Three years after my dad was diagnosed with pancreatic cancer, his body finally succumbed to the illness and it became clear that he was going to die very soon. I didn’t have children, and I wasn’t sure I was ready for children. But there was nothing sweeter than seeing him interact with kids, and when I realized that I’d never get to tell him when I one day became pregnant — would never get to see that specific joy on his round, expressive face — I threw away my half-finished birth control pack and bought a bottle of prenatal vitamins. One morning, four days before he died, I sat next to him on his bed as he prepared to swallow the panoply of pills that were managing his nausea, edema, and pain, and said to him, “Look, Dad. I’m taking my pills too. We can do it together.” I showed him the clearly labeled NatureMade bottle and slipped a folic acid tablet into my mouth, watching as it dawned on him what I meant. He was too weak to speak very loudly at that point, but he turned his face toward the ceiling, his eyes glossy with tears, and he managed to whisper, “I wish you so much good. I wish you so much good.”
His death unmoored me. In the months that followed, my mind felt like the home of a hoarder, bursting with disorganized, toxic thoughts, and regrets—Had I spent enough time with him since his diagnosis? Did he understand how much I loved him? Did he feel at peace when he died? Was he in pain? For weeks, my eyes were rubbed so raw from crying that it looked like I’d been hit in the face. The only things that felt good were lying in beds and baths, eating nothing but sugar, and going on long bike rides, pumping my fury out through the pedals.
A month after he died I turned 35, marking the first year of my life I’d spend without him. I was also, suddenly, the same age my mom had been when she’d gotten pregnant with my little sister, her third child.
My husband and I had started to talk about having children at that point, but now my grief complicated the decision. As my siblings, mom, extended family and I mourned, it felt more important than ever to add kids to the family. I told myself that while, yes, my dad was gone, if I were to have four children that were each made up of 25% his DNA, then I’d be recreating a whole him, adding back to the world that which had been subtracted. At the same time, I couldn’t imagine a day when I’d regain the energy and optimism required to bring a new human into the world.
The emotional impact of my dad’s death left me in no physical state to manage a pregnancy either. The loss tugged persistently at a corner of my brain and panic flooded me with cortisol every time I realized it was real. In my depressed state, my appetite was too scarce. I shivered constantly, as if all the blood from my extremities had gone to fueling my overworked brain and heart. I either slept too little or couldn’t find a reason to get out of bed. My body was too turbulent a home for a baby, and I knew the addition of mercurial hormones and morning sickness would be more than I could handle. My biggest fear was feeling trapped by my pregnancy; that when I found myself seized by dreadful surges of anxiety, I’d be unable to soothe them with medication or vigorous exercise without harming the fetus.
But now I was as close to my 40s as my 20s, and I was acutely aware that 35 is a line often drawn when it comes to having kids, after which a woman’s fertility may begin to decline. That gnawed at me. I didn’t want to risk having a pregnancy I couldn’t emotionally or physically handle. I didn’t want to bank on waiting until I got healthier — in my state, the depression felt endless — and potentially miss the window before my fertility started to drop. I wanted to pause time, giving my mind the time to heal while my body remained young and fertile.
Although the science is still relatively new, I had friends who froze their eggs for various reasons. A friend who had the BRCA gene, a marker for cancer, wanted to freeze her eggs so that they could be screened. Others had done so after unsuccessful attempts at conceiving naturally, while still others were single women in their 30s who wanted to increase the chance they’d be able to have kids. They had positive experiences, and it seemed like my best option. I would freeze my eggs and press pause on pregnancy until I felt ready.
I’m lucky to work in media, where editors are gifted everything from extravagant vacations to botox injections. Extend Fertility a New York City clinic that specializes in egg freezing at a price that’s 40% below the national average, offered me a complimentary round of egg freezing. (Had I paid myself, it would have cost $6,500.) The service includes a fertility assessment, training in how to administer injections, regular monitoring, easy access to nurses and doctors, and the actual egg extraction procedure. I paid for the storage of the eggs ($425 a year) and the medications needed to stimulate my ovaries, which cost around $3,000 (my health insurance covered a portion).
I was anxious but eager to begin the process — I knew that it could be an emotionally and physically taxing experience, but I was also looking forward to the relief I imagined I’d feel afterwards. The egg freezing process begins on the second day of your period, so I made an orientation appointment at Extend’s clinic in midtown Manhattan for the week before I was due to begin my cycle. When I arrived, I met my patient coordinator, Jordana, and a nurse drew blood to assess my anti-mullerian hormone level (AMH), which is an indicator of what they call ovarian reserve (or how many total eggs you have). Dr. Bat-Sheva Maslow, a physician around my age, performed a trans-vaginal ultrasound to assess the number of egg follicles I had (which indicates how many eggs you can expect to be retrieved in a given extraction). I sat down with her afterwards, and she candidly told me about the process: what to expect, the numbers that indicated where I sat on the fertility spectrum, and how many eggs we could hope to retrieve.
My AMH level was 2.11, which is average for my age, and my follicle count was 16, which is in the 50th percentile for a 20 year old. I felt a surprising amount of pride for this last number—I wanted to announce to the world that, yes, I am 35, but I have the follicle count more typical of someone 15 years younger. My self worth suddenly felt tightly tied to my fertility. Most of all, I was relieved — I’d been afraid I’d learn that my system wasn’t working properly, ruling out the chance of a natural pregnancy or making the egg freezing process more strenuous.
Dr. Maslow told me that egg freezing is by no means foolproof, and there’s a misconception that if you retrieve, say, 20 eggs, then you’ll be able to have 20 babies. In reality, only some of those eggs will be mature enough or healthy enough to use, and even fewer will successfully be turned into embryos. And, only a portion of those embryos will be genetically sound. For a good chance at having one live birth, she said I should freeze at least 10 eggs.
Even with those risks, I wanted to proceed. I knew with certainty that I couldn’t have a child at this moment in my life, and that fact was further contributing to my anxiety. If I could freeze my eggs, maybe I’d have more time. Essentially, I was buying my own peace of mind.
After speaking with Dr. Maslow, I met with a nurse named Valerie who carefully walked me through the next steps in the process. I learned that I’d have to administer hormone shots to myself for eight to 12 days to get my egg follicles to produce multiple eggs, instead of just a single egg as is typical during ovulation. When the follicles grew to sufficient size, I would administer a shot of Lupron, which triggers ovulation, 36 hours before my scheduled egg retrieval procedure. My hormone regimen required that I give myself shots of Menopur and Follistim, which stimulate egg follicle growth, for the first few nights of the course, and then add Cetrotide, which prevents ovulation, from day four. Valerie showed me how to administer the injections, somewhat assuaging my fear of needles.
On the first night, I was nervous to give myself the shots. I called a friend who had done IVF so that she could advise me on how to pierce a needle through my own belly in the least painful way possible. I’ve fainted when getting my blood drawn before, and I worried that these needles would bring on the same reaction. As I penetrated my skin with the spear and plunged the fluid into my stomach, my vision got splotchy. I was nauseated and clammy, and I sat down on the floor until the dizziness let up. Then I cried, for my body, for the pregnancy I’d hoped to be ready for by now, for my dad, and for my future kids who would never know their grandfather.
I became accustomed to giving myself the shots shockingly quickly. By night three I didn’t have to watch the instructional videos, and my dizziness subsided as my confidence increased. I was proud of myself. I felt like I was toughening up with each shot, learning the level of stress my body and brain could withstand.
But as the hormones built up in my body each day, I felt more crampy, foggy, lightheaded, and sick to my stomach. My belly spotted with tender bruises and itchy red patches where the needles had gone in. My breasts felt as heavy as bricks, and I showered with a bikini top on because leaving them unsupported was too painful. By day six I felt full, like I couldn’t possibly fit any more medicine into my body. I went to the Extend clinic for monitoring every couple of days, where, with remarkable efficiency, the sweet nurses tested the hormone levels in my blood and the doctor on duty tracked the development of my follicles, assessing when I’d be ready for extraction.
Blessedly, by day eight I was ready to proceed with the egg extraction. By then, my abdomen felt heavy but fragile, like a sudden movement could jolt something loose. (And it could — you can’t exercise during the process due to risk of something called “ovarian torsion.”)
Exactly 36 hours after my final injection, I was lying on an examination table waiting for the twilight anesthesia to kick in so that Dr. Maslow could enter my ovaries with a long needle to extract all the eggs that had developed. I woke up just 30 minutes later feeling drowsy and crampy. The doctor came to check on me and notified me that they’d been able to retrieve 16 eggs, the maximum that we’d hoped for. Later, I learned that 15 of them were mature enough to freeze. She called it a “textbook perfect cycle.”
When my head cleared from the anesthesia, I experienced a distinct sense of calm unlike I’d felt in a long time. Maybe I’d get pregnant naturally when the time was right. Maybe I’d have trouble doing so, and would be glad to have a safety net. Maybe I’d try to use those eggs and, for one reason or another, it wouldn’t work. Whatever the outcome, I was relieved to feel that, rather than allowing anxiety about my fertility hamper my ability to heal from my father’s death, I’d taken some measure of control over my reproductive destiny. Ironically, that relief actually brought me a little closer to feeling ready to one day have that little kid who is one quarter my dad. That night, I slept better than I had in weeks.
DESIGN AND ART DIRECTION ANDREINA CARRILLO. ANIMATION BY MISHA TOWNSEND.
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