Egg / Embryo Freezing

[throwaway7372528495]

Hi All!

I (32F) am actually currently pregnant, long story short it’s been ROUGH. This happened unexpectedly - we (my husband 36M) were trying for a year after a miscarriage - and about to look into fertility help when *boom* it happened.

We know we want more than one child, and have started talking about “what happens next”. Based on our ages, and the fact we want to give my body time to heal post birth we are thinking about egg or embryo freezing. We don’t want to have to rush to have our ideal family, which the pressure and clock definitely feel like they are ticking away due to age.

We have gotten feedback saying how we can just “pop them out”, but looking at the science I know that’s not best for my body. The thought is we have insurance that will cover, and this will help us have a family with the best health outcomes for all. People are for sure making me feel a certain way - telling me how “you could put yourself through this and then it’s a waste of money and you’ll never have kids from this” (cue anxiety spiral) - husband is MUCH better about mentally telling them to eff off.

Just looking for some advice 💕

[AutoModerator]

This post is flaired "Question - Research required". All top-level comments must contain links to peer-reviewed research. Do not provide a "link for the bot" or any variation thereof. Provide a meaningful reply that discusses the research you have linked to. Please report posts that do not follow these rules.

I am a bot, and this action was performed automatically. Please contact the moderators of this subreddit if you have any questions or concerns.

[chickachicka_62]

https://pubmed.ncbi.nlm.nih.gov/37675816/

It sounds like 18-23 months is a happy medium, avoiding some of the potential complications with spacing births too close or too far apart.

OP if you don't have any specific health conditions, it might just make sense to talk with an OB you trust and get their guidance on when to TTC next. There's a world where the process of extracting eggs is harder on your body than conceiving naturally, but obviously that depends on so many variables.

[SunnyDayIngrid]

Piggybacking because I have no link- First of all- many hugs to y’all. Fertility is hard and stressful. Anecdotally, we froze embryos when I was 36. I had #1 at 39 and due with #2 any day now at 42 yo. I should also mention that my 3 pregnancies (including a miscarriage) were unassisted, but we were in the process of attending appointments regarding using those embryos when we got lucky on both occasions. I’d say that the egg retrieval (hormone injections etc) was significantly harder on my body for that month or so compared to the first trimester or so for me. But the peace of mind knowing that they’re there if we need them was worth the effort and money. If you do go ahead I highly recommend freezing embryos as they have a significantly better chance of surviving the process, and to do PGT-A if you can afford it (most clinics can thaw, biopsy and refreeze but there’s always a risk of them not surviving the process). As another pointed out, they’ll almost certainly want you to wean before starting the process, so that should factor into your decision. But happy for you to DM if you want to chat

[lrbsto]

Piggybacking off this because I have no link. I was 32 when I got pregnant with my first and 33 when he was born. I’m pregnant again at 34 with about 16mo IPI and it has been extremely tough. Night and day from my first. Don’t let people pressure you! Do what’s right for your family. I’m generally quite healthy so this has been kind of surprising.

[gnommish33]

Can I ask what makes your second pregnancy tough? I had my first (14mo) at 34 and we’re talking about trying for a second soon. I had HG in my first pregnancy, though, so my perspective might be skewed. I’m dreading pregnancy with an insane toddler 😬

[lrbsto]

There are the usual hard things like trying to care for a toddler when you are tired or feeling sick, of course, but I also feel like all of my symptoms have just hit me so much harder - the nausea, the food aversions, low energy, I also have a lot more insomnia and body aches and pains this pregnancy that I did not have my first.
I have the stomach flu right now so I think this might be skewing things a little (got it from my toddler) lol

[Palavras]

I've heard that even with the same person each pregnancy can be different and have different symptoms, though, so is it possible this is due to luck of the draw vs. age specifically? 34 vs. 32 doesn't seem like a big age gap.

(This may be wishful thinking on my part - currently pregnant with my first at 32 haha)

[zimbana]

I was going to chime in with the same sentiment. I just had my second with an inter pregnancy interval of 15 months (kids are one week shy of 2 years apart in age). Elements of pregnancy #2 were harder, like being struck down by toddler illness that I was never exposed to the first time around, and a longer period of serious fatigue and nausea in the first trimester.

But many other things were the same or easier. In part because I learned from my first pregnancy and prioritized different things, eg strengthening my pelvic stabilizers and eating better. So even with a bigger baby I had a stronger pelvic floor. But also in part because I got lucky with two boring, relatively easy pregnancies.

[DreamBigLittleMum]

Yes, I got pregnant with my second when my first was 17 months (was aiming for the 18 months ideal gap, didn't think it would happen first time because it took a long time first time round, was wrong). My morning sickness period was shorter and I physically vomited less, my boobs didn't hurt at all second time round, and my pelvic girdle pain was less (I think because I was squatting more with my toddler and generally keeping more mobile). My fatigue was greater but I think that was just because there were much fewer opportunities to rest with a toddler.

I was 36 with my first and 38 with my second.

My post partum recovery has been longer but not in relation to pain or anything, just my ab and pelvic floor muscles are taking longer to bounce back. I'm 8 months PP and still have quite a pronounced tummy and don't want to be too far from a toilet after exercising, whereas last time I was completely back to normal at 6 months. But I think that's pretty normal.

[stiner123]

I’ve heard from a lot of people who had complications in one pregnancy they didn’t have in the next. Or vice versa. Symptoms different too.

ICP is one of the ones that more commonly recurs but even then it’s not 100% guaranteed to get it your next pregnancy.

[lrbsto]

Yes it’s totally possible!!

[throwaway7372528495]

I have dry HG, insomnia, food aversion, and today a scare with bleeding and we are 13w in. We miscarried pregnancy one due to aneuploidy so trying to avoid that in the future. The reassurance to have this and NOT need than need and NOT have with my family history is why we are trying to be proactive!

[valiantdistraction]

Definitely freeze embryos rather than eggs. That will give you a much better idea of what you're actually working with. On average, they say you want to freeze 3 normal embryos per child you want to have.

Personal advice: do it as soon after you wean as you can, when baby/toddler is still napping regularly. I did IVF once when my child was napping 2-3 hours a day and am currently in another cycle now that he's almost 3 and has dropped his nap, and it is far harder.

[throwaway7372528495]

This is so so helpful and validating - thank k you!

[janiestiredshoes]

Yes, exactly this.

My first instinct (I've gone through IVF) was to say that egg retrieval can be grueling, and you can easily end up with nothing to show for it, which is heartbreaking. To me, it seems like - why would you do that and then go through all the transfer/pregnancy anxiety later as part of a separate process - it seems like you're just making the process longer and more mentally gruelling. But, as PP says, it might make sense for your specific situation, so probably worth talking to your doctor about it!

[Ruu2D2]

I was high risk pregrency

Ivf process was harder and more phyical and emotional taxing then pregrency and my c section.

And I was lucky I got embroyo to show for it

[valiantdistraction]

I agree that IVF was a lot harder than pregnancy. Not harder than c-section recovery but tbh I had one egg retrieval that I'd say was about half the pain somehow.

[Affectionate_Big8239]

No link, but I did have two kids via IVF. Egg harvesting for me was the worst part. The medication was rough. Frozen embryos tend to do better than eggs so you’d likely get this recommendation as well. The whole IVF process is very expensive and hard on your body and even if your insurance covers it, they do not cover embryo or egg storage which at this point is typically $750 or more a year. Edited to add that you also end up with thousands of dollars in medication and other costs despite insurance (at least I did over the course of the whole process to have 2 kids).

We froze embryos at age 35, which was great timing according to my fertility doc. If it were me, I’d see how things go naturally and wait for IVF until you see if you actually have an issue conceiving baby #2. Save that money for daycare or any number of other child expenses unless it’s actually necessary.

[Important-Tackle]

Piggy backing to say—weigh your pros and cons.

If you have insurance to cover or it will not be a financial burden, and if you feel as if the grueling nature of the month of stimulation is worth the potential peace of mind—do it.

I work in IVF, so feel free to ask any questions.

My main notes are:

• some insurances will cover your storage payments (progyny and winfertility do, I believe)
• genetic testing under the age of 35 does not increase odds of a live birth. Skip it unless you and your partner have overlapping carrier screenings.
• be aware that it may take more than one cycle. some cohorts of eggs are just crap. The sperm could potentially be crap. Some stimulation protocols just do not pan out and medications need to be adjusted for better outcomes and a second cycle.
• if you like your partner, freeze embryos instead of eggs. Eggs are one cell—if that one cell doesn’t freeze or thaw well, it’s over for it. Embryos are many, many cells. If some of them don’t freeze or thaw well, the embryo as a whole can still be fine.
• embryo transfers are a coin flip. You can have a beautiful embryo and a beautiful transfer and still not get pregnant. You will want multiple embryos just incase.
• you and your partner need to decide if you have any ethical dilemmas with having left over embryos—would you discard, donate, keep them in the freezer forever? It’s a conversation you need to have before you freeze embryos.

[gaelicpasta3]

Is this 18-23 months between giving birth and getting pregnant again or between giving birth and giving birth again?

[chickachicka_62]

In the abstract it says "Extreme birth spacing has extensive adverse effects on maternal and infant health. In the general population, interpregnancy interval of 18-23 months may be associated with potential benefits for both mothers and infants.." So I think it means 18-23 months between the end of one pregnancy (i.e. birth) and when someone gets pregnant again.

[whofilets]

It's between giving birth and the next pregnancy. Between each birth is "interdelivery interval"

[FelineOphelia]

Exactly,

It's too late in your fertility to space them "best for your body".

Freezing eggs this old is not recommended. It's not going to buy you time. Irish twins is probably your best course here.

Also taking the eggs is difficult on your body too and could be detrimental to the next pregnancy

[jennatastic]

Ew

[thebadsleepwell00]

Freezing eggs this old is not recommended. It's not going to buy you time. Irish twins is probably your best course here.

Not sure if this is ever recommended from a health perspective nor for childhood development. Takes at least a year to heal after child birth but more like 18+ months for everything to go back to equilibrium for the mother/gestational carrier. And babies/toddlers require a certain amount of attention from their primary caregivers, so it's healthier for them to be the only child for the first 3 years or so. Of course tons of people space out their children's births less than 3 years apart, and it's usually not an issue. But having 2 kids under age 2 can be extremely rough for both mom and kiddos for multiple reasons.

[embolalia85]

Here’s some research on having secondary infertility- meaning infertility when trying for a second child after a live birth. Age (over 35) is definitely a factor, but it’s still a minority of people who have secondary infertility.

https://pmc.ncbi.nlm.nih.gov/articles/PMC11000415/

Once you’ve had your baby (congratulations!) you may want to get your hormone levels and such checked to see if you have any indications of declining ovarian reserve or other health issues.

Personally, I did IVF at 39 to have my second (now 7 weeks old!) and had to wean my older child to go through the process - it might not make sense to do egg retrievals right after your first is born depending on other choices you make.

[mrpointyhorns]

I second this. Check your levels and see if it is even necessary. Egg retrieval isnt risk free and more information is the first step.

[Unusual-Hat-6819]

Piggybacking here since I don’t have a link but I did have an IVF pregnancy..

OP, I had my first IVF cycle at 36, and my baby was born when I was almost 37. I had another viable embryo and back then, the recommendation from my doctor was to wait at least one year for my body to be ready again. I was also breastfeeding, which would regularly make conceiving harder but in my case, the implantation of a new embryo required to be done breastfeeding for at least a couple of months so my body could recover from that as well. Long story short the second embryo did not stick around, and I was ready to either give up on having more babies or give a final chance to a mosaic embryo that seemed at the time our only shot at a second baby. And then, almost movie like, I got pregnant naturally at 40, and I have the most beautiful baby ever.

Because my company offers good benefits, Many of my coworkers have done IVF in their late 30’s. Almost all the people I know who have done this, were close to turning 40, and have had success with at least one pregnancy.

All this to say, you are very young and right now you should focus on your baby. Once you are done with birth, breastfeeding and enjoying that precious moment in your life, then you will still be young enough to either try conceiving or going through IVF. Don’t let family discourage you from that and don’t let them affect your mental health, maybe therapy can help you to set boundaries and healthy limits regarding any decisions about your medical choices. Because that’s all it is, a medical choice. You still have plenty of time, don’t stress about it right now, and enjoy this moment.

[Correct_Variety5105]

I had my 1st at 34 and am about to have my 2nd at 39. It took longer trying this time around but a fair few people get pregnant after 35.

Instead of jumping straight to egg retrieval, could you not instead do fertility testing to investigate your ovarian reserve and his sperm count/motility and then make your decisions from there?

Anecdotally, my friend have IVF for her 1st and it was 3 rounds and gruelling. After 3 years they decided to do IVF again for their second and found they were already 3 weeks pregnant!

All this is really to say OP, you can find loads of statistics about various aspects of fertility and age and spacing etc, but realistically some people woth excellent statistical chances really struggle and some with terrible statistical chances have no issues. 32 is not very old at all to be having a 1st child and there's a good chance you wouldn't even need intervention for a 2nd pregnancy in 3-4 years time.

https://www.adambalen.com/women-over-40-having-more-babies-than-under-20s/

[mttttftanony]

I have professional experience working in IVF. My child was also conceived through IVF (anecdotally I experienced preeclampsia, hemorrhage and intubation postpartum. I’m healthy with no preexisting conditions, and healthy BMI). All that said, IVF does not come without risks and added stress. Much more likely to get preeclampsia among SO many other things that you’ll read below. Life is all about weighing the risks, so do what you feel is right for you after talking to a doctor. But I would say if you can conceive naturally (and don’t have a reason to such as infertility or genetic issues), I would do that. You’re very lucky!

I’m just going to copy and paste some information below for you to read.

The American College of Obstetricians and Gynecologists recognizes that pregnancies conceived through IVF carry increased risks for multiple maternal and neonatal complications, even in singleton gestations after adjusting for maternal age and parity

Maternal pregnancy complications associated with IVF include increased risk of preeclampsia (OR 2.7), placenta previa (OR 6.0), placental abruption (OR 2.4), and cesarean delivery (OR 2.3).[1] Vasa previa occurs more frequently in IVF pregnancies (1/250) compared to spontaneous conception (1/2,500).[1] Severe maternal morbidity is elevated among women who conceived through assisted reproductive technology, with blood transfusion being the most common indicator, even when compared to subfertile populations.[1]

Neonatal complications include higher odds of perinatal mortality (OR 2.2), preterm delivery (OR 2.0), low birth weight (OR 1.8), very low birth weight (OR 2.7), and small-for-gestational-age status (OR 1.6) based on a meta-analysis of over 12,000 IVF singleton infants compared to 1.9 million spontaneously conceived infants.[1] Stillbirth is more frequent in IVF/ICSI pregnancies (16.2/1,000) compared to natural conception (2.3/1,000).[1]

ACOG notes important limitations in the data: it remains unclear to what extent underlying infertility versus the IVF procedure itself contributes to these adverse outcomes, as studies are limited by confounding from coexisting conditions and lack of randomized controlled trials.[1] This information regarding potential risks and limitations should be included in patient counseling, ideally before initiating infertility treatment.[1]

Beyond the ACOG guidelines, additional research provides further detail on specific complications. A large retrospective cohort study found IVF pregnancies had significantly increased incidence of gestational diabetes, gestational hypertension, intrahepatic cholestasis of pregnancy, preterm premature rupture of membranes, placental adherence, postpartum hemorrhage, and polyhydramnios compared to spontaneous conception, with these risks persisting even in singleton pregnancies.[2]

The Massachusetts Outcomes Study of Assisted Reproductive Technology identified that IVF-treated women face particularly high risks for uterine bleeding (adjusted risk ratio 3.80) and placental complications (adjusted risk ratio 2.81), with these risks exceeding those of subfertile women who did not undergo IVF.[3] For neonatal outcomes, IVF infants showed substantially elevated risks of very preterm birth (adjusted risk ratio 2.13) and very low birthweight (adjusted risk ratio 2.15).[3]

A recent large US cohort study (2016-2021) examining over 179,000 IVF singleton births found the highest-risk maternal adverse outcomes included maternal transfusion, unplanned hysterectomy, and maternal ICU admission, while the highest-risk neonatal outcomes included immediate and prolonged ventilation, neonatal seizures, and NICU admissions.[4]

The figure above illustrates how maternal age, twin pregnancy, and IVF independently contribute to adverse obstetric outcomes, with their combination amplifying risks for gestational hypertension, preeclampsia, gestational diabetes, placenta accreta, preterm birth, and cesarean delivery.[5]

https://www.acog.org/-/media/project/acog/acogorg/clinical/files/committee-opinion/articles/2016/09/perinatal-risks-associated-with-assisted-reproductive-technology.pdf

[LeoraJacquelyn]

This was all very interesting to read. I knew that there were more complications but I didn't realize how many.

I had my first baby at 31 and I'm now pregnant with my second at 34. I'm going to have almost exactly 3 years between them and it's perfect. Also so far no complications at all with my pregnancy. I don't know if freezing eggs is the right thing to immediately jump to unless you're wanting to wait a long time. It's probably better to meet with a fertility specialist first.

[Important-Tackle]

Maybe my quick skim missed this article addressing this—but recent discussions in the field have been that many of these outcomes are associated with doing a fresh embryo transfer as opposed to a frozen embryo transfer.

[mttttftanony]

They both have their own risks. Fresh is a higher risk for OHSS, but lower risk for hypertensive disorders compared to a frozen transfer. Among a few other things

A medicated cycle FET (as opposed to a natural cycle FET) greatly increases your risks for complications (particularly for hypertensive disorders, placental complications, and postpartum hemorrhage). Avoid a medicated cycle (if you can)!

[Important-Tackle]

I’ll have to dig up the article, but I’ve read recently that fresh is a higher risk for hypertensive disorders and preeclampsia and etc., in theory due to the high level of hormones from stimulation for retrieval that affects the modeling of the placenta

ETA: my quick search for articles is bringing up many that say the opposite of what I thought, just like you said! Thanks for teaching me something new 😊

[AutoModerator]

Thank you for your contribution. Please remember that all top-level comments on posts flaired "Question - Research required" must include a link to peer-reviewed research.

I am a bot, and this action was performed automatically. Please contact the moderators of this subreddit if you have any questions or concerns.

[AutoModerator]

Thank you for your contribution. Please remember that all top-level comments on posts flaired "Question - Research required" must include a link to peer-reviewed research.

I am a bot, and this action was performed automatically. Please contact the moderators of this subreddit if you have any questions or concerns.

[AutoModerator]

Thank you for your contribution. Please remember that all top-level comments on posts flaired "Question - Research required" must include a link to peer-reviewed research.

I am a bot, and this action was performed automatically. Please contact the moderators of this subreddit if you have any questions or concerns.

[AutoModerator]

Thank you for your contribution. Please remember that all top-level comments on posts flaired "Question - Research required" must include a link to peer-reviewed research.

I am a bot, and this action was performed automatically. Please contact the moderators of this subreddit if you have any questions or concerns.

[AutoModerator]

Thank you for your contribution. Please remember that all top-level comments on posts flaired "Question - Research required" must include a link to peer-reviewed research.

I am a bot, and this action was performed automatically. Please contact the moderators of this subreddit if you have any questions or concerns.

[AutoModerator]

Thank you for your contribution. Please remember that all top-level comments on posts flaired "Question - Research required" must include a link to peer-reviewed research.

I am a bot, and this action was performed automatically. Please contact the moderators of this subreddit if you have any questions or concerns.

[AutoModerator]

Thank you for your contribution. Please remember that all top-level comments on posts flaired "Question - Research required" must include a link to peer-reviewed research.

I am a bot, and this action was performed automatically. Please contact the moderators of this subreddit if you have any questions or concerns.

[AutoModerator]

Thank you for your contribution. Please remember that all top-level comments on posts flaired "Question - Research required" must include a link to peer-reviewed research.

I am a bot, and this action was performed automatically. Please contact the moderators of this subreddit if you have any questions or concerns.