WEBVTT - Egg Freezing: From an Expert’s Perspective w/ Dr. Natalie Crawford 0:00:00.280 --> 0:00:03.119 Welcome to Katie's Crib, a production of Shonda Land Audio 0:00:03.240 --> 0:00:06.760 in partnership with I Heart Radio. When Idea first started, 0:00:07.000 --> 0:00:09.120 we didn't have medications to make more than one eggro 0:00:09.240 --> 0:00:13.520 at a time, so we followed somebody's natural ovulation, trying 0:00:13.520 --> 0:00:15.720 to watch the one egg get mature. And then you 0:00:15.760 --> 0:00:18.680 don't have this minimally invasive ego trivial Katie. They would 0:00:18.720 --> 0:00:21.480 go like a surgery, a real life surgery through the 0:00:21.520 --> 0:00:25.160 abdomen into yeah, yes, and they would stick a needle 0:00:25.360 --> 0:00:27.600 into that one little follicle. You get one little shot 0:00:27.640 --> 0:00:29.520 at it, but you have to be like general anesthesia 0:00:29.560 --> 0:00:32.960 all the way asleep. Wow, you guys, this has come 0:00:33.800 --> 0:00:45.040 so far. Information provided by Dr Crawford during this podcast 0:00:45.120 --> 0:00:48.040 is for general education purposes and should not be relied 0:00:48.120 --> 0:00:52.680 upon as professional medical advice, diagnosis, or treatment for any individual. 0:00:53.560 --> 0:00:59.360 Hello everybody, Hello, Hello, Welcome back to Katie's Crib. We've 0:00:59.520 --> 0:01:05.360 got a real fancy, impressive doctor in the house today, 0:01:05.400 --> 0:01:08.800 which I love. I'm very excited to have this conversation. 0:01:09.160 --> 0:01:13.760 This is a conversation that I have with my girlfriends 0:01:13.800 --> 0:01:18.120 constantly on all coasts, all cities. It is a hot 0:01:18.160 --> 0:01:21.840 topic and this is what Dr Natalie Crawford does all day, 0:01:21.880 --> 0:01:26.520 all night. Dr Natalie Crawford is a fertility physician in Austin, Texas, 0:01:26.560 --> 0:01:29.200 and she's the co founder of a boutique fertility practice 0:01:29.280 --> 0:01:33.040 called for Fertility. She's also the host of the as 0:01:33.080 --> 0:01:36.600 a Woman podcast and her YouTube channel, Natalie Crawford m D. 0:01:37.280 --> 0:01:40.520 Dr Crawford's work focuses on empowering women and promoting fertility 0:01:40.520 --> 0:01:46.880 awareness and education. She's married to Austin Native Jason Crawford 0:01:47.000 --> 0:01:50.480 and they have two young children. Welcome to Katie's crib. 0:01:51.120 --> 0:01:57.320 Dr Crawford, you must be busy, Katie. Thank you so 0:01:57.400 --> 0:01:59.400 much for having me. I am so I am busy. 0:02:00.000 --> 0:02:03.680 People are finally talking about fertility or not putting it 0:02:03.720 --> 0:02:05.880 away in the closet or having as much stigma as 0:02:05.880 --> 0:02:07.760 their husband in the past. And I really feel like 0:02:07.800 --> 0:02:12.440 this is an area or even very educated, very successful 0:02:12.480 --> 0:02:15.280 women do not understand a lot about their own fertility, 0:02:15.320 --> 0:02:17.520 in their own body. And there's huge room for improvement 0:02:17.639 --> 0:02:20.560 for making sure that we can all know how our 0:02:20.560 --> 0:02:22.600 body works and how it's supposed to work. Because if 0:02:22.600 --> 0:02:24.440 we don't know the basics, how do we know when 0:02:24.480 --> 0:02:26.160 something's wrong or how do we know to get help. 0:02:26.800 --> 0:02:29.600 That's a percent. I can remember the first time, just 0:02:29.639 --> 0:02:32.240 trying to get pregnant and going to like an acupunctures 0:02:32.280 --> 0:02:34.840 and she was like, what's your ovulation juices? And I 0:02:34.880 --> 0:02:36.280 was like, I don't know? And she was like, you 0:02:36.280 --> 0:02:39.239 don't know about your body and when what days happen 0:02:39.360 --> 0:02:42.639 and when things get egg white versus clear, versus stretchy 0:02:42.760 --> 0:02:46.440 versus thick. And I was like, I'm so mortified about 0:02:46.480 --> 0:02:49.960 my own not know it, just not knowing about what 0:02:50.000 --> 0:02:51.959 my body does and when it does it and why 0:02:52.040 --> 0:02:54.800 it does it. And it's so cool that you know 0:02:54.840 --> 0:02:58.880 all about that stuff. We've heard about the egg retrieval process. 0:02:59.160 --> 0:03:01.960 We've actually done episode about the egg retrieval process from 0:03:02.000 --> 0:03:04.079 two of my best friend Stephanie Black and Lindsay Craft. 0:03:04.400 --> 0:03:06.280 But I would love to hear about the egg retrieval 0:03:06.360 --> 0:03:10.800 experience from an expert's perspective. Yes, I'm excited for you 0:03:10.840 --> 0:03:16.160 to explain blastocyst stage. Just take me through like the 0:03:16.240 --> 0:03:21.000 big sweeping things about egg retrieval process. Let's do it. 0:03:21.120 --> 0:03:24.400 Let's rewind, because I think to understand the agg retrieval 0:03:24.400 --> 0:03:27.520 process real quick, we got to understand what happens on 0:03:27.520 --> 0:03:29.480 a month to month basis, so you can understand what 0:03:29.480 --> 0:03:31.760 we're going to do, and then I'll talk quickly about 0:03:31.720 --> 0:03:34.920 egg retrieval, and then what happens after what is a blasts. 0:03:35.640 --> 0:03:37.720 The reality is most of us think in our brain 0:03:37.960 --> 0:03:39.920 we lose one egg per month. That's the egg that 0:03:39.960 --> 0:03:43.000 you ovulate, and that's not really how the human body works. 0:03:43.480 --> 0:03:45.880 I like to use this terrible analogy, but if you 0:03:45.920 --> 0:03:49.200 can imagine inside your ovary, if there's a little vault 0:03:49.240 --> 0:03:50.960 and that's where all your eggs are kept. So when 0:03:51.000 --> 0:03:53.600 you're born, you're vault is full. You lose eggs out 0:03:53.600 --> 0:03:55.480 of the vault. When the vault is empty, you go 0:03:55.520 --> 0:03:58.520 in him in a pause. What actually happens every month 0:03:58.600 --> 0:04:01.560 is that a group of eggs is released from the vault. 0:04:01.600 --> 0:04:04.880 At one time, one of these is chosen to ovulate, 0:04:05.280 --> 0:04:07.800 the rest of them die, and the next month another 0:04:07.840 --> 0:04:10.520 group comes out. And you can't change this process. Meaning 0:04:10.520 --> 0:04:12.880 when you're pregnant, it happens, when you're on birth control pills, 0:04:12.880 --> 0:04:15.680 it happens. We're always losing eggs out of that vault. 0:04:16.120 --> 0:04:18.240 But the number of eggs that come out of the 0:04:18.320 --> 0:04:22.400 vault is correlated to the number that is inside the vault, 0:04:22.480 --> 0:04:26.279 meaning when you're vults really full, you release more every month, 0:04:26.560 --> 0:04:28.400 and when you're about to go into menopause you only 0:04:28.440 --> 0:04:31.760 release a couple. This is a fact I've never known 0:04:31.800 --> 0:04:34.200 any of this. I'm already mind blown. Okay, okay, we're 0:04:34.200 --> 0:04:36.479 about to blow your mind. So when you do I 0:04:36.600 --> 0:04:39.719 v F for egg freezing, like real big picture. All 0:04:39.760 --> 0:04:41.599 I'm trying to do is get the eggs that have 0:04:41.720 --> 0:04:44.320 come out of the vault for this one month to grow, 0:04:44.760 --> 0:04:46.400 and then I'm going to take those eggs out of 0:04:46.400 --> 0:04:50.640 your body. So instead of, for example, having twenty eggs 0:04:50.640 --> 0:04:53.520 come out of the vault, one ovulates and nineteen die, 0:04:53.960 --> 0:04:57.320 I'm trying to say, hey this month, hey, March of two, 0:04:57.800 --> 0:05:00.040 I want to get all twenty eggs to grow. So 0:05:00.040 --> 0:05:01.920 I'm gonna give you hormone chots to get all those 0:05:01.960 --> 0:05:04.120 eggs to grow, and then I'm going to take them 0:05:04.120 --> 0:05:05.880 all out of your body at one time. So that's 0:05:05.880 --> 0:05:10.440 what the egg retrieval is. So Number one, understanding how 0:05:10.440 --> 0:05:13.080 many eggs you might have is really helpful because it 0:05:13.160 --> 0:05:15.160 changes how we get them all to grow. But also 0:05:15.440 --> 0:05:19.400 set your expectations appropriately, and that's one thing that all 0:05:19.440 --> 0:05:22.159 women can handle this process, but we're really bad. Just 0:05:22.279 --> 0:05:25.280 as a whole of walking blindly through a forest when 0:05:25.320 --> 0:05:28.080 you have no idea what's coming, everything is going to 0:05:28.200 --> 0:05:31.120 be harder. But if you have somebody who tells you, hey, 0:05:31.320 --> 0:05:33.760 you have less than average for your age, and that's 0:05:33.800 --> 0:05:35.880 why you're going to get fewer than your best friend 0:05:35.920 --> 0:05:38.440 when she goes through this process, it helps you set 0:05:38.440 --> 0:05:41.560 parameters for expectations. So we can see how many eggs 0:05:41.560 --> 0:05:43.720 are outside the vault by ultrasound and a blood test 0:05:43.760 --> 0:05:46.200 called a m H. So those things help us quantify 0:05:46.680 --> 0:05:50.280 number of eggs. Are they always correct? They give us 0:05:50.320 --> 0:05:54.160 categories like average for your age, above average, below average, 0:05:54.160 --> 0:05:57.839 because your body is setting an actual number every month. 0:05:57.920 --> 0:06:01.560 So if I say average for a thirty year old 0:06:01.600 --> 0:06:03.200 is going to be twenty eggs out of the vault 0:06:03.320 --> 0:06:05.600 one month, and maybe twenty and then eighteen and the 0:06:05.760 --> 0:06:10.200 nineteen and so there's some variation. But the other thing 0:06:10.240 --> 0:06:12.880 that happens is that, and we all peripher a Y 0:06:12.960 --> 0:06:16.360 know this. The quality of eggs starts to decrease as 0:06:16.360 --> 0:06:20.960 we get older. Genetic stability inside the eggs decreases. I 0:06:21.040 --> 0:06:23.719 like to think about those eggs inside the vault taking 0:06:23.720 --> 0:06:25.800 the wear and tear of your life. They're breaking down. 0:06:25.839 --> 0:06:28.719 The proteins are breaking down, and just like our joints 0:06:28.720 --> 0:06:30.320 get sore as we get older and we get wrinkles 0:06:30.320 --> 0:06:32.240 on our face, the same thing starts to happen inside 0:06:32.240 --> 0:06:34.880 our eggs. So at age thirty, the number that's like 0:06:35.600 --> 0:06:39.240 brandished in our brain as women, approximately half your eggs 0:06:39.279 --> 0:06:41.200 are going to be normal and half of them are not. 0:06:41.720 --> 0:06:44.240 And this is why we start talking about doing IVF 0:06:44.800 --> 0:06:47.640 or egg freezing. Understanding how many eggs you have helps, 0:06:48.000 --> 0:06:52.240 but also understanding expectations for how many maybe genetically normal, 0:06:52.640 --> 0:06:56.279 sets the road of expectations. So it's kind of the basis. 0:06:56.279 --> 0:06:58.440 So we're gonna do IVF for egg freezing, I want 0:06:58.440 --> 0:07:00.880 to understand how old are you? How many eggs am 0:07:00.880 --> 0:07:03.479 I expecting to get. You're gonna take hormone shots for 0:07:03.520 --> 0:07:05.320 a couple of weeks, which are going to get the 0:07:05.320 --> 0:07:07.560 eggs to grow, and then you're gonna come in for 0:07:07.640 --> 0:07:10.720 the egg retrieval procedure. People are the most nervous or 0:07:10.760 --> 0:07:13.560 anxious about that procedure because it's like the big moment 0:07:13.680 --> 0:07:17.680 for egg freezing. It's really a minimally invasive procedure. There's 0:07:17.680 --> 0:07:20.920 no knives, there's one needle. Very simple compared to a 0:07:20.920 --> 0:07:24.160 lot of other procedures. It is done typically under a 0:07:24.280 --> 0:07:28.760 light anesthesia I think colonoscopy, so you're breathing on your own, 0:07:29.120 --> 0:07:32.400 no intubation, no breathing machine, none of that stuff. We 0:07:32.440 --> 0:07:34.320 don't want you to feel it. We do attach a 0:07:34.440 --> 0:07:37.200 really long y'all can't see me. My hands are very 0:07:37.240 --> 0:07:41.640 long right now, very long needle to the vaginal ultrasound 0:07:41.960 --> 0:07:44.360 and you can see it. It's a little bright white 0:07:44.400 --> 0:07:47.560 line on ultrasound. And we enter vaginally into the ovaries 0:07:47.600 --> 0:07:50.440 while we watch with the ultrasound, and you see these 0:07:50.480 --> 0:07:54.000 follicles that have grown, these small fluid filled structures. Each 0:07:54.000 --> 0:07:56.440 one house is an egg. It will enter into a 0:07:56.520 --> 0:08:00.320 little follical. The little follical drains and collapses and you 0:08:00.360 --> 0:08:04.040 get test tubes follow all that folicular fluid and eggs. 0:08:04.560 --> 0:08:08.920 When did this egg freezing procedure first exist? So the 0:08:08.960 --> 0:08:13.320 oldest IVF baby is like forty one, So that's the 0:08:13.360 --> 0:08:16.800 oldest person who's been born from IVF. When ivy A 0:08:16.920 --> 0:08:19.600 first started, we didn't have medications to make more than 0:08:19.640 --> 0:08:23.600 one eggrow at a time, so we followed somebody's natural ovulation, 0:08:24.080 --> 0:08:27.600 trying to watch the one egg get mature. Oh my god, 0:08:27.720 --> 0:08:30.280 what a pain in the ass. And then you don't 0:08:30.280 --> 0:08:33.120 have this minimally invasive ego trievill Katie. They would go 0:08:33.360 --> 0:08:36.360 like a surgery, a real life surgery through the abdomen 0:08:36.640 --> 0:08:40.000 into yeah, yeah, and they would sack a needle into 0:08:40.040 --> 0:08:42.160 that one little follicle. You get one little shot at it, 0:08:42.160 --> 0:08:44.080 but you have to be like general anesthesia all the 0:08:44.080 --> 0:08:49.440 way asleep. Wow, you guys, this has come so far. 0:08:49.960 --> 0:08:52.200 Ain't that crazy? And you know it was so stigmatized. 0:08:52.200 --> 0:08:54.680 These women would go and they would have to spend 0:08:54.720 --> 0:08:57.640 a couple of weeks, like at the hotel outside the 0:08:57.720 --> 0:09:01.120 fertility clinic, because it's real sur tree. You don't want 0:09:01.120 --> 0:09:03.640 to miss that one egg window, one egg, it's all. 0:09:03.679 --> 0:09:06.320 I'd imagine you're waiting on this one moment to maybe 0:09:06.400 --> 0:09:09.959 have surgery the next day for your IVF, and if 0:09:09.960 --> 0:09:12.199 you miss it and you ovulate, then you gotta wait 0:09:12.240 --> 0:09:14.360 a whole another month to get it. I v F 0:09:14.440 --> 0:09:19.560 has changed so far, and sometimes we take for granted 0:09:19.600 --> 0:09:22.840 how great that is that we can improve these odds 0:09:22.880 --> 0:09:26.280 so amazing by having these medications, did it used to 0:09:26.360 --> 0:09:29.880 be even more expensive. They did, and because it was 0:09:29.920 --> 0:09:33.040 so much less successful, you have to do it multiple times, 0:09:33.040 --> 0:09:35.400 and there wasn't just the availability to do that because 0:09:35.400 --> 0:09:37.920 there were you know, women and couples who wanted to 0:09:37.960 --> 0:09:40.679 do this, and if you could only cycle one patient, 0:09:40.760 --> 0:09:44.000 you're watching them so closely. There's no way to scale. 0:09:44.000 --> 0:09:46.199 And there was originally one clinic in the US that 0:09:46.240 --> 0:09:49.120 didn't and now there's tons of great fertility clinics and 0:09:49.200 --> 0:09:53.040 good places you can go. So when the day we 0:09:53.160 --> 0:09:55.520 get the eggs out of the egg retri bo, we 0:09:55.600 --> 0:09:58.360 consider ovulation day, so that's day zero, so that would 0:09:58.360 --> 0:10:01.320 be equating it to natural cons option. The day that 0:10:01.360 --> 0:10:04.319 an egg is released from the ovary. We then if 0:10:04.360 --> 0:10:08.560 we were doing IVF and going to make embryos, we 0:10:08.600 --> 0:10:11.120 get a sperm, example that same day as day zero, 0:10:11.600 --> 0:10:14.880 and then we fertilize the eggs with the sperm. Does 0:10:14.920 --> 0:10:17.360 it have to happen on day zero? It does if 0:10:17.400 --> 0:10:19.800 you're gonna make embryos, it does. Otherwise the eggs have 0:10:19.840 --> 0:10:22.920 to be frozen. They only live for twenty four hours 0:10:22.920 --> 0:10:25.160 that's in the body or out, meaning if you don't 0:10:25.200 --> 0:10:27.560 get them fertilized at just the right time, they are 0:10:27.640 --> 0:10:30.640 going to seal off and be they cannot be penetrated 0:10:30.679 --> 0:10:35.280 by sperm. This is so stressful. So the egg is 0:10:35.280 --> 0:10:38.920 this tiny little window. So in an IVF cycle, luckily 0:10:38.960 --> 0:10:40.480 we know exactly what it is. We just took the 0:10:40.480 --> 0:10:43.880 egg out of the body. Most places are now doing 0:10:43.920 --> 0:10:46.920 a type of fertilization called X which means you take 0:10:47.000 --> 0:10:49.200 up a little sperm and a little pipette and you 0:10:49.320 --> 0:10:51.680 crack open the egg and you put the sperm inside. 0:10:52.400 --> 0:10:55.760 That's the newest and gives us the highest fertilization rates. 0:10:55.800 --> 0:10:58.560 These embryologists are amazing. These are the people who train 0:10:58.640 --> 0:11:01.520 years to be able to these micro manipulation techniques under 0:11:01.559 --> 0:11:04.200 the microscope, so they Number one is the first thing, 0:11:04.200 --> 0:11:06.360 you have an actual embryo, meaning the egg is either 0:11:06.400 --> 0:11:09.520 accepted the sperm and divided or it has not, So 0:11:09.640 --> 0:11:13.320 that's when you have. However, many fertilized that normally happens 0:11:13.320 --> 0:11:16.160 in the fallopian tube. So for going back to natural conception, 0:11:16.600 --> 0:11:20.200 embryos fertilized in the fallopian tube. They then have to 0:11:20.320 --> 0:11:24.080 grow and develop from that little to cell embryo into 0:11:24.120 --> 0:11:27.720 about a three hundred cell blast asist over the next 0:11:27.760 --> 0:11:30.680 five to six days. That is where the embryo is 0:11:30.679 --> 0:11:33.320 separated into what will become the placinta and the baby. 0:11:33.720 --> 0:11:36.719 And essentially that is the implantation stage embryo. That's when 0:11:36.720 --> 0:11:40.200 an embryo could grow into the uterus. So normally that 0:11:40.240 --> 0:11:43.600 process takes five or six days from the fallopian tube 0:11:43.600 --> 0:11:46.440 to get in the uterus. And that's what's happening in 0:11:46.480 --> 0:11:50.280 the IVF lab, Meaning that's the environment where we're watching 0:11:50.320 --> 0:11:54.560 these little embryos growing culture. And I always say, not 0:11:54.640 --> 0:11:56.640 like our body, but the I v F flab is 0:11:56.960 --> 0:12:00.240 the perfect temperature and pH and there's no inflammation shan 0:12:00.400 --> 0:12:04.520 or toxins or others things. So it's this ideal environment. However, 0:12:05.160 --> 0:12:08.679 even in that ideal environment, not every egg will be fertilized. 0:12:09.120 --> 0:12:12.200 Not every fertilized egg will make it to a blast assist. 0:12:12.840 --> 0:12:15.720 Not every blast assist will be genetically normal. That's based 0:12:15.760 --> 0:12:19.600 on your age, and not every genetically normal blast assists 0:12:19.640 --> 0:12:22.840 will implant and become a baby. Is there a client's 0:12:22.880 --> 0:12:25.559 story that you can walk us through for a scenario example, 0:12:26.040 --> 0:12:28.360 think of someone you've worked with of how many eggs 0:12:28.440 --> 0:12:30.360 you lost through the process all the way to the 0:12:30.440 --> 0:12:35.440 birthing process. Let's pretend you're an average thirty two year old. 0:12:35.520 --> 0:12:37.679 You have about twenty eggs. Our goal is to try 0:12:37.720 --> 0:12:40.080 to get them all to maturity at the same pace. 0:12:40.640 --> 0:12:43.120 The body's goal is to not let that to happen, 0:12:43.240 --> 0:12:45.439 because your body doesn't want to have twenty babies at 0:12:45.440 --> 0:12:48.320 one time, so the ovary is going to resist that. 0:12:48.840 --> 0:12:52.000 We are typically unable to get every egg mature that 0:12:52.080 --> 0:12:54.000 we can, but we usually do a really good job. 0:12:54.280 --> 0:12:56.679 So most of the time you're going to see around 0:12:56.760 --> 0:13:00.640 eighty maturity. So let's say if we have twenty eggs, 0:13:00.679 --> 0:13:02.760 we go through the process, and let's say we get 0:13:03.000 --> 0:13:06.320 eighteen of the mature. Fantastic, they're frozen. We love it. 0:13:06.640 --> 0:13:09.800 About eighty five to nine of eggs survived. The freeese 0:13:09.840 --> 0:13:11.840 thought that's not a hundred. So you need to in 0:13:11.880 --> 0:13:15.120 your brain or have your doctor roll with you. Okay, 0:13:15.120 --> 0:13:18.160 I'm gonna lose a couple of eggs just from normal process. 0:13:18.720 --> 0:13:22.880 That number, just for comparison ten years ago was forty survival, 0:13:23.000 --> 0:13:27.040 So I just have ent survival, so way better. But 0:13:27.200 --> 0:13:29.480 so if I have eighteen eggs, okay, now in my brain, 0:13:29.559 --> 0:13:32.360 I lost two and that freeze thought process now I 0:13:32.400 --> 0:13:36.320 have sixteen six. Typical fertilization rates with sperm are going 0:13:36.360 --> 0:13:40.200 to be about seventy. So let's say of the sixteen, 0:13:40.559 --> 0:13:45.040 twelve of them have now fertilized. From there, about half 0:13:45.080 --> 0:13:48.559 of them will make it through to that blastess of stage. 0:13:48.840 --> 0:13:52.040 So now we're at six and then based on age, 0:13:52.120 --> 0:13:56.240 we would expect fifty to sixty percent normal, and so 0:13:56.360 --> 0:13:59.520 that would be okay, let's say conservatively three and then 0:13:59.600 --> 0:14:02.880 each of those is going to have approximately a sixty 0:14:03.679 --> 0:14:06.440 chance of a live birth. So in the math equation, 0:14:06.720 --> 0:14:11.280 we usually like having two embryos, and the equation for 0:14:11.360 --> 0:14:14.400 every baby you want to have. So in this one, 0:14:14.520 --> 0:14:17.600 you had eighteen mature eggs frozen. That's the number that's 0:14:17.600 --> 0:14:19.800 in your brain. I'm rolling around, I have eight team 0:14:19.840 --> 0:14:23.400 at your eggs. Wonderful. That makes us feel good for 0:14:23.440 --> 0:14:26.640 a baby and maybe a chance for a second baby. 0:14:26.680 --> 0:14:30.480 But if you are dead set I need two kids 0:14:30.480 --> 0:14:32.920 because my sister is my world and I would never 0:14:32.960 --> 0:14:35.280 want to have an only child, we're going to want 0:14:35.280 --> 0:14:37.240 to hire number than eighteen. And this is even in 0:14:37.280 --> 0:14:41.680 your early thirties, and so somebody should be working that 0:14:41.760 --> 0:14:45.200 equation for you. On the flip end. That should not 0:14:45.240 --> 0:14:47.400 scare anybody, right, don is the Hey, I'm trying to 0:14:47.440 --> 0:14:49.520 optimize this, and I want to put the numbers in 0:14:49.640 --> 0:14:53.440 my camp. I've had somebody go through and get three eggs. 0:14:53.480 --> 0:14:57.280 She had bad in demetriosis. She was thirty five. That's 0:14:57.280 --> 0:14:59.640 what we could get. She could only afford you the 0:14:59.640 --> 0:15:02.600 process once. When we went to thaw them, two of 0:15:02.640 --> 0:15:05.360 them fertilized, one of them grew out. It was normal. 0:15:05.520 --> 0:15:08.440 It is a living child now. So these numbers give 0:15:08.560 --> 0:15:12.360 us perspective, but it's also not everything. It is not everything, 0:15:12.400 --> 0:15:13.840 and it doesn't mean that if you have a low 0:15:13.880 --> 0:15:25.840 number it's not worth it. As you mentioned on your 0:15:25.880 --> 0:15:29.120 As a Woman podcast, it's important that you can view 0:15:29.160 --> 0:15:31.360 what you have as the assurance that it may or 0:15:31.400 --> 0:15:34.840 may not be. Why should we get our eggs harvested 0:15:34.960 --> 0:15:38.080 when there's such a low percentage that the eggs will 0:15:38.120 --> 0:15:41.600 even survive. That's a really good question. I always tell 0:15:41.800 --> 0:15:45.600 people just to think about their goals overall, and when 0:15:45.680 --> 0:15:48.640 we should start thinking about egg freezing is if we 0:15:48.720 --> 0:15:52.200 are in our early thirties or later and we're not 0:15:52.280 --> 0:15:55.160 ready to have a family. However, we know that is 0:15:55.200 --> 0:15:58.160 a goal. We don't want to let pass us by 0:15:58.640 --> 0:16:01.640 because we don't know if you are going to run 0:16:01.640 --> 0:16:04.680 out of eggs early, and what if you have missed 0:16:04.720 --> 0:16:08.440 your window of opportunity. This come about because we'll see 0:16:08.480 --> 0:16:12.080 women walk in the office at thirty nine and suddenly 0:16:12.120 --> 0:16:14.920 they have a very low account and they need IVF 0:16:15.040 --> 0:16:19.000 for whatever reason. But they're looking at multiple cycles, thousands 0:16:19.000 --> 0:16:21.240 and thousands of dollars. And if we had had a 0:16:21.320 --> 0:16:24.360 cohort of eggs that had a higher percentage genetically normal, 0:16:24.680 --> 0:16:27.440 and we had more of them, you just keep doors open. 0:16:28.240 --> 0:16:31.160 One thing I don't love is that people will often 0:16:31.360 --> 0:16:34.880 equate egg freezing to an insurance policy on their fertility, 0:16:34.960 --> 0:16:38.280 Like I'm insuring my fertility, And I always say, an 0:16:38.280 --> 0:16:41.720 insurance policy is a guarantee. Right if your house burns 0:16:41.760 --> 0:16:44.200 down and you have house insurance, you're going to get 0:16:44.240 --> 0:16:47.720 money for a new house. This is an investment. This 0:16:47.800 --> 0:16:50.760 is like the stock market. The return on that investment 0:16:51.160 --> 0:16:53.960 depends on the environment of which you're going to go 0:16:54.040 --> 0:16:57.080 cash it in on, meaning what's the sperm going to be, 0:16:57.200 --> 0:16:59.880 what is your medical condition? Other factors that we may 0:17:00.120 --> 0:17:03.120 be able to know right now do influence some of 0:17:03.160 --> 0:17:06.520 that progression through culture, and what your outcomes look like. However, 0:17:07.040 --> 0:17:09.280 investing your money is a good thing, and making smart 0:17:09.320 --> 0:17:12.960 financial investments are good, and so investing in yourself and 0:17:13.000 --> 0:17:16.800 your future. Fertility is something that has shown in studies 0:17:16.880 --> 0:17:19.240 even if you never go and use your eggs later, 0:17:19.960 --> 0:17:23.399 that it's giving you happiness along the process because it 0:17:23.440 --> 0:17:27.120 allows you to explore other relationships without feeling the pressure 0:17:27.600 --> 0:17:30.800 of that biological clock. Oh yeah, I've never had so 0:17:30.840 --> 0:17:35.320 many friends do a thing that has brought them peace 0:17:35.359 --> 0:17:38.600 of mind. I've had many friends who didn't even use them, 0:17:38.960 --> 0:17:41.359 and then I've had friends use them and both the same, 0:17:41.520 --> 0:17:45.040 Just very relieved and happy that the option was there 0:17:45.359 --> 0:17:48.480 and that they did it. For family planning, one thing 0:17:48.480 --> 0:17:50.960 we don't always think about is is not just about 0:17:51.000 --> 0:17:53.840 baby one or when you start your family. The good 0:17:53.880 --> 0:17:56.760 thing about having frozen eggs that are good quality and 0:17:56.880 --> 0:17:59.760 from when you were younger is that if you meet 0:17:59.800 --> 0:18:02.000 that life partner or you're ready to get pregnant with 0:18:02.040 --> 0:18:03.960 a sperm donor and be a single mom, whatever the 0:18:04.000 --> 0:18:06.359 situation is, how old are you going to be if 0:18:06.359 --> 0:18:08.040 you want to add a sibling to that? Right? How 0:18:08.040 --> 0:18:10.360 many years are going to pass before you're ready? And 0:18:10.400 --> 0:18:13.480 we know that those fertility rates, the egg number go down, 0:18:13.880 --> 0:18:17.080 the quality of the eggs becomes worse. So having those 0:18:17.119 --> 0:18:19.320 eggs expands what you might be able to have as 0:18:19.320 --> 0:18:22.879 far as a total family size, and that's important to 0:18:22.920 --> 0:18:26.399 people too. We often get really tunnel vision focused on 0:18:26.440 --> 0:18:29.359 that baby one. I see people come to me thirty 0:18:29.400 --> 0:18:31.320 eight or thirty nine. They're starting their family, but they 0:18:31.440 --> 0:18:33.680 really want to have three or four kids because they 0:18:33.680 --> 0:18:36.439 grew up with siblings, or they really want a big family. 0:18:36.480 --> 0:18:39.240 That's just part of this dream. And I'm I said 0:18:39.240 --> 0:18:40.880 here and say look at the math. If you got 0:18:40.880 --> 0:18:44.320 pregnant tomorrow, where are we more trying for baby two 0:18:44.359 --> 0:18:47.800 and three? And so very often if we're in those 0:18:48.040 --> 0:18:52.280 more advanced reproductive ages, we are looking at IVF and 0:18:52.320 --> 0:18:56.159 saving embryos for what we call embryo banking, maybe family 0:18:56.200 --> 0:18:58.520 planning goals. Hey, I'm for seeing that I want to 0:18:58.560 --> 0:19:00.960 have a kid in my four reason that may be tough, 0:19:01.000 --> 0:19:03.320 So I'm going to have some normal embryos right now 0:19:03.720 --> 0:19:06.399 when they're easier to get in fine, so I can 0:19:06.480 --> 0:19:08.280 achieve that goal. And that's why I think about the 0:19:08.280 --> 0:19:10.199 big picture, or not just the right now goal. But 0:19:10.240 --> 0:19:13.399 maybe your big picture goal, at least in your ideal world. 0:19:13.440 --> 0:19:15.959 We all know goals change and we feel different as 0:19:16.000 --> 0:19:18.920 time goes on. But if you can do something that's 0:19:18.920 --> 0:19:21.359 going to keep doors open or get you closer to 0:19:21.440 --> 0:19:25.520 achieving that reproductive goal, we shouldn't just ignore it, like 0:19:25.800 --> 0:19:27.520 you know so many of us did for so long, 0:19:27.960 --> 0:19:31.080 just because there there was no other option. The reality is, 0:19:31.119 --> 0:19:33.600 when I was the right age to freeze my eggs, 0:19:33.880 --> 0:19:35.639 I couldn't. There's nowhere that would have done it. It 0:19:35.680 --> 0:19:38.440 wasn't a thing that was offered because the technology wasn't 0:19:38.440 --> 0:19:40.520 as good. So, just as we talked about how the 0:19:40.560 --> 0:19:43.800 ivy of technology has gotten better, an egg is a 0:19:43.840 --> 0:19:47.000 single cell. A blast assist is three D cells, So 0:19:47.080 --> 0:19:50.359 freezing an embryo it is much stronger and sturdier, and 0:19:50.400 --> 0:19:54.639 they survive very well. A single cell mostly of water. 0:19:55.160 --> 0:19:58.440 I now need to freeze it, preserve its genetic integrity, 0:19:58.520 --> 0:20:01.080 and be able to thaw it with accuracy so that 0:20:01.119 --> 0:20:04.240 it can function and accept a sperm and become an embryo. 0:20:04.640 --> 0:20:07.400 That's pretty amazing when you think about what is happening, 0:20:07.720 --> 0:20:13.920 and so that technology changed from and the success rate 0:20:13.960 --> 0:20:17.520 of freezing and throwing eggs went up dramatically. That's when 0:20:17.520 --> 0:20:19.960 we started seeing this offered people getting trained in the 0:20:20.000 --> 0:20:22.480 new technology, and that's why now you have to wait 0:20:22.520 --> 0:20:26.320 till enough people get trained enough clinics. This does feel commonplace, 0:20:26.359 --> 0:20:28.280 and it does feel like you can walk in to 0:20:28.400 --> 0:20:30.639 any fertility clinic can get your eggs frozen. But ten 0:20:30.720 --> 0:20:34.680 years ago you definitely could not. That was not an option. Wow, 0:20:34.720 --> 0:20:37.679 I'm so relieved this has come so far. It's comes 0:20:37.760 --> 0:20:41.479 so far, and I think sometimes people carry these just ideas. 0:20:41.520 --> 0:20:45.119 Are that these misconceptions, which I completely understand. What are 0:20:45.119 --> 0:20:47.800 the biggest misconceptions when it comes to egg freezing. The 0:20:47.840 --> 0:20:50.880 biggest one that I see is that it's going to work. 0:20:50.920 --> 0:20:53.359 I'm going to do iba for I'm going to freeze 0:20:53.359 --> 0:20:56.840 my eggs and that will work for me. It has 0:20:56.880 --> 0:20:59.560 the highest chance of working. It's the only thing that 0:20:59.600 --> 0:21:03.359 exceeds natural conception. I mean, I have no other technology clothes, 0:21:04.080 --> 0:21:08.400 but it's not a guarantee. And that's really it's hard personally. 0:21:08.400 --> 0:21:10.240 It makes my job hard, but it's also hard for 0:21:10.280 --> 0:21:15.640 patients because it is financially very expensive. The other kind 0:21:15.680 --> 0:21:18.720