18 percent, but it rises to 38 percent by age 40. The risk of a chromosomal abnormality, such as Down syndrome, is 1 in 384 at age 30 but increases to 1 in 66 by age 40. And that is assuming you can even get pregnant at age 40.

When I wrote about “Preservation IVF” 10 years ago, we got some blowback. Some readers criticized us as extreme “planners” and wondered whether I would write about this 10 years later when we’d be “struggling with Failure IVF.” So here’s the second half of our story — of our path from a frozen embryo to our baby boy — and of some of the lessons learned and insights gained about IVF then and now.

With our future family in mind, my husband, Paul, and I worked toward our goal of saving enough money to support children and pay for college but still being free enough to give those future children lots of time and love. Paul worked at becoming a partner at a large law firm and I built my real estate business and found a home for our family.


Why men should also worry about waiting too long to have kids


Then, four years after we froze our embryos, and before we had any thought of using them, we got pregnant the old-fashioned way. Our wonderful surprise daughter was born in 2013 and, planning or no, parenthood began.

Another four years later, as I approached age 39, my husband and I decided we wanted to have a second child. We were ready to use our frozen embryos.

I visited my gynecologist for a checkup and underwent a comprehensive physical. We returned to the two clinics — New Hope Fertility Clinic (NHFC) and Sher Institute for Reproductive Medicine in New York — where we created and froze our embryos to find out what had changed in IVF medical technology in 10 years. One of those doctors performed a sonogram to confirm that my uterus lining (interior) was healthy. Now it would be up to us when we wanted to transfer an embryo.

We decided to start in October 2017. Just like the process 10 years before, I would visit the clinic on Day 3 of my menstrual cycle (Day 1 is the start of your period) and have a quick blood test and ultrasound to monitor my hormones and ovaries so the doctor could transfer the embryo at the right time.

When undergoing IVF to freeze embryos, I looked for a natural, minimal medication approach. I also wanted a natural transfer approach — one that works with your own ovulation pattern. Many IVF clinics require a woman to get her body on the clinic’s schedule — providing birth control pills and other drugs to shift her cycle time so that the embryo transfer falls during their working days. I did not want that.

I also learned that many doctors at clinics will treat you just as they would any other patient with infertility problems. But we were not typical patients — I did not have any proven fertility problems to this point. More important, we were using frozen embryos from young, fertile people — who happened to be my husband and me — rather than a donor.

As a result, fertility-inducing protocols, such as hormone supplements before, during and after the transfer, did not seem to apply. The original two clinics we’d dealt with were both willing to use the more natural approach.

The main question for us was which of the frozen embryos to use first? We were told all of our embryos had about a 50 percent chance of becoming a healthy pregnancy. We also considered the location of the embryos. We had stored our embryos in two different locations — at NHFC and a long-term storage facility — to reduce the risk of an electricity or storage tank failure in one location that could destroy them. While rare, this has happened. In 2018, two clinics — Pacific Fertility in California and University Hospitals Fertility Center in Cleveland — had storage tank failures that resulted in losing thousands of frozen embryos and eggs.


Fertility clinic informs hundreds of clients their eggs may have been damaged


We decided to select first from the group of natural IVF embryos created without using any drugs at all as opposed to those created with low dosages of fertility drugs, conveniently stored at NHFC where we would do the transfer.

We arrived at the IVF clinic on the morning of the transfer. The embryo was thawed just before our arrival. The insertion procedure took about five to 10 minutes. After resting for a few minutes, I went home to take it easy for the rest of the day. Then I just had to wait.

Two weeks later it was clear that implantation hadn’t worked. We’d have to try again.

Yes, this was disappointing. But a week later I started the process again. And seven days later we found out I was pregnant. I had the standard and frequent follow-up appointments at the IVF clinic for nine weeks. Then I was turned over to my obstetrician for the rest of my pregnancy. Besides severe morning sickness for 18 weeks and typical uncomfortable symptoms like heartburn, everything went well and I delivered a healthy 8-pound, 10-ounce baby boy.

Looking back now, I recall a variety of thoughts and feelings that I had along the way.

When we began this process 10 years ago, it was about a calculated result — preserving our fertility. It was insurance. We were on a mission to get good-quality blastocyst embryos to freeze because we wanted to be parents in the far-off future, not then. I wasn’t like everyone else in the waiting room hoping for a baby — that was years away for us.

Now, I was like everyone else in the waiting room — wanting a baby right then. It is different when you are actually ready to transfer the embryos. I felt nervous — getting my blood taken and ultrasounds done, wondering if I would be pregnant soon. I wanted this to work. I knew the statistics were on our side but having every step of your very early pregnancy monitored so often, hoping it will work, is stressful.

I was also struck by what has changed with IVF in 10 years.

It is now cheaper and easier to freeze your eggs — or embryos — for the future. Employers such as Facebook and Google offer egg freezing as a perk to their employees. While egg freezing (as opposed to the embryo freezing we did) is no longer considered “experimental” as it was 10 years ago, according to the American Society of Reproductive Medicine (ASRM), many clinics tend to suggest embryo freezing over egg freezing if possible because of better success rates.

Embryo freezing has a long and successful history, with tens of thousands of healthy babies born from frozen embryos (mostly from IVF couples who saved leftover embryos after having their first IVF pregnancy). Fewer babies have been born from frozen eggs, in part because each frozen egg that is thawed has just a 2 to 12 percent success rate, according to ASRM, vs. the approximately 50 percent chance we’d been told.

Perhaps I would have gotten pregnant again the old-fashioned way. But nearing 40, we knew that would be risky, especially when comparing those risks against using an embryo from our 30- and 32-year-old selves. It took planning and time to produce, store and use that embryo, but it was far easier — emotionally and financially — than what other 40-year-olds are enduring at IVF clinics right now.

And in the end, with a beautiful boy in my arms, it seemed worth it. And worth being able to wait and grow our family when we were ready.


<email>health-science@washpost.com</email>



<i>
Her struggle to conceive with frozen eggs
</i>



Are fertility drugs safe? The industry says yes; critics worry they’re overprescribed.



I figured motherhood would change me, I didn’t realize egg freezing would.



The maddeningly inscrutable world of IVF costs


Gillian St. Lawrence

The Washington Post

Embryo freezing was a way to preserve our fertility until we were ready for parenthood. A decade later, we have a baby boy.

HANDOUT on 11/9/19

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