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Egg Freezing 101: Unpacking My Experience & Talking Fertility Q&A With Dr. Michelle Kappy · Hurdle with Emily Abbate

• 0:00
  Speaker 1: It's okay to just get information and just to make
• 0:03
  Speaker 1: a consult and talk to an expert and then decide
• 0:07
  Speaker 1: from there.
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  Speaker 2: Hey everyone, Emily Badi here, you are listening to another
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  Speaker 2: episode of Hurdle, a podcast featuring the mindset, secrets, and
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  Speaker 2: true stories of the most inspiring woman in sports and wellness,
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  Speaker 2: empowering you to live a healthier, happier, more motivated life
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  Speaker 2: and of course, conquer your own hurdles.
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  Speaker 3: This week's episode is a little different.
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  Speaker 4: Than your usual are usual, and that is because I
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  Speaker 4: am talking about my egg freezing experience with the woman
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  Speaker 4: who helped me go through it all. Her name is
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  Speaker 4: doctor Michelle Cappy.
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  Speaker 2: She is an OBG I n at spring At Fertility,
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  Speaker 2: and it was really important to me to do this.
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  Speaker 3: It's important for me to do this because.
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  Speaker 2: I went into that experience back in March feeling like
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  Speaker 2: I wanted more information. I was craving to learn wherever
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  Speaker 2: I could, from whoever I could, to make the experience
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  Speaker 2: feel a.
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  Speaker 3: Little bit easier. It's overwhelming. It's something that I did
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  Speaker 3: not take lightly.
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  Speaker 2: It's something that I thought long and hard about if
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  Speaker 2: it was for me, and I talk about that with
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  Speaker 2: doctor KAPPI in today's episode, amongst many other things I
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  Speaker 2: do want to say before I get into the specifics
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  Speaker 2: of what we chat about in today's podcast. I did
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  Speaker 2: my egg freezing at a fertility clinic here in New
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  Speaker 2: York City called Spring Fertility. I paid for it in full.
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  Speaker 2: I was not gifted any part of this. Spring is
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  Speaker 2: a full service fertility clinic that specializes in IVF, egg
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  Speaker 2: freezing and third party reproductive services such as sergacy and
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  Speaker 2: donor tissue. They've got locations here in New York and
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  Speaker 2: Long Island, but as well as San Francisco Bay Area
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  Speaker 2: and Portland, Oregon. And it was important for me to
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  Speaker 2: tell you about this and then because I really appreciated
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  Speaker 2: their patient centric approach. It is so intimidating all of this,
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  Speaker 2: and so many women that I spoke to about their
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  Speaker 2: experience talked about feeling like just another number. I mean,
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  Speaker 2: every day that I would go into the clinic, there
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  Speaker 2: were so many women there waiting for care, and it
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  Speaker 2: felt so wonderful to feel like I mattered in all
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  Speaker 2: of this.
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  Speaker 3: I had a.
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  Speaker 2: Massive, it felt like team of people rallying around me,
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  Speaker 2: access to a patient portal where I could communicate directly
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  Speaker 2: with my financial coordinator and my patient care advocate, and
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  Speaker 2: my doctor directly and nurses, and there were just so
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  Speaker 2: many people on my team, and so I really appreciated
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  Speaker 2: the support at Spring doing this thing that was so
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  Speaker 2: emotionally involved and taxing, and so I wanted to bring
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  Speaker 2: doctor Cappy on the show to talk about everything.
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  Speaker 3: And we talk about everything.
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  Speaker 2: We talk about managing the logistics and the medication protocols.
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  Speaker 2: We talk about the reality of egg counts and attrition.
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  Speaker 2: I mean, results are highly individualized, cycle to cycle, in
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  Speaker 2: person to person, and it was so helpful for me
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  Speaker 2: to understand that there is a natural attrition that occurs
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  Speaker 2: from the number of follicles that you see at your
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  Speaker 2: first appointment to the final number of mature eggs that
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  Speaker 2: get frozen. We demystify what is often referred to as
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  Speaker 2: the cliff and have a real honest conversation about what
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  Speaker 2: happens biologically to egg quantity and quality as individuals head
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  Speaker 2: into their mid thirties. We talk about the uncertainty of
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  Speaker 2: fertility preservation. We talk about the difficulties that go hand
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  Speaker 2: in hand with doing this on your own, and how
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  Speaker 2: it felt for me to do it alone. We talk
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  Speaker 2: about the operation and the postop recovery and movement guidelines.
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  Speaker 3: We really talk about it all.
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  Speaker 2: So what I hope is that this episode brings you
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  Speaker 2: some of the things that I felt like I didn't
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  Speaker 2: have going into this process. From the jump, we get
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  Speaker 2: very specific and I open up about some details of
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  Speaker 2: my process, including numbers of follicles and eggs that we retrieved,
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  Speaker 2: and for some that can be understandably a very triggering thing,
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  Speaker 2: so I want to make sure that I disclaim that upfront. Again,
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  Speaker 2: my intention here, my goal here is to provide information
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  Speaker 2: that makes this feel a little less scary for others
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  Speaker 2: that are going through this, that are debating going through this,
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  Speaker 2: And if you do have any more questions anything, I'm
• 4:43
  Speaker 2: here to be as much of a help as I
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  Speaker 2: can as possible. You can always reach out to me
• 4:47
  Speaker 2: over email. It's hello at Hurdle dot us. Make sure
• 4:53
  Speaker 2: you're following along with Hurdle over on social It's over
• 4:55
  Speaker 2: at Hurdle podcast.
• 4:56
  Speaker 3: You can also check.
• 4:57
  Speaker 2: Out Iheartwoman Sports over at Iheartwoman Sports and me over
• 5:00
  Speaker 2: at Emily Body.
• 5:01
  Speaker 3: Listen to Hurdle with Emily A.
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  Speaker 2: Body on the iHeartRadio app, Apple Podcasts, or wherever you
• 5:07
  Speaker 2: get your podcasts and with that, let's get into it.
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  Speaker 2: Let's get to hurdling.
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  Speaker 3: Today.
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  Speaker 2: I am sitting down with doctor Michelle Cappy. She is
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  Speaker 2: a Board certified obgu I N a reproductive endocrinology and
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  Speaker 2: infertility specialist, also a fertility specialist at Spring Fertility. My doctor,
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  Speaker 2: doctor Kapy. Welcome to hurdle. How are we We're doing great.
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  Speaker 2: So nice to see you, Emily, so nice to see you.
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  Speaker 2: I feel like it's been forever, but also no time
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  Speaker 2: at all since I've seen you.
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  Speaker 1: I know, it's all out of sight, out of mine.
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  Speaker 1: Now you're on the other side, You're living your good life,
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  Speaker 1: which is which is wild? I know, how do you
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  Speaker 1: feel now?
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  Speaker 2: I feel I feel completely like myself and candidly, I
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  Speaker 2: felt like myself pretty quickly after the procedure. I would
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  Speaker 2: liken the first two days to kind of feeling like
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  Speaker 2: I had the flu, but like I wasn't congested, like my.
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  Speaker 3: Whole body just ached.
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  Speaker 2: And then within four days I really started to feel
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  Speaker 2: like myself, and I would say about a week later,
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  Speaker 2: generally speaking, I was back to normal exercise. Probably didn't
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  Speaker 2: feel normal for like maybe two weeks, but I was
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  Speaker 2: able to start jogging just over a week later.
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  Speaker 3: That's great.
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  Speaker 1: That sounds like a really normal post operative recovery. And
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  Speaker 1: for you to get back to a lot of movement
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  Speaker 1: was a big deal. I know, we sort of talked
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  Speaker 1: about that, Yeah, you started. It was a thing important.
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  Speaker 1: It was a big deal.
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  Speaker 2: And it was also something that I had heard so
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  Speaker 2: many different varieties of or like versions of what movement
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  Speaker 2: could look like for an individual during this process, and
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  Speaker 2: I think I genuinely thought that I was going to
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  Speaker 2: be able to move more before the retrieval than I
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  Speaker 2: ultimately was able to.
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  Speaker 3: Hm hmm.
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  Speaker 1: Do you feel like you were putting some restrictions on
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  Speaker 1: yourself different than what I.
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  Speaker 3: Told you to do.
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  Speaker 2: You had told me that, you know, after a few
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  Speaker 2: days of the injections, that I probably would want to
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  Speaker 2: really just stick to walking around, And that's I mean,
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  Speaker 2: that's exactly what happened. And I'll let you explain why
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  Speaker 2: it is that you want to stick with that. But
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  Speaker 2: for me, it was like I got to this point
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  Speaker 2: pretty quickly into the injections process that like, I wasn't
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  Speaker 2: going anywhere fast.
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  Speaker 3: But why is it important.
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  Speaker 2: That an individual tapers down their movement while they're going
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  Speaker 2: through the stimulation.
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  Speaker 1: Yeah, one of my pet peeves actually is that old
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  Speaker 1: sense of you need to cold turkey, stop everything, stop moving,
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  Speaker 1: don't move your body. And I think that that's even
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  Speaker 1: more restrictive and overwhelming for a lot of people who
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  Speaker 1: like to move around. Especially in New York City. We
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  Speaker 1: have a lot of very career driven individuals, and movement
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  Speaker 1: is a part of people's day to day. So all
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  Speaker 1: that we want is safety and that's the main focus.
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  Speaker 1: Without making it seem so overwhelming to tell people that
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  Speaker 1: they should think of that as something that you would
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  Speaker 1: want to do, kind of an early pregnancy. I liken
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  Speaker 1: it to that oftentimes, because I want you to be moving.
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  Speaker 1: I don't want someone to get a blood clot. You
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  Speaker 1: should still be moving around enjoying your life. But the
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  Speaker 1: ovaries are on a blood supply, and as they're physically
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  Speaker 1: getting bigger with the days and days of stimulation medication,
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  Speaker 1: they're at increased risk for turning on themselves on that
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  Speaker 1: blood supply. That's called ovary intortionion. It's a surgical emergency.
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  Speaker 1: It's really serious, it hurts a lot, and so that's
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  Speaker 1: the risk in all of this. And so as the
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  Speaker 1: ovaries are getting bigger. We don't want them to twist,
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  Speaker 1: and so doing things like walking around you can walk
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  Speaker 1: for miles, not doing things that really stress the body.
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  Speaker 1: So for you, that's no marathon training. That's things like
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  Speaker 1: not doing a Berrie's boot Camp class where you're doing
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  Speaker 1: a lot of jumping or acrobatics. But long walks are fine,
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  Speaker 1: even modified pilates and yoga, just not doing a lot
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  Speaker 1: of Russian twists or things where you're stressing the abdominal core. Yeah,
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  Speaker 1: but things can be modified, and I encourage people to
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  Speaker 1: continue moving just with modifications.
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  Speaker 3: Yeah.
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  Speaker 2: I mean, it had been other than an injury, it
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  Speaker 2: had been a while where I had truly taken like
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  Speaker 2: a three week step back from movement. I mean, all
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  Speaker 2: things considered, I think we did injections for something like
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  Speaker 2: twelve thirty in fourteen days, and then there's that week
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  Speaker 2: period after you do the retrieval, and so it was
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  Speaker 2: humbling getting back into the swing of things, for sure.
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  Speaker 1: Yeah, do you feel like you're happy that you followed
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  Speaker 1: the rules and restricted yourself knowing that it could be physically.
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  Speaker 3: Dangerous to you. You're like, so everyone really listen when
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  Speaker 3: I say please be careful.
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  Speaker 2: I know, I really did, and I felt like it
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  Speaker 2: was me taking a different type of time for myself.
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  Speaker 2: I think that there's something really beautiful when it comes
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  Speaker 2: to both weightlifting and running, which are the two ways
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  Speaker 2: that I move most often. There's something really beautiful about
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  Speaker 2: the therapeutic qualities that both of those activities bring. But
• 10:46
  Speaker 2: it was almost like I protected the walk, like the
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  Speaker 2: walk became my solace, my opportunity to spend some time
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  Speaker 2: with myself to process some of the thoughts, the feelings,
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  Speaker 2: the emotions that I was dealing with as a part
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  Speaker 2: of this process.
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  Speaker 3: And so so I really really liked it.
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  Speaker 2: But it was super interesting because I could truly see
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  Speaker 2: the decline of what I felt like was good for
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  Speaker 2: me or what I was capable of. It was like,
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  Speaker 2: maybe say on day five, I'm walking on the treadmill
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  Speaker 2: and I'm at something like a four point zero, and
• 11:17
  Speaker 2: literally on day six, I was like, oh, we are
• 11:20
  Speaker 2: not max and above a three here, Like this is
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  Speaker 2: just not what feels good for my body for a
• 11:26
  Speaker 2: myriad of reasons, some of which we'll get into in
• 11:28
  Speaker 2: a little bit. But I just I felt really in
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  Speaker 2: tune with what was happening, and I'm happy that I
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  Speaker 2: tapered it in.
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  Speaker 1: Yeah, and that's really impressive because not everyone is as
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  Speaker 1: in tune with their bodies. But I think something that
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  Speaker 1: you mentioned is really important. Creating a little bit of
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  Speaker 1: a routine in all of this newness, whether it's journaling
• 11:50
  Speaker 1: or acupuncture, or going for those walks or treating yourself
• 11:54
  Speaker 1: to a meal, having a music session, all that's really
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  Speaker 1: important and good for mental health, good for the stress
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  Speaker 1: of everything that's going on. And so I love that
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  Speaker 1: you had that time and made it special.
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  Speaker 2: Oh, there was a whole routine, especially for the injections.
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  Speaker 2: I want to hear there was music playing. It wasn't
• 12:12
  Speaker 2: a specific song, but I'm forgetting. A girlfriend of mine
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  Speaker 2: did her injection shortly after me, and she would play
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  Speaker 2: like the exact same song every night, which I was like,
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  Speaker 2: that's another level of this.
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  Speaker 3: But there was music.
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  Speaker 2: And then after I was finished, every night, like there
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  Speaker 2: was definitely a sweet treat.
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  Speaker 3: It was like injection sweet treat. Oh yeah, in that
• 12:30
  Speaker 3: order you deserve it. Yes, I mean I'm a sweet
• 12:32
  Speaker 3: treat every night. So I think that that's great, But
• 12:35
  Speaker 3: of course you have to reward yourself.
• 12:37
  Speaker 1: Yeah, it is really a difficult process emotionally, physically, mentally,
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  Speaker 1: So those little rewards are so crucial.
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  Speaker 2: So I'm sure that so many women come to you
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  Speaker 2: similar to the way that I did, and they are
• 12:52
  Speaker 2: unsure if it's even something that they want to go
• 12:55
  Speaker 2: ahead with, large in part because yes, it can be overwhelming,
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  Speaker 2: and also it is an expensive decision, but also because
• 13:04
  Speaker 2: there's just so much unknown with it.
• 13:06
  Speaker 3: Talk to me a little.
• 13:07
  Speaker 2: Bit about how you speak to women who show up
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  Speaker 2: and they're like, I'm here because I feel like I
• 13:13
  Speaker 2: should be, but I have no idea if I want
• 13:16
  Speaker 2: to do this or not.
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  Speaker 1: I think that one of the first things I do,
• 13:20
  Speaker 1: and you may or may not remember, but I try
• 13:24
  Speaker 1: to meet people where they're at. So one of the
• 13:27
  Speaker 1: first things that I ask them are what are your
• 13:30
  Speaker 1: goals are? What can I do for you to help you? Because,
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  Speaker 1: just like you said, person A may not have the
• 13:37
  Speaker 1: same goals as person BE, even if what I see
• 13:41
  Speaker 1: on their chart is that they want fertility preservation, that
• 13:45
  Speaker 1: could be so different to each person. So I think
• 13:48
  Speaker 1: that that's really important if you have a partner, if
• 13:51
  Speaker 1: you don't have a partner, if this is really scary,
• 13:54
  Speaker 1: I may tailor the consult really differently. If you're extremely
• 13:59
  Speaker 1: unjure sure about this decision, Versus if you say, just
• 14:02
  Speaker 1: tell me the time and place and I want to
• 14:04
  Speaker 1: do this immediately. There's a lot of education that has
• 14:08
  Speaker 1: to happen for everyone. I think that women, men in general,
• 14:13
  Speaker 1: people are not educated about their fertility at all, and
• 14:18
  Speaker 1: about infertility, about birth control, all of it. It's not
• 14:22
  Speaker 1: something that's part of our education system right now. So
• 14:26
  Speaker 1: I use a full hour to just educate and ask
• 14:30
  Speaker 1: them what they want to know, what their goals are.
• 14:34
  Speaker 1: And then for people who are more unsure or even
• 14:38
  Speaker 1: if you know, I think just to create a safe
• 14:42
  Speaker 1: space to say this is a conversation. You can take
• 14:45
  Speaker 1: this at face value. I can educate you. I can
• 14:48
  Speaker 1: tell you what I know. You can tell me what
• 14:49
  Speaker 1: you know, and have that conversation and get information, because
• 14:55
  Speaker 1: information gathering is one of the biggest goals that I
• 14:59
  Speaker 1: have for education, advocacy and information. So they can feel
• 15:05
  Speaker 1: armed with that empowerment and then you choose what to
• 15:09
  Speaker 1: do with that next. I like to set up after
• 15:11
  Speaker 1: we do an ultrasound and blood work, typically at the
• 15:14
  Speaker 1: first appointment, I like to set up a phone call
• 15:17
  Speaker 1: with my patients just to say, hey, this is what
• 15:20
  Speaker 1: we found. Let's regroup, let's talk about this. Not everyone
• 15:24
  Speaker 1: does that, by the way, I think that it's important
• 15:27
  Speaker 1: for me to connect with someone again, have them sit
• 15:30
  Speaker 1: with the information and take a little bit of time
• 15:35
  Speaker 1: for them to decide whether they want to move forward
• 15:39
  Speaker 1: or they just wanted the information, and then we talk
• 15:40
  Speaker 1: about that, and then we can talk about next steps
• 15:43
  Speaker 1: after that. Or someone can just say it was a
• 15:46
  Speaker 1: really great consult and I'm so glad that I did
• 15:48
  Speaker 1: that and I have that information, and that's that I'm
• 15:52
  Speaker 1: saying someone, you can have this information and maybe come
• 15:56
  Speaker 1: back in a few years. Maybe you don't need to
• 15:58
  Speaker 1: do anything, or you're in a good place emotionally, physically
• 16:02
  Speaker 1: we talk about your ovarian reserve, and we don't need
• 16:06
  Speaker 1: to do anything else, right, and that's okay.
• 16:09
  Speaker 2: Yeah, I think a big thing that was I guess
• 16:13
  Speaker 2: scary is a big word. I don't think it was scary.
• 16:16
  Speaker 2: But the fact is is that I am turning thirty
• 16:19
  Speaker 2: eighth this week, and so.
• 16:23
  Speaker 3: I made it to thirty eight. And you know, we
• 16:26
  Speaker 3: hear so.
• 16:27
  Speaker 2: Much about the cliff of thirty five, which I would
• 16:32
  Speaker 2: love for you to talk a little bit about, because
• 16:34
  Speaker 2: I came in to spring, and I thought to myself, well, like,
• 16:38
  Speaker 2: I'm going to come here for this information. I'm going
• 16:40
  Speaker 2: to come here and like learn what I'm working with
• 16:43
  Speaker 2: and figure it out. So let's start by talking a
• 16:45
  Speaker 2: little bit about what this I'm using air quotes here,
• 16:48
  Speaker 2: what's the cliff and what do we need to know?
• 16:52
  Speaker 1: The ominous cliff is this biological clock that unfortunately really
• 16:59
  Speaker 1: is a thing. It is a biological change in the
• 17:05
  Speaker 1: human body. For women, if you're born biologically female, you
• 17:11
  Speaker 1: experience a change in the chromosomes of your egg The
• 17:17
  Speaker 1: eggs are in your body from before you're born, so
• 17:22
  Speaker 1: you're born with all the eggs are ever going to have.
• 17:24
  Speaker 1: When you're actually when your mother is five months pregnant,
• 17:27
  Speaker 1: that's actually when you have the most eggs. You have
• 17:30
  Speaker 1: six to seven million eggs, and by the time you're
• 17:32
  Speaker 1: born you take your first breath, it goes down to
• 17:35
  Speaker 1: one to two million, So that's actually the largest amount
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  Speaker 1: of attrition that someone has in their eggs. And then
• 17:42
  Speaker 1: once you hit your puberty, your ovulation, it goes down
• 17:46
  Speaker 1: to about three to five hundred thousand eggs. And what
• 17:49
  Speaker 1: happens is those eggs don't regenerate so if you have
• 17:56
  Speaker 1: your skin cells, your hair cells, if you're a male,
• 18:00
  Speaker 1: your sperm cells regenerate every so often, whether it's months
• 18:05
  Speaker 1: to years, those cells are regenerating, but your egg cells don't.
• 18:10
  Speaker 1: So once they're gone, they're gone. There's a lot of
• 18:13
  Speaker 1: research being done about ovarian aging and what.
• 18:16
  Speaker 3: We can do to slow that process.
• 18:18
  Speaker 1: But in this day and age, right now, in technology,
• 18:23
  Speaker 1: we cannot reverse age are ovaries and our eggs. So
• 18:29
  Speaker 1: when we get into our mid thirties, really around the
• 18:32
  Speaker 1: age thirty five thirty six, we start to see a
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  Speaker 1: change both in the genetics of the eggs, the quality
• 18:39
  Speaker 1: and the quantity of eggs. So it really is a
• 18:43
  Speaker 1: drastic change. This is based on a lot of population
• 18:47
  Speaker 1: data that we've had, so I would not call it
• 18:50
  Speaker 1: a cliff Necessarily, you're not at your thirty fourth birthday
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  Speaker 1: partying it up and then you hit thirty five and
• 18:58
  Speaker 1: you just go into a black hole, no longer fertile.
• 19:01
  Speaker 1: But there is a really drastic decline in fertility and
• 19:06
  Speaker 1: all fertility related outcomes, so pregnancy rates, live birth rates,
• 19:11
  Speaker 1: and IVF efficiency. So it's really tough because I want
• 19:18
  Speaker 1: people to understand that there is going to be a
• 19:20
  Speaker 1: change that happens for women specifically, which of course is unfair,
• 19:25
  Speaker 1: but it's important people understand that and are proactive about
• 19:29
  Speaker 1: it and prepare for it. Now, that doesn't mean that
• 19:34
  Speaker 1: you have to do something, but at least to know
• 19:37
  Speaker 1: and be armed with that information I think is worthwhile.
• 19:41
  Speaker 3: Yeah, super helpful.
• 19:42
  Speaker 2: So if you had to give an average amount of
• 19:47
  Speaker 2: eggs that you maybe a range obviously that women would have,
• 19:52
  Speaker 2: let's say around age thirty versus age thirty five, what
• 19:55
  Speaker 2: do you typically see in that range?
• 19:59
  Speaker 1: It's we have to create a range necessarily. But if
• 20:04
  Speaker 1: you're coming in because you could be someone who has
• 20:07
  Speaker 1: a high ovarian reserve or a low ovarian reserve in general,
• 20:11
  Speaker 1: and what I mean by ovarian reserve is having the
• 20:16
  Speaker 1: egg count. So what you have both in your vault
• 20:21
  Speaker 1: that is in your non accessible egg vault as well
• 20:26
  Speaker 1: as what is the functional egg count that we can
• 20:30
  Speaker 1: see on ultrasound. So at your first appointment, we took
• 20:33
  Speaker 1: a look on the ultrasound at your ovaries. We looked
• 20:36
  Speaker 1: at your little follicles. It's the bubbles that contain the eggs,
• 20:42
  Speaker 1: and that's your functional group of eggs. So in general,
• 20:48
  Speaker 1: we're looking at somewhere between like tens to teens on average,
• 20:53
  Speaker 1: but it's really different for everyone, and someone could have
• 20:56
  Speaker 1: a high ovarian reserve or a low ovarian reserve, and
• 21:01
  Speaker 1: so it's important to just know that information because you
• 21:04
  Speaker 1: don't know if you don't look.
• 21:06
  Speaker 2: Yeah, and what I found to be really interesting, And
• 21:09
  Speaker 2: in the interro to this episode, I'm going to disclaim
• 21:11
  Speaker 2: that we're going to talk numbers and everything. But when
• 21:13
  Speaker 2: I came in, I think in our first appointment, we
• 21:16
  Speaker 2: saw something like thirty six follicles, Like it was a
• 21:19
  Speaker 2: lot of follicles, and I remember being extremely surprised by
• 21:23
  Speaker 2: that because that's not what I had heard from other
• 21:27
  Speaker 2: friends experiences who are of a similar age to me.
• 21:32
  Speaker 2: So coming in it was like I felt really excited
• 21:35
  Speaker 2: about that information. And then I talked to so many
• 21:38
  Speaker 2: women who some maybe had a similar experience, and then
• 21:43
  Speaker 2: they walked out with three or four viable X.
• 21:46
  Speaker 3: Right. So everyone is just so different, so.
• 21:50
  Speaker 1: Different, And I try to say that to everyone that
• 21:52
  Speaker 1: you have to have blinders on because you could be
• 21:55
  Speaker 1: doing it at the same time as your best friend.
• 21:58
  Speaker 1: Maybe you're the same age, you do the same exercises,
• 22:02
  Speaker 1: you live a healthy life, same diet, but you could
• 22:05
  Speaker 1: have two completely different ovarian reserves. Yeah, And so just
• 22:09
  Speaker 1: knowing what yours is and working with that and trying
• 22:13
  Speaker 1: to say, I cannot replicate what my best friend is
• 22:16
  Speaker 1: doing or someone who's in the same situation as me,
• 22:20
  Speaker 1: because they could respond differently to the SAI dose.
• 22:23
  Speaker 3: You can respond differently cycle to cycle.
• 22:25
  Speaker 1: That's what's crazy to Yeah, So it's really individualized person
• 22:30
  Speaker 1: to person.
• 22:30
  Speaker 2: And I think that was something else that I didn't
• 22:33
  Speaker 2: really have a foundational understanding going into this on, which
• 22:38
  Speaker 2: was that you could have a really big ovarian reserve
• 22:42
  Speaker 2: and not yield a lot of eggs at the end
• 22:45
  Speaker 2: of it, and that many women will go through multiple
• 22:50
  Speaker 2: cycles to harvest and it sounds like such a funny
• 22:53
  Speaker 2: word to use, but to harvest as many eggs as possible.
• 22:56
  Speaker 2: That one cycle for me was like, so it was difficult.
• 23:01
  Speaker 2: I wouldn't say that it was so difficult that I
• 23:03
  Speaker 2: would say to someone, oh, I'd never want to do
• 23:05
  Speaker 2: that again if my goal was to harvest more eggs.
• 23:08
  Speaker 3: But it was difficult.
• 23:09
  Speaker 2: So I do see some of my friends that are
• 23:12
  Speaker 2: going through this now and they are looking for a
• 23:14
  Speaker 2: greater result, and they're doing multiple cycles, and my heart
• 23:17
  Speaker 2: just breaks for them knowing how it feels to be
• 23:20
  Speaker 2: doing the injections and going through the whole process.
• 23:22
  Speaker 3: Like it's just a lot.
• 23:24
  Speaker 1: Absolutely, it's a lot physically, emotionally, mentally, And we certainly
• 23:30
  Speaker 1: have patients who come in and they go through a
• 23:34
  Speaker 1: cycle multiple times and maybe they get an egg at
• 23:38
  Speaker 1: the end of it, maybe they don't. It all depends
• 23:40
  Speaker 1: on where someone's starting off, and sometimes people don't grasp
• 23:45
  Speaker 1: the fact that you could do nothing wrong, you could
• 23:48
  Speaker 1: have lived the most wonderful, healthy, optimal life. And it's
• 23:53
  Speaker 1: more of a factor of genetics and age and chronic inflammation.
• 23:57
  Speaker 3: So there's a lot that goes into it.
• 24:00
  Speaker 1: But I try to tell people to have blinders on
• 24:04
  Speaker 1: because otherwise you compare, you compare yourselves to others.
• 24:24
  Speaker 2: Something that's important to touch on here is also that
• 24:27
  Speaker 2: depending on you your situation, your blinders on, you might
• 24:32
  Speaker 2: have a different set of medications that you might use
• 24:36
  Speaker 2: than somebody else, which is also something that I didn't
• 24:39
  Speaker 2: know about going into this. Now there is some commonalities,
• 24:43
  Speaker 2: but let's talk a little bit about how those medications
• 24:45
  Speaker 2: can change and why they would change.
• 24:47
  Speaker 1: Yeah, so there are a bunch of different protocols that
• 24:51
  Speaker 1: we have at our disposal, and what we have in
• 24:54
  Speaker 1: the US might actually be a little bit different than
• 24:57
  Speaker 1: how they practice in another country Europe especially. We have
• 25:01
  Speaker 1: some patients who come from there and they had a
• 25:05
  Speaker 1: different set of medications, both in name and in what
• 25:09
  Speaker 1: their doctor and practice used. But typically you want to
• 25:15
  Speaker 1: be utilizing a couple of injectable medications. So for you,
• 25:23
  Speaker 1: we made sure to use something called fallistim organi LEF
• 25:27
  Speaker 1: as well as men appure. These are medications that combine
• 25:32
  Speaker 1: follicle stimulating hormone LH hormones that are going to activate
• 25:38
  Speaker 1: at the brain level to get to the ovary to
• 25:41
  Speaker 1: say to the eggs, we want you to come out.
• 25:44
  Speaker 3: Let's go yeah.
• 25:45
  Speaker 1: So I like to call it kind of egg food.
• 25:49
  Speaker 1: Sometimes people also use pills. You can use a pill
• 25:54
  Speaker 1: to add a little bit of oomph to the process,
• 25:57
  Speaker 1: something like clomate and letrozol to try to get more
• 26:02
  Speaker 1: follicles to grow. You can also use a pill called
• 26:05
  Speaker 1: provera to be used as an antagonist to make you
• 26:10
  Speaker 1: not ovulate early. So the third medication that's an injectible
• 26:14
  Speaker 1: that we often use is an antagonist called ganerelics. Or centritide,
• 26:19
  Speaker 1: And the purpose of that is so that we want
• 26:22
  Speaker 1: you to ovulate your eggs, but at the right time,
• 26:25
  Speaker 1: once we think they're going to be at the correct
• 26:27
  Speaker 1: developmental stage or mature, so we don't want them to
• 26:31
  Speaker 1: be ovulated early. So that's why we do that third medication,
• 26:34
  Speaker 1: whether it's a pill or injectible, And that's sort of
• 26:38
  Speaker 1: how we do majority of the cycles. In some protocols,
• 26:43
  Speaker 1: we may start at a different time. You don't have
• 26:46
  Speaker 1: to start at the beginning of your menstrual cycle. You
• 26:48
  Speaker 1: can start halfway through in the second half. You can
• 26:51
  Speaker 1: take a medication to kind of pause your cycle or
• 26:54
  Speaker 1: do a priming. There's a lot of variation there, but
• 26:57
  Speaker 1: the important part is that I like to look and
• 27:00
  Speaker 1: at spring we look at your individual situation. So in
• 27:05
  Speaker 1: encompassing your weight, your age, your ovarian reserve, your goals,
• 27:09
  Speaker 1: your timeline, and creating an individualized protocol for you that
• 27:14
  Speaker 1: might be different than someone in a similar situation or
• 27:18
  Speaker 1: someone who has a different ovarian reserve.
• 27:21
  Speaker 2: Yeah, and so all of those different medications, what they'll
• 27:24
  Speaker 2: do typically is or what happened for me was that
• 27:27
  Speaker 2: they outlined exactly what I would need the doses of everything.
• 27:31
  Speaker 2: It gets sent to a pharmacy and they estimate how
• 27:35
  Speaker 2: much it's going to cost. And there were a couple
• 27:37
  Speaker 2: of different options, like there was a spring, an option
• 27:40
  Speaker 2: where I could go like all in and pick the
• 27:42
  Speaker 2: medication package, which was one cost, and then there was
• 27:46
  Speaker 2: another option where I would just pay for the medications
• 27:49
  Speaker 2: as I used them. And what had happened was the
• 27:52
  Speaker 2: financial team was like, Okay, based on the information that
• 27:55
  Speaker 2: doctor Cappy gave us, it seems as though it'll be
• 27:58
  Speaker 2: more affordable for you if you don't do the medication page,
• 28:00
  Speaker 2: you won't need that amount of medication, so this is
• 28:04
  Speaker 2: a more economical option for you. But all of that
• 28:07
  Speaker 2: to say, that process, I think was candidly probably the
• 28:11
  Speaker 2: most overwhelming part of it for me period, because you're
• 28:15
  Speaker 2: talking to a pharmacy, you don't know the answers, really
• 28:18
  Speaker 2: like I don't have the answers. I need someone else
• 28:21
  Speaker 2: to facilitate this, and that like cue other trauma, because
• 28:24
  Speaker 2: it's like I like to be independent, I like to
• 28:27
  Speaker 2: do things on my own, and I couldn't answer the
• 28:29
  Speaker 2: questions they were asking me, So it felt like really overwhelming,
• 28:33
  Speaker 2: and in New York, at least What is often the
• 28:38
  Speaker 2: case is that you're working with pharmacies that deliver these
• 28:41
  Speaker 2: medications to you.
• 28:42
  Speaker 3: So whereas if you have.
• 28:45
  Speaker 2: A conventional insurance that would cover some of this, you
• 28:48
  Speaker 2: might go to your regular pharmacy. For me, as someone
• 28:50
  Speaker 2: that was paying out of pocket, it went to a
• 28:52
  Speaker 2: new pharmacy.
• 28:53
  Speaker 3: I was unfamiliar with it.
• 28:54
  Speaker 2: So yeah, I would say that that part was probably
• 28:56
  Speaker 2: the most overwhelming part besides literally like when I came
• 28:59
  Speaker 2: out and I was done.
• 29:01
  Speaker 3: Yeah.
• 29:01
  Speaker 1: No, I hear that a lot, And it's really unfortunate
• 29:05
  Speaker 1: because you want to start off with someone in a
• 29:11
  Speaker 1: really good place, it's already going to be overwhelming, and
• 29:14
  Speaker 1: so we try as best we can to minimize the
• 29:17
  Speaker 1: anxiety before you even start, before you step in the
• 29:19
  Speaker 1: door to start your cycle. But sometimes there's pieces that
• 29:23
  Speaker 1: are out of our control. We don't have our own pharmacy.
• 29:26
  Speaker 1: No fertility center has its own pharmacy. So at Spring
• 29:30
  Speaker 1: they try to make it as economical as possible and
• 29:34
  Speaker 1: try to make it as easy as possible. But there's
• 29:37
  Speaker 1: going to be some snaff oos when it comes to
• 29:40
  Speaker 1: using an outside pharmacy, and I hear that a lot.
• 29:44
  Speaker 1: I think asking as many questions as you can to
• 29:48
  Speaker 1: your team clarifying what is my dose going to be?
• 29:51
  Speaker 1: What medications am I going to be using. You did
• 29:54
  Speaker 1: all the right things to try to arm yourself with
• 29:56
  Speaker 1: as much information as you can, because sometimes the pharmacies
• 29:59
  Speaker 1: will list out all of the prices that you had
• 30:03
  Speaker 1: if you had so much medication, and it's like, I
• 30:06
  Speaker 1: don't need fourteen thousand dollars worth of medication.
• 30:09
  Speaker 3: The thing is like, I didn't. I didn't know any better.
• 30:11
  Speaker 2: So I get the first estimate and I think it
• 30:13
  Speaker 2: said something like nine or ten thousand dollars, and I
• 30:16
  Speaker 2: was literally like, uh, did I miss something here because
• 30:21
  Speaker 2: that's not what I thought was gonna happen. And yeah,
• 30:23
  Speaker 2: like you don't know any better, so then you have
• 30:24
  Speaker 2: to go back and check and all these things. And
• 30:27
  Speaker 2: I think, you know, obviously a part that plays into
• 30:29
  Speaker 2: this is this I'm doing this on my own thing
• 30:34
  Speaker 2: that I'm sure you hear so much about from the
• 30:38
  Speaker 2: individuals that come into your office. It's like, this feels
• 30:41
  Speaker 2: so hard already, and sometimes you're just like, can someone
• 30:43
  Speaker 2: else just carry this burden for a little bit and
• 30:46
  Speaker 2: someone else just tell me what to do? And I
• 30:48
  Speaker 2: expressed to this frustration with a few friends, and some
• 30:51
  Speaker 2: of them told me that they actually paid nurses to
• 30:55
  Speaker 2: come to their homes and do the injections. I think
• 30:58
  Speaker 2: someone had price quoted me with something and maybe it
• 31:00
  Speaker 2: was like another fifteen hundred dollars or something. It wasn't
• 31:03
  Speaker 2: something that I felt like I really needed. But I mean,
• 31:05
  Speaker 2: if it's covered by your work or your insurance and
• 31:08
  Speaker 2: that's something that's interesting to you, then it's available.
• 31:12
  Speaker 1: Yeah, it's typically not a covered option for people. I
• 31:16
  Speaker 1: think a lot of fertilities out of pocket part for them. Right,
• 31:19
  Speaker 1: that would definitely be an out of pocket cost. I
• 31:22
  Speaker 1: think that fertility centers try to make it as manageable
• 31:26
  Speaker 1: as possible. Yeah, at Spring we do a medication class
• 31:29
  Speaker 1: that you can attend in person, you could do on zoom,
• 31:32
  Speaker 1: and then we send you videos. And I like to
• 31:34
  Speaker 1: send our patients instructions because everyone's a different learner a
• 31:39
  Speaker 1: visual They like to see things, read it. But there
• 31:43
  Speaker 1: are certainly people who just don't like needles or the
• 31:46
  Speaker 1: process is overwhelming and they just want, even if it's
• 31:49
  Speaker 1: the first or second time, to have someone do it
• 31:52
  Speaker 1: for them, show them exactly what to do. So I
• 31:54
  Speaker 1: think that's reasonable we offer that too, but it's really
• 32:01
  Speaker 1: just overwhelming. I think, like you said, more so even
• 32:04
  Speaker 1: before you get there and the anticipation of I'm doing
• 32:08
  Speaker 1: this alone or even if you do it with a
• 32:10
  Speaker 1: partner with a friend, it can be super overwhelming. So
• 32:14
  Speaker 1: there's the emotional and physical aspects of starting. But it's frustrating.
• 32:20
  Speaker 1: I hear you it's frustrated to deal with the pharmacies
• 32:23
  Speaker 1: and to get everything in order. And then you do.
• 32:26
  Speaker 1: Typically hear that people release a sigh after they have
• 32:30
  Speaker 1: all their medications. They know what they're doing, it's been
• 32:33
  Speaker 1: a few days and they get.
• 32:35
  Speaker 3: Into a groove.
• 32:36
  Speaker 1: But before you start, and when you're starting out that
• 32:38
  Speaker 1: first night, it's scary.
• 32:40
  Speaker 3: Yeah, it's scary.
• 32:41
  Speaker 2: I just I remember maybe the day before I started
• 32:45
  Speaker 2: the injections. I'm like sitting trying to deal with the
• 32:47
  Speaker 2: pharmacy and I'm just like sitting at my desk and
• 32:49
  Speaker 2: I feel so overwhelmed. And I literally just called my
• 32:53
  Speaker 2: friend and I was like, I just feel like I
• 32:55
  Speaker 2: need help. That's that I don't, like, I don't know
• 32:57
  Speaker 2: what to do, Like I don't know how to handle this.
• 32:59
  Speaker 2: I've never done before, and I mean, this is about
• 33:02
  Speaker 2: egg freezing. It's not about egg freezing. It's like, there
• 33:04
  Speaker 2: are so many instances in life where you're not going
• 33:06
  Speaker 2: to have the answers and all you can do is
• 33:08
  Speaker 2: the best you can with the resources that are available
• 33:10
  Speaker 2: to you, right, And so you know, I did the
• 33:13
  Speaker 2: best I could with the resources that were available to me.
• 33:15
  Speaker 2: And like you said, after I got to that first
• 33:17
  Speaker 2: night of injections, I had a friend came over and
• 33:20
  Speaker 2: she brought cookies and we like played music and it
• 33:23
  Speaker 2: was so funny. Hours before she showed up, she said,
• 33:25
  Speaker 2: so I just want to double check, like, am I
• 33:27
  Speaker 2: doing the injections?
• 33:29
  Speaker 3: And I'm like, oh my god.
• 33:30
  Speaker 2: Can you imagine if I invited you in my house
• 33:33
  Speaker 2: and I didn't tell you that I was hoping that
• 33:35
  Speaker 2: you would literally inject me with medication. No, I was like,
• 33:39
  Speaker 2: you are not doing the medication injecting. I was like,
• 33:42
  Speaker 2: you're just here for moral support.
• 33:43
  Speaker 3: She just had a kid. She is like a powerhouse.
• 33:46
  Speaker 3: She's great.
• 33:46
  Speaker 2: But I would, oh my god, I would never. I
• 33:49
  Speaker 2: would never. I mean, some people, hey, all the power
• 33:51
  Speaker 2: to you.
• 33:52
  Speaker 1: Yeah, I mean I have friends who are also patients,
• 33:55
  Speaker 1: and I either FaceTime with them or they come over
• 33:59
  Speaker 1: to my house and I do it for them. It's
• 34:01
  Speaker 1: certainly a lot to expect that lay people will be
• 34:07
  Speaker 1: able to inject themselves. Yeah, and mix things. It's very
• 34:11
  Speaker 1: science y, right thing. So I wish that we had
• 34:15
  Speaker 1: it's in development. But the menipure pen, it would be
• 34:20
  Speaker 1: so nice to not have to do the powders with
• 34:22
  Speaker 1: the saline.
• 34:23
  Speaker 2: And let's explain that because I don't think that a
• 34:26
  Speaker 2: lot of people understand how that works. So basically, the menopure,
• 34:29
  Speaker 2: which is like I would say, the medication that's pretty
• 34:32
  Speaker 2: common for everyone that's going through this. Yeah, So it
• 34:35
  Speaker 2: comes in these small vials and in the vial there's
• 34:39
  Speaker 2: like something that looks like a little pill that you
• 34:42
  Speaker 2: put saline into the vial and then you mix the medication.
• 34:45
  Speaker 3: That's a good way to explain it.
• 34:46
  Speaker 2: Yes, And depending on what your dose is, you might
• 34:49
  Speaker 2: need to mix together a couple of vials to get
• 34:52
  Speaker 2: what it is that you need. And so instantly, these
• 34:55
  Speaker 2: everyday people that are going through this become Walter White
• 34:59
  Speaker 2: in their kitchen.
• 35:00
  Speaker 3: Yeah, totally.
• 35:01
  Speaker 1: And I think at first that's overwhelming, and you can
• 35:05
  Speaker 1: tell me whether you felt this way, But by day three,
• 35:09
  Speaker 1: day four, you're doing it. And you don't even have
• 35:12
  Speaker 1: to look at the instructions. You know what you're doing.
• 35:15
  Speaker 1: But it's a learning curve for sure.
• 35:18
  Speaker 2: Yeah, And to your point earlier when you were talking
• 35:20
  Speaker 2: about all the resources that are available, I actually felt
• 35:23
  Speaker 2: like that was so helpful, having both something I could
• 35:26
  Speaker 2: read and something I could watch. And then I too
• 35:29
  Speaker 2: have like a very dear friend that's an internal medicine
• 35:32
  Speaker 2: doctor and works at Brown and so like I'm on
• 35:33
  Speaker 2: FaceTime with her and there's like one moment where I
• 35:36
  Speaker 2: thought I spilled some of my medication.
• 35:37
  Speaker 3: I'm like, what do I do? I don't know what
• 35:39
  Speaker 3: I'm doing. Yeah, And it's just kind of like all
• 35:41
  Speaker 3: part of the process, right, you know.
• 35:43
  Speaker 2: And that's why it's so important to then go in
• 35:47
  Speaker 2: for these monitoring appointments. So talk to me a little
• 35:49
  Speaker 2: bit about the purpose of the monitoring appointments that individuals
• 35:53
  Speaker 2: will go to throughout this ten twelve fourteen day period.
• 35:58
  Speaker 1: So the monitoring, well, I'll just say to clarify to
• 36:02
  Speaker 1: it's typically the cycle is twelve to fourteen days on average.
• 36:08
  Speaker 1: Your first visit, we typically just do an ultrasound. We
• 36:13
  Speaker 1: don't even do blood work at that first visit unless
• 36:16
  Speaker 1: we see something like assists or you're starting at a
• 36:19
  Speaker 1: different time in your cycle. But typically it's an ultrasound
• 36:22
  Speaker 1: and then you go home and you do your thing
• 36:24
  Speaker 1: for a few nights. The first week, it's really just
• 36:28
  Speaker 1: two visits. For the most part. You come back maybe
• 36:31
  Speaker 1: four or five days later, because you don't need to
• 36:34
  Speaker 1: uproot your life by coming in to the doctor every
• 36:38
  Speaker 1: single day. I think that's something really unique about Spring
• 36:42
  Speaker 1: is we're really intentional about that aspect of the patient experience.
• 36:48
  Speaker 1: We know what's going on at home and when we
• 36:51
  Speaker 1: see you in the office and we're bringing you in
• 36:53
  Speaker 1: and interrupting your day because we want to make sure
• 36:57
  Speaker 1: that things are moving in the right direction that second
• 37:00
  Speaker 1: and through the second visit, we do about three other
• 37:05
  Speaker 1: ultrasounds besides that with blood work, and we're checking your
• 37:09
  Speaker 1: hormones to make sure that they're rising appropriately. We're doing
• 37:12
  Speaker 1: an ultrasound and looking at the follicles, the little homes
• 37:15
  Speaker 1: for the eggs, and almost every visit I see you
• 37:20
  Speaker 1: at Spring, that's how we do it again, really wanting
• 37:24
  Speaker 1: you to have a positive patient experience where you know
• 37:28
  Speaker 1: me and I know you, and you can ask me
• 37:30
  Speaker 1: questions and I can check in with you and see
• 37:33
  Speaker 1: how you're doing, and give you tips and tricks and
• 37:36
  Speaker 1: explain to you what's going on with your body and
• 37:38
  Speaker 1: physically showing you. We have the ultrasound right above so
• 37:41
  Speaker 1: that you can see what I'm looking at, and it's
• 37:44
  Speaker 1: not just me knowing, it's you knowing what's happening with
• 37:47
  Speaker 1: your body.
• 37:47
  Speaker 3: Yeah, which is so important, right.
• 37:49
  Speaker 1: I think I think it is. I hope I hope
• 37:52
  Speaker 1: people like that aspect of it. I know, as someone
• 37:55
  Speaker 1: who's done this myself and do it for patients all
• 37:57
  Speaker 1: the time, I think people really like to be as
• 38:00
  Speaker 1: involved as possible and know what's going on with their bodies.
• 38:04
  Speaker 1: And so then the first half about two visits, and
• 38:07
  Speaker 1: then the second half maybe two or three visits. And
• 38:11
  Speaker 1: a lot of people will ask me, if you go
• 38:13
  Speaker 1: to another fertility center or if you hear of a
• 38:17
  Speaker 1: friend who goes somewhere else, shouldn't I be seen every
• 38:20
  Speaker 1: single day? Isn't that important? Don't you want to know
• 38:22
  Speaker 1: what's going on? And to that we say, we know
• 38:25
  Speaker 1: what's going on. It's really intentional. We want you to
• 38:29
  Speaker 1: not dread every time you're coming in. People don't like
• 38:33
  Speaker 1: getting blood drawn. I don't want to get blood drawn
• 38:35
  Speaker 1: every single day, and so spacing out the visits so
• 38:39
  Speaker 1: that we don't miss something, but we're intentionally bringing you
• 38:42
  Speaker 1: in to look at the progress was really important.
• 38:46
  Speaker 2: And so basically the goal is at that last monitoring
• 38:50
  Speaker 2: appointment to see.
• 38:51
  Speaker 1: What we want to use the hormone levels and the
• 38:55
  Speaker 1: size of the follicles the homes of the eggs to
• 39:00
  Speaker 1: say you look like you're ready, we can remove these eggs.
• 39:04
  Speaker 1: We use population data and everything that we have to
• 39:07
  Speaker 1: say this is a good size for you. And now
• 39:11
  Speaker 1: thirty six hours after you do a trigger shot, which
• 39:13
  Speaker 1: is just a final injection similar to the others, except
• 39:17
  Speaker 1: this is going to make you ovulate. Thirty four to
• 39:20
  Speaker 1: thirty six hours later, you then have your procedure where
• 39:24
  Speaker 1: we can extract the eggs.
• 39:26
  Speaker 2: If I remember what was like the average this is
• 39:29
  Speaker 2: like a very inside baseball question, but if you're listening
• 39:32
  Speaker 2: to this at the right time, you'll probably want to
• 39:33
  Speaker 2: know what was like the average size that you were
• 39:36
  Speaker 2: looking for for the follicles.
• 39:38
  Speaker 1: Typically over fourteen millimeters, so something like the high teens,
• 39:43
  Speaker 1: low twenties got the sweet spot for most people caveat
• 39:48
  Speaker 1: to data is this is population data someone might respond
• 39:52
  Speaker 1: to stimulation differently, so sometimes you have to use that
• 39:57
  Speaker 1: first cycle is sort of diagnosed. Not everyone is cookie cutter,
• 40:02
  Speaker 1: and so we try to monitor as best we can
• 40:05
  Speaker 1: and assume that the follicles at a certain size will
• 40:09
  Speaker 1: yield a mature egg, mature being the correct developmental stage
• 40:13
  Speaker 1: to be frozen or to be combined with sperm. But
• 40:17
  Speaker 1: it doesn't always happen that way. That's why we tell
• 40:21
  Speaker 1: people that there may be a attrition from the amount
• 40:25
  Speaker 1: that we get at the retrieval to the amount that
• 40:29
  Speaker 1: is frozen.
• 40:29
  Speaker 2: Yeah, I can't remember if it was twenty one or
• 40:33
  Speaker 2: twenty four, but I know that going into my procedure
• 40:38
  Speaker 2: we had something like twenty one or twenty four, and
• 40:40
  Speaker 2: then just to reflect on what I said earlier, we
• 40:42
  Speaker 2: started with thirty six, right. So it's like a lot
• 40:45
  Speaker 2: of things worked, and I went in feeling like really
• 40:48
  Speaker 2: optimistic and really positive, but also understanding that there was
• 40:52
  Speaker 2: going to be attrition and not all of those follicles
• 40:55
  Speaker 2: would release an egg.
• 40:57
  Speaker 1: Right, And it's important to know that cycle to cycle
• 41:01
  Speaker 1: it can change a little bit. There's a range that
• 41:04
  Speaker 1: each person's body has each month the functional eggs, but
• 41:09
  Speaker 1: sometimes you start a cycle, and I think this is
• 41:11
  Speaker 1: what happened for you as well. When I do your
• 41:14
  Speaker 1: first ultrasound, you may have X number, but then it
• 41:17
  Speaker 1: may be a little bit different in the cycle that
• 41:20
  Speaker 1: you actually start your stimulation medications.
• 41:24
  Speaker 3: If it's half the.
• 41:26
  Speaker 1: Amount that we expect, then I would tell someone, let's
• 41:29
  Speaker 1: not do it this cycle, let's regroup. But if it's
• 41:33
  Speaker 1: within the range, then we go for it. For the
• 41:36
  Speaker 1: most part.
• 41:37
  Speaker 3: Got it.
• 41:37
  Speaker 2: So can someone come in a few times and that happens,
• 41:42
  Speaker 2: and if that happens, then what happens next.
• 41:46
  Speaker 3: If it's happening a.
• 41:47
  Speaker 1: Few times where we're seeing a lower number, then maybe
• 41:50
  Speaker 1: we saw in the past that could be someone's new normal,
• 41:53
  Speaker 1: and that may just be a shift in the conversation
• 41:56
  Speaker 1: of maybe this is where your body is at. Really
• 42:00
  Speaker 1: depends on the person and the situation. But for you,
• 42:04
  Speaker 1: I think we knew that we were in a good
• 42:06
  Speaker 1: starting place that was very reasonable, and then we talked
• 42:10
  Speaker 1: about throughout this is how many were expecting to get.
• 42:14
  Speaker 1: This is the range. Because I'm never going to say
• 42:15
  Speaker 1: an exact number, I've got a range, and I think
• 42:18
  Speaker 1: we were able to get in that range for you.
• 42:22
  Speaker 1: But I always say we expect between seventy five to
• 42:26
  Speaker 1: eighty percent of the egg's retrieve to end up being
• 42:30
  Speaker 1: mature gotcha being the correct developmental stage to be frozen.
• 42:35
  Speaker 1: Sometimes it's higher than that and we're really excited. Maybe
• 42:39
  Speaker 1: a follicle that was smaller ends up being leading to
• 42:44
  Speaker 1: a mature egg. Sometimes we get less maturity than we expect,
• 42:50
  Speaker 1: and that's really tough, and it's important to have that
• 42:52
  Speaker 1: conversation about what went on, what can we do differently
• 42:56
  Speaker 1: if someone did this again?
• 42:58
  Speaker 2: Right, Yeah, I remember talking to my retrieval. I had
• 43:03
  Speaker 2: so many wonderful people just reaching out to me, some
• 43:05
  Speaker 2: that I knew and some that I didn't. And that
• 43:07
  Speaker 2: morning was just so interesting because I remember that it
• 43:12
  Speaker 2: felt really emotional in that this was like the one
• 43:16
  Speaker 2: part that I really was just I was, I was
• 43:20
  Speaker 2: on my own, I was going to the place by myself,
• 43:22
  Speaker 2: like I was heading in to do this, and it
• 43:24
  Speaker 2: was just like, wow, this is a little bit more
• 43:28
  Speaker 2: emotional than I anticipated. And as I was thinking that
• 43:30
  Speaker 2: and walking around Brian Park because I'm early for my
• 43:33
  Speaker 2: egg retrieval, I get a message from someone and she said,
• 43:38
  Speaker 2: don't let the number define you. And again, like I said,
• 43:42
  Speaker 2: going into this, I didn't have an understanding of just
• 43:47
  Speaker 2: how difficult the numbers and what could happen or what
• 43:51
  Speaker 2: doesn't happen could be for so many myself included, and
• 43:56
  Speaker 2: so to go into that appointment, I mean, up until
• 43:58
  Speaker 2: this point, I've never publicly talked about the number of
• 44:02
  Speaker 2: vollcals or exit I retrieved, or you know, what happened there,
• 44:06
  Speaker 2: because I do know that it can be such a
• 44:08
  Speaker 2: sensitive topic for so many people, and so I have
• 44:12
  Speaker 2: compassion and care and concern for that, and also just
• 44:15
  Speaker 2: such a deep appreciation as a result for what my
• 44:19
  Speaker 2: body did, and knowing that, like my friend said, that
• 44:23
  Speaker 2: number wasn't going to change how I feel about myself,
• 44:26
  Speaker 2: and I know that throughout the process, I truly did
• 44:29
  Speaker 2: the best I could with what I.
• 44:31
  Speaker 3: Had, right right.
• 44:33
  Speaker 1: I love that your friend said that, But the number
• 44:35
  Speaker 1: doesn't define you, because people do hang their hats on
• 44:40
  Speaker 1: a number, and I don't blame them for that, especially
• 44:44
  Speaker 1: if you're doing multiple cycles. If you put a lot
• 44:46
  Speaker 1: of weight onto this, you're taking everything out of the equation.
• 44:51
  Speaker 1: It's you're giving up your body for a few weeks,
• 44:53
  Speaker 1: You're putting in finances. It's a lot that you're putting
• 44:57
  Speaker 1: into this. So I understand how the number holds a
• 45:00
  Speaker 1: lot of weight, but it really doesn't define someone. You
• 45:03
  Speaker 1: could have a high number and have done everything wrong
• 45:08
  Speaker 1: in your life, or you could have a low number
• 45:11
  Speaker 1: and have done it all right. And it is important
• 45:16
  Speaker 1: to know that a number is all that you get
• 45:20
  Speaker 1: with egg freezing. You don't know what the quality of
• 45:25
  Speaker 1: those eggs are. You can't find that out until if
• 45:29
  Speaker 1: you decide to thaw or warm the eggs in the
• 45:32
  Speaker 1: future and actually use them. So a number is just that.
• 45:37
  Speaker 1: It's just a number, but it does hold a lot
• 45:41
  Speaker 1: of weight to people. I understand that.
• 45:44
  Speaker 2: Is there any average on that in the fawing like
• 45:46
  Speaker 2: that we can guesstimate how many of them typically are viable.
• 45:50
  Speaker 1: So it's spring, our thaw rate is around ninety three percent,
• 45:54
  Speaker 1: which is really excellent when you compare it to other
• 45:58
  Speaker 1: centers in the US it's typically around eighty five to
• 46:00
  Speaker 1: ninety percent. Technologies come a long way, but that still
• 46:05
  Speaker 1: means that maybe not every egg is going to survive
• 46:09
  Speaker 1: this thawing process. And then there's other attrition that happens.
• 46:14
  Speaker 1: And I like to talk about this at everyone's initial
• 46:16
  Speaker 1: appointment and I like to talk about it again in
• 46:19
  Speaker 1: the future when we're going through all of the results,
• 46:22
  Speaker 1: so that people really understand that I know, and I
• 46:26
  Speaker 1: want them to note that there's going to be attrition
• 46:29
  Speaker 1: and so to set your expectations accordingly. Typically from the
• 46:35
  Speaker 1: amount that are frozen and then thowed, it's about a
• 46:40
  Speaker 1: forty percent conversion to get to that next stage, which
• 46:44
  Speaker 1: we call the blastosis. So they have to eggs, have
• 46:47
  Speaker 1: to combine with sperm, they have to fertilize around seventy
• 46:51
  Speaker 1: to seventy five percent fertilize, and then they have to
• 46:53
  Speaker 1: make it to the next stage, which is called a
• 46:55
  Speaker 1: blastois stage. That's the embryo stage, at which people can
• 47:00
  Speaker 1: take a tiny biopsy about three to seven cells from
• 47:04
  Speaker 1: an embryo, send it for genetic testing to actually figure
• 47:08
  Speaker 1: out whether it's genetically normal or not. But I want
• 47:12
  Speaker 1: them to know that if you get ten eggs frozen,
• 47:15
  Speaker 1: you're probably not going to get ten embryos at the
• 47:17
  Speaker 1: end of this, and so I try to say that
• 47:20
  Speaker 1: over and over again so that people aren't surprised when
• 47:25
  Speaker 1: there is natural attrition that happens.
• 47:27
  Speaker 3: Right, So again that ten number, maybe they would get six.
• 47:32
  Speaker 1: Probably less probably if you have ten that are thought
• 47:36
  Speaker 1: you maybe would get four three to four, and then
• 47:40
  Speaker 1: it depends on your age as to whether they're going
• 47:44
  Speaker 1: to actually be viable right, genetically normal.
• 48:03
  Speaker 2: Once I decided that I was going to do it,
• 48:05
  Speaker 2: I was like, well, I'm not getting any younger. So yes,
• 48:08
  Speaker 2: it's promising and exciting that they're such a high number
• 48:11
  Speaker 2: of follicles, and then also very exciting when you go
• 48:14
  Speaker 2: in you start with so many eggs, but it's like
• 48:16
  Speaker 2: you don't know the quality of those eggs, and so
• 48:19
  Speaker 2: if you're someone that doesn't thrive in the unknown, Hi,
• 48:22
  Speaker 2: it's me, raises my hand, then you just don't really
• 48:26
  Speaker 2: know what you're getting yourself into.
• 48:28
  Speaker 1: Right, right, it's a lot of unknowns. We do have
• 48:32
  Speaker 1: data for thowed eggs, and we do know so for
• 48:36
  Speaker 1: someone who's around thirty seven, based on population data, around
• 48:41
  Speaker 1: thirty five percent of those eggs should be genetically abnormal,
• 48:47
  Speaker 1: so around sixty five percent should be able to give
• 48:51
  Speaker 1: a viable egg embryo. But all those are our numbers
• 48:57
  Speaker 1: for people. It makes it more real when people actually
• 49:01
  Speaker 1: go to make embryos, because, like we were talking about
• 49:04
  Speaker 1: at the beginning, sometimes it's just out of sight, out
• 49:06
  Speaker 1: of mind, and you don't necessarily need to use those
• 49:10
  Speaker 1: eggs right away.
• 49:11
  Speaker 3: Yeah.
• 49:11
  Speaker 1: So the one piece about egg freezing that as frustrating
• 49:14
  Speaker 1: is we don't know the quality, both the viability, the
• 49:19
  Speaker 1: genetics of the eggs, and also how they respond to
• 49:23
  Speaker 1: the environment around them, their competency.
• 49:25
  Speaker 2: I was literally thinking the other day, I was like,
• 49:27
  Speaker 2: I did my egg retrieval and then I like was
• 49:29
  Speaker 2: just like, so, yeah, like, I haven't mess a job.
• 49:31
  Speaker 3: I don't know what's going on. We're like hanging out.
• 49:34
  Speaker 3: Visit I need to come visit them.
• 49:36
  Speaker 2: I need to, like, I will need to move them,
• 49:39
  Speaker 2: which is something that's very helpful with Spring. I know,
• 49:41
  Speaker 2: depending on where you are, there are a few different
• 49:44
  Speaker 2: storage opportunities or solutions that you can use. And so
• 49:47
  Speaker 2: coincidentally there's somewhere near where I grew up that I
• 49:50
  Speaker 2: can store them and it's very thankfully a fraction of
• 49:53
  Speaker 2: the price, and Spring is really great and that they
• 49:57
  Speaker 2: cover your transfer so that one trans first, so for me,
• 50:00
  Speaker 2: I'll be able to put them in their new little
• 50:02
  Speaker 2: home in Connecticut.
• 50:03
  Speaker 3: I just need to I need to pack them up
• 50:05
  Speaker 3: and get them on their way.
• 50:06
  Speaker 2: Obviously I am not actually I am not actually packing
• 50:08
  Speaker 2: them up, but I need to set them up in
• 50:10
  Speaker 2: their new home.
• 50:12
  Speaker 3: I do want to talk a little bit about egg retrieval.
• 50:14
  Speaker 2: Day before we kind of talk about the after In
• 50:17
  Speaker 2: that I said that I went to the clinic. For
• 50:19
  Speaker 2: most individuals, this is something that happens in the morning hours, correct, Okay,
• 50:23
  Speaker 2: So for me, I believe my egrotrieval was at eight thirty.
• 50:27
  Speaker 2: I got there at seven thirty, and I felt like
• 50:29
  Speaker 2: it was a swift operation, Like I from the moment
• 50:33
  Speaker 2: I got there, I was like whisked in to talk
• 50:35
  Speaker 2: to one person, to talk to someone else, to get
• 50:37
  Speaker 2: ready to Everything was very efficient.
• 50:40
  Speaker 3: It was very efficient.
• 50:41
  Speaker 1: We're a well oiled machine because it has to be,
• 50:44
  Speaker 1: because everything is really time sensitive. We tell you that
• 50:48
  Speaker 1: the most important piece of your process is getting the
• 50:54
  Speaker 1: time right of your trigger shot, and we similarly want
• 50:58
  Speaker 1: it to be timed right when we're actually extracting the
• 51:01
  Speaker 1: eggs from you.
• 51:02
  Speaker 2: Yeah, this is something else that we didn't even touch
• 51:05
  Speaker 2: on with the injections, because I've actually heard some conflicting
• 51:08
  Speaker 2: information on the timing of those. I know for me,
• 51:11
  Speaker 2: I was aiming to do them within like the same
• 51:13
  Speaker 2: thirty minute period every night. But I've heard something as
• 51:16
  Speaker 2: big as that window can be about three hours.
• 51:18
  Speaker 3: What's the deal on that.
• 51:19
  Speaker 1: I typically say two hours for the injections, and every
• 51:23
  Speaker 1: fertility center maybe a little bit different in how they
• 51:26
  Speaker 1: structure the injections. Sometimes you can do that third shot,
• 51:29
  Speaker 1: that antagonist shot set a tighter gainer relics at nighttime.
• 51:33
  Speaker 1: Sometimes you do it with your other medications in the morning.
• 51:36
  Speaker 1: That one is a bit more time sensitive. So within
• 51:38
  Speaker 1: the thirty minutes is what we recommend for that one.
• 51:42
  Speaker 1: Within a couple hours for the other medications is totally fine.
• 51:46
  Speaker 1: But for that trigger shot, I say within ten minutes.
• 51:50
  Speaker 2: Yeah, because you want to get it very precise to
• 51:52
  Speaker 2: when your scheduled servesiery time is. So I got into
• 51:56
  Speaker 2: the clinic, they wheeled me back. A nurse came in
• 51:59
  Speaker 2: and started to explaining everything to me and got me
• 52:02
  Speaker 2: in my gown and it was so cute. You brought
• 52:04
  Speaker 2: little eye patches over which I was like, I'm going
• 52:07
  Speaker 2: to use these afterward.
• 52:08
  Speaker 3: When we're recovering. Yeah, memories.
• 52:11
  Speaker 2: But I got my little set up and you came
• 52:14
  Speaker 2: to say hi, and literally before I knew it, I
• 52:16
  Speaker 2: was getting wheeled into the operating room and when I
• 52:21
  Speaker 2: tell you that, I remember about thirty seconds of that space.
• 52:24
  Speaker 2: It was like, Hi, Emily, here are these two cute
• 52:27
  Speaker 2: little nursing assistants, and then there is the embryologist, and
• 52:32
  Speaker 2: then there's the anesthesiologist. And before you go into ther
• 52:36
  Speaker 2: you have you're already have the needle in your arm
• 52:38
  Speaker 2: for the anesthesia. So it's like, all of a sudden,
• 52:41
  Speaker 2: this antesthesiologist that I met four minutes not no, I'm sorry,
• 52:44
  Speaker 2: twenty seconds before, just pushes a different medication.
• 52:47
  Speaker 3: I don't even remember counting down. I was out. I
• 52:50
  Speaker 3: was out.
• 52:50
  Speaker 1: Yeah, And a lot of people experience a whirlwind of
• 52:54
  Speaker 1: emotions that morning, and so I think it's helpful for
• 52:58
  Speaker 1: patients to just not have to think about what they
• 53:01
  Speaker 1: have to do. So when you get there, we know
• 53:05
  Speaker 1: exactly what needs to be done and what we need
• 53:07
  Speaker 1: to do, and so I just want people to kind
• 53:10
  Speaker 1: of relax.
• 53:11
  Speaker 3: That's why we give.
• 53:12
  Speaker 1: Those eye patches and you're in a nice heated massage
• 53:15
  Speaker 1: chair and you're sitting there and hanging out. I like
• 53:18
  Speaker 1: to say hello to people beforehand. I may have asked
• 53:21
  Speaker 1: you what song you wanted to listen.
• 53:22
  Speaker 2: To you I do think you asked me that and
• 53:24
  Speaker 2: I was like, I have no I can't think, so then.
• 53:27
  Speaker 1: I DJ and then typically we have you walk back
• 53:33
  Speaker 1: with our one of our medical assistants into the operating room.
• 53:37
  Speaker 1: And then you may feel like you're at a pit stop.
• 53:40
  Speaker 1: We're putting monitors on you. We're doing double triple, quadruple
• 53:44
  Speaker 1: tracks with us. You the embryologist, so we have everything
• 53:49
  Speaker 1: electronic with your name, your eggs, you're a wristband, so
• 53:53
  Speaker 1: it's all really precise. And your role in that moment
• 53:56
  Speaker 1: is just to become zen. That's what I want for people.
• 53:59
  Speaker 1: Just get into a nice yoga zen group and then
• 54:04
  Speaker 1: we tell you when the medication's coming. But as our antithesiologists,
• 54:09
  Speaker 1: as often, propofol often wins because it's we want you
• 54:13
  Speaker 1: to be asleep, we want you to be comfortable, and
• 54:16
  Speaker 1: then you wake up in recovery.
• 54:18
  Speaker 3: So how long is the surgery Usually.
• 54:19
  Speaker 1: It's typically fifteen to twenty minutes. Okay, So once we
• 54:24
  Speaker 1: position you, then we do these double triple checks. We
• 54:28
  Speaker 1: scan your armband, we go through who you are named,
• 54:31
  Speaker 1: date of birth with our embryologists. We introduce everyone in
• 54:34
  Speaker 1: the room. I set a good tune and then the
• 54:37
  Speaker 1: probofol comes and you're asleep, and then what I do
• 54:42
  Speaker 1: is I clean off the area everything's as sterile as possible,
• 54:46
  Speaker 1: and then I go in with the same transvaginal ultrasound
• 54:49
  Speaker 1: that I used in all of your visits, except this
• 54:52
  Speaker 1: time it has a needle guide on the end of
• 54:54
  Speaker 1: it where the needle goes through and there's no incision
• 54:58
  Speaker 1: that happens. A lot of people have misconceptions about what's
• 55:01
  Speaker 1: happening when they're asleep. The way that it would feel
• 55:04
  Speaker 1: is the same way you're getting a transnational ultrasound in
• 55:08
  Speaker 1: an appointment, except this time then there's a tiny, tiny
• 55:11
  Speaker 1: needle that goes through an under ultrasound guidance. I aspirate
• 55:16
  Speaker 1: the fluid from all of the follicles, and then as
• 55:19
  Speaker 1: that's happening, there's a little tubing that goes through and
• 55:23
  Speaker 1: the fluid is coming out. The follicular fluid is coming
• 55:26
  Speaker 1: out and being collected and then handed off to our
• 55:29
  Speaker 1: embryologist who's looking in the room under this really specialized
• 55:35
  Speaker 1: hood that has really specific conditions that are best for
• 55:41
  Speaker 1: the eggs, and they're looking through the fluid, finding the
• 55:45
  Speaker 1: eggs and then telling us how many eggs were getting
• 55:48
  Speaker 1: and then as soon as you went to sleep, you
• 55:51
  Speaker 1: also wake up really quickly fifteen to twenty minutes later,
• 55:55
  Speaker 1: bring you over to pack you post off bay, and
• 55:59
  Speaker 1: then we chat about how many X we got.
• 56:01
  Speaker 2: Yeah, and that was it, and so I woke up.
• 56:05
  Speaker 2: I don't remember like the initial wake up, but I
• 56:07
  Speaker 2: do remember that I was waiting for I was awake
• 56:13
  Speaker 2: for not very long before my mom came in and
• 56:16
  Speaker 2: this distinct like emotional release when I just like saw it,
• 56:22
  Speaker 2: it was wonderful and lovely that it was my mom.
• 56:25
  Speaker 2: But I think at that point for anyone to come
• 56:27
  Speaker 2: in that could just like deal with shit for a
• 56:29
  Speaker 2: second like that, I didn't have to like answer questions
• 56:33
  Speaker 2: or feel out paperwork or just be responsible for one second.
• 56:37
  Speaker 2: I saw her and I just like start bawling, and
• 56:38
  Speaker 2: I'm like, no, I'm okay, I'm.
• 56:40
  Speaker 3: Okay, everything's fine. I'm just like really overwhelmed for the moment.
• 56:43
  Speaker 2: And then I got my act together and I think
• 56:46
  Speaker 2: I did my eye patches and we like sat there
• 56:48
  Speaker 2: for a little bit, and then you came in, and
• 56:50
  Speaker 2: so we retrieved nineteen Aggie's little guys, and seventeen of
• 56:58
  Speaker 2: them ended up being great, which was a really I mean,
• 57:02
  Speaker 2: for me personally, it was probably as good of a
• 57:05
  Speaker 2: situation as I could have hoped for. I was really
• 57:09
  Speaker 2: hopeful in my process that because it is such an
• 57:12
  Speaker 2: expensive situation, that I would do this once and I
• 57:16
  Speaker 2: would be good with it. And so I don't know
• 57:18
  Speaker 2: if I necessarily had a benchmark number in my head,
• 57:21
  Speaker 2: but when I heard that, I was like, I'm good,
• 57:24
  Speaker 2: Like this feels good for me for where I'm at,
• 57:27
  Speaker 2: especially as someone that I'm obviously doing this because I
• 57:30
  Speaker 2: want the opportunity to have children, but I'm still at
• 57:33
  Speaker 2: this point right now candidly that I don't know if
• 57:35
  Speaker 2: I will. So it's not like I'm sitting here saying
• 57:38
  Speaker 2: I want to have a football team. If I wanted
• 57:40
  Speaker 2: to have four or five children, then maybe I would
• 57:43
  Speaker 2: handle this differently, but that's just not where I'm at.
• 57:46
  Speaker 2: So hearing that information from you a few days later,
• 57:49
  Speaker 2: after I went home and rested up.
• 57:52
  Speaker 3: I felt really good about it.
• 57:54
  Speaker 2: Yeah.
• 57:54
  Speaker 1: Yeah, And you're describing a really common scenario post operatively
• 57:59
  Speaker 1: with people are a little bit more emotional from the anesthesia,
• 58:02
  Speaker 1: So it was probably a combo of things for you
• 58:06
  Speaker 1: and hearing the numbers, and I think people feel really
• 58:11
  Speaker 1: empowered to know that they went through all of this
• 58:14
  Speaker 1: and when you get a good result, you feel good
• 58:17
  Speaker 1: about that. It's not like that for everyone, and that's
• 58:21
  Speaker 1: the tough that's the tough thing about this. But I
• 58:25
  Speaker 1: think it's important for people to have that support person,
• 58:30
  Speaker 1: whether it's a mom, a friend, a colleague, someone who
• 58:34
  Speaker 1: can be there throughout the process that you can go
• 58:37
  Speaker 1: to so that you don't feel alone even though you
• 58:41
  Speaker 1: are doing it on your own. I think that's really
• 58:45
  Speaker 1: really important. It doesn't get talked about enough the emotional
• 58:48
  Speaker 1: side of it.
• 58:49
  Speaker 3: It was funny.
• 58:49
  Speaker 2: We like took the subway home because I was like,
• 58:51
  Speaker 2: getting in a car is just going to feel like
• 58:53
  Speaker 2: I didn't know how long it was going to take
• 58:54
  Speaker 2: with the traffic, and we were in midtown or going
• 58:56
  Speaker 2: to Brooklyn, and I was just like, let's just take
• 58:57
  Speaker 2: the queue. It's so easy. And she was like, like
• 59:00
  Speaker 2: it's so easy. This feels overwhelming. I'm like, mom, you
• 59:02
  Speaker 2: can tap to pay now. We are we are golden.
• 59:05
  Speaker 2: We are golden.
• 59:06
  Speaker 3: So she's so cute.
• 59:07
  Speaker 2: She's like holding on to me like I'm a senior
• 59:09
  Speaker 2: citizen to make sure that like I got home okay,
• 59:11
  Speaker 2: and we got back and we ate a bagel and
• 59:14
  Speaker 2: then I literally passed out for probably like two or
• 59:17
  Speaker 2: two and a half hours. And then I don't remember
• 59:20
  Speaker 2: who told me this, and I don't know if it
• 59:23
  Speaker 2: was at Spring, but someone was like, you shouldn't sleep alone.
• 59:27
  Speaker 3: I don't remember like who told me that, but I
• 59:29
  Speaker 3: was like okay.
• 59:30
  Speaker 2: So I like texted one of my best friends and
• 59:31
  Speaker 2: I was like, come sleep over crazy, So she came
• 59:34
  Speaker 2: and they told me to eat all of the salty things.
• 59:37
  Speaker 2: So I was drinking. I think I had two elements
• 59:40
  Speaker 2: that day. And then we got ramen for dinner and
• 59:42
  Speaker 2: I was just a happy little clam and went to bed.
• 59:45
  Speaker 2: I mean, I again, I felt super achy. But other
• 59:48
  Speaker 2: than that, you know, I I was in good spirits.
• 59:51
  Speaker 2: I was happy that it was done.
• 59:52
  Speaker 1: Yeah, right, And I think I said to you after,
• 59:56
  Speaker 1: it's a big deal when you go through it, and
• 59:59
  Speaker 1: I hope that you felt proud of yourself. It's the
• 1:00:05
  Speaker 1: only thing that you can do to protect your reproductive
• 1:00:08
  Speaker 1: autonomy and to give yourself optionality. And for you, that's
• 1:00:12
  Speaker 1: all it was. Like you said you didn't know whether
• 1:00:15
  Speaker 1: you wanted kids, whether you still don't know whether you
• 1:00:17
  Speaker 1: want kids, and that's okay, That's a good enough reason
• 1:00:21
  Speaker 1: to do it, just to invest in yourself and to
• 1:00:24
  Speaker 1: give yourself that optionality in the future.
• 1:00:27
  Speaker 2: Yeah, it really is kind of crazy to like have
• 1:00:30
  Speaker 2: no idea if I'm going to use them if I
• 1:00:33
  Speaker 2: do you like, I have no idea. But the other
• 1:00:36
  Speaker 2: thing that's really been interesting for me, and something that
• 1:00:40
  Speaker 2: I've been talking to my life coaches about, is that
• 1:00:43
  Speaker 2: before I decided that I was going to freeze my eggs,
• 1:00:46
  Speaker 2: when it came to dating and stuff, I never really
• 1:00:49
  Speaker 2: felt like I was on a timeline, Like I'm just
• 1:00:51
  Speaker 2: kind of like living my life and doing whatever it
• 1:00:53
  Speaker 2: is that I do, contrary to what I think society
• 1:00:56
  Speaker 2: impresses upon women very often. However, once I froze my eggs,
• 1:01:01
  Speaker 2: I kind of almost felt like I needed to like
• 1:01:04
  Speaker 2: put myself out there more. I'm like, well, now I
• 1:01:07
  Speaker 2: only have you know, X amount of years if I
• 1:01:10
  Speaker 2: want to use my eggs, like if I want to
• 1:01:12
  Speaker 2: be the person that if I try to get pregnant
• 1:01:14
  Speaker 2: naturally and it doesn't happen, and then we want to
• 1:01:17
  Speaker 2: use my eggs, like I have, you know, an age
• 1:01:20
  Speaker 2: in mind where I probably wouldn't do that after right,
• 1:01:23
  Speaker 2: and so again. Turning thirty eighth this week, it was
• 1:01:26
  Speaker 2: kind of wild. It's so funny because so many women
• 1:01:29
  Speaker 2: that I've spoken with say, well, I feel so free
• 1:01:32
  Speaker 2: and liberated and like, look at this great thing, and yes,
• 1:01:35
  Speaker 2: and I now I'm like, oh, shoot, I better get
• 1:01:38
  Speaker 2: I better get on my way.
• 1:01:39
  Speaker 3: M hmm. This is kind of how I feel. And
• 1:01:41
  Speaker 3: that's that's okay.
• 1:01:43
  Speaker 1: It's going to bring up different emotions for different people,
• 1:01:46
  Speaker 1: and so you it making you feel a little bit
• 1:01:49
  Speaker 1: more isolated and analyzing where you are in life sounds
• 1:01:53
  Speaker 1: really normal to me. It may be freeing for someone
• 1:01:57
  Speaker 1: else to say, great, I can step back, I don't
• 1:01:59
  Speaker 1: have to worry about this anymore. So it's different for everyone,
• 1:02:02
  Speaker 1: it's very normal. I hear that a lot.
• 1:02:04
  Speaker 2: Yeah, Oh, you're so validating for me. Yeah, this was
• 1:02:08
  Speaker 2: so great. I'm so happy that we chatted a bit.
• 1:02:11
  Speaker 3: Me too, Me too.
• 1:02:12
  Speaker 1: I'm glad that you were able to come to the
• 1:02:16
  Speaker 1: decision to do this. I think it's not right for everyone,
• 1:02:21
  Speaker 1: but it was right for you. And I hope people
• 1:02:25
  Speaker 1: know that it's okay to just get information and just
• 1:02:28
  Speaker 1: to make a consult and talk to an expert and
• 1:02:31
  Speaker 1: then decide from there.
• 1:02:33
  Speaker 3: Yeah, I think that's so important.
• 1:02:35
  Speaker 2: And for a long time, and I've shared a little
• 1:02:38
  Speaker 2: bit about this, I used the money as the excuse,
• 1:02:43
  Speaker 2: and what I came to realize was that this is
• 1:02:47
  Speaker 2: something that I felt like I deserved for myself. I
• 1:02:52
  Speaker 2: am the kind of person that you know, if a
• 1:02:55
  Speaker 2: friend needs something, I'll drop everything and help or you know,
• 1:02:59
  Speaker 2: I'm so happy to give to others, but I don't
• 1:03:02
  Speaker 2: often take the time to do that for myself.
• 1:03:05
  Speaker 3: So this albeit a very big expense.
• 1:03:10
  Speaker 2: Even if you can have that mentality when it comes
• 1:03:13
  Speaker 2: to the appointment to learn about what's going on with
• 1:03:17
  Speaker 2: you and your body, I would say, like just do it, Like,
• 1:03:20
  Speaker 2: don't let the excuses be the reason that you're not
• 1:03:24
  Speaker 2: going for it, and know that there's so much empowerment
• 1:03:29
  Speaker 2: that you can have just by knowing what's going on
• 1:03:32
  Speaker 2: with you and your body. And again, I'll reiterate this
• 1:03:34
  Speaker 2: till the cows come home. I have no idea if
• 1:03:36
  Speaker 2: I'm going to use my eggs, and I wouldn't have
• 1:03:38
  Speaker 2: changed a thing, Like I'm so happy that I went
• 1:03:42
  Speaker 2: through it. I am also grateful for like my definitive nature,
• 1:03:47
  Speaker 2: Like I heard about spring and I didn't even search elsewhere,
• 1:03:51
  Speaker 2: and I did like a brief amount of research, but
• 1:03:55
  Speaker 2: it was just like, once I found you and I
• 1:03:58
  Speaker 2: saw you and I felt comfortable, I was like, well,
• 1:04:01
  Speaker 2: I'm not going to keep searching. I'm not going to
• 1:04:03
  Speaker 2: add to this decision fatigue. Right, I'm going to get somewhere.
• 1:04:06
  Speaker 2: I'm going to make this decision and I'm going to
• 1:04:08
  Speaker 2: go all in. And so that is the kind of
• 1:04:10
  Speaker 2: person that I am. But yeah, I would just say
• 1:04:12
  Speaker 2: that it's so important to prioritize.
• 1:04:16
  Speaker 3: Yourself and do what feels right for you. Yeah. Absolutely.
• 1:04:20
  Speaker 3: I think you.
• 1:04:22
  Speaker 1: Said something really important, which is you do need to
• 1:04:26
  Speaker 1: do your research and you need to make sure that
• 1:04:30
  Speaker 1: the person that you're going to go on this journey
• 1:04:32
  Speaker 1: with your doctor your clinic is the right fit for you.
• 1:04:37
  Speaker 1: I may not be everyone's cup of tea. Someone else
• 1:04:40
  Speaker 1: may not be the right person for them. So it's
• 1:04:44
  Speaker 1: important for you to mesh with your doctor and to
• 1:04:47
  Speaker 1: also know that these this is a place that has
• 1:04:51
  Speaker 1: good outcomes, that is making sure that the patient experience
• 1:04:55
  Speaker 1: is at the forefront of their minds. Yeah, that's I
• 1:04:58
  Speaker 1: think really really important as a physician, in as a
• 1:05:01
  Speaker 1: prior patient, I think that's really important and to make
• 1:05:05
  Speaker 1: sure that you are getting the best experience that you
• 1:05:08
  Speaker 1: can for such a vulnerable time in your life and
• 1:05:11
  Speaker 1: it matters. Yeah, and somewhere that will really prioritize you.
• 1:05:16
  Speaker 2: Yeah, Oh, something I didn't mention that I want to
• 1:05:18
  Speaker 2: make sure when we talk about like prioritizing you. That
• 1:05:21
  Speaker 2: was really helpful about this, and I do know that
• 1:05:23
  Speaker 2: this is a tool that a lot of clinics and
• 1:05:25
  Speaker 2: locations use.
• 1:05:26
  Speaker 3: That patient portal was so helpful.
• 1:05:28
  Speaker 2: I felt like I literally had a direct line to
• 1:05:31
  Speaker 2: learning about whatever it is that I wanted to learn about,
• 1:05:33
  Speaker 2: whether it was with you or a nurse, or I
• 1:05:36
  Speaker 2: had a financial consultant, I had a patient care coordinator.
• 1:05:39
  Speaker 2: Like I felt like I had like my own small
• 1:05:42
  Speaker 2: little basketball time, right, Yes, And so that was really
• 1:05:45
  Speaker 2: helpful because again, like, yes, I'm doing it on my own,
• 1:05:48
  Speaker 2: and so much of it is alone. But I came
• 1:05:51
  Speaker 2: to this really great understanding during the process that I
• 1:05:55
  Speaker 2: wasn't alone in my experience in that so many other
• 1:05:57
  Speaker 2: women have dealt with this, and so I knew that
• 1:05:59
  Speaker 2: I could do it as well. And then I also
• 1:06:01
  Speaker 2: had this really great care team that was available to me,
• 1:06:03
  Speaker 2: which was great yeah.
• 1:06:06
  Speaker 1: I kind of think of it as a I'm going
• 1:06:08
  Speaker 1: to date myself as a millennial, but kind of aim
• 1:06:12
  Speaker 1: you instant message.
• 1:06:13
  Speaker 3: And what did the kids using the stake?
• 1:06:16
  Speaker 2: They're on like teams and stuff, So there's slack you
• 1:06:20
  Speaker 2: just thought a little slack channel with all your peeps exactly.
• 1:06:22
  Speaker 1: But it's kind of like that, and it's really important because,
• 1:06:25
  Speaker 1: as we've talked about, it can be scary, it can
• 1:06:28
  Speaker 1: be overwhelming. You don't want to be calling your fertility
• 1:06:31
  Speaker 1: center twenty times, not reaching your doctor, not reaching your team.
• 1:06:35
  Speaker 1: That can be really really isolating and scary. So that's
• 1:06:38
  Speaker 1: something that we valued and prioritize, and I'm glad that
• 1:06:42
  Speaker 1: we offer that and that you had a good experience.
• 1:06:45
  Speaker 3: Did you always think that you wanted to go into
• 1:06:47
  Speaker 3: this line of medicine. I always knew I wanted to
• 1:06:50
  Speaker 3: be a doctor.
• 1:06:51
  Speaker 1: Yeah. I was a Women's studies double major. I knew medicine.
• 1:06:56
  Speaker 1: I liked surgery and procedures. I thought I would go
• 1:07:00
  Speaker 1: into ear nose and throat. My mom as a psychologist
• 1:07:04
  Speaker 1: for deaf and hard of hearing students, and so I
• 1:07:07
  Speaker 1: sort of grew up in that role. But I love
• 1:07:12
  Speaker 1: women's health and I think it's a really important population
• 1:07:15
  Speaker 1: and I love to be able to sort of even
• 1:07:18
  Speaker 1: bigger population now, to work with LGBTQ patients, and just
• 1:07:22
  Speaker 1: to be able to give someone a family and optionality,
• 1:07:26
  Speaker 1: whether they want a family, whether they don't want a family.
• 1:07:29
  Speaker 3: I love it. I'm hies. Well, I'm glad that you
• 1:07:32
  Speaker 3: did me too.
• 1:07:35
  Speaker 2: For people that want to keep up with you or
• 1:07:37
  Speaker 2: follow along with you, or maybe even learn more about Spring,
• 1:07:40
  Speaker 2: give me the details.
• 1:07:41
  Speaker 3: Where can they find you?
• 1:07:43
  Speaker 1: They can find me at Spring Fertility and Bryant Park
• 1:07:46
  Speaker 1: in New York City. We have two locations in the
• 1:07:51
  Speaker 1: New York area, and then we have some locations on
• 1:07:53
  Speaker 1: the West Coast. And also look at my instagram Michelle
• 1:07:56
  Speaker 1: CAPYMD and yeah, be happy to see anyone.
• 1:08:02
  Speaker 3: Anyone have a chat.
• 1:08:03
  Speaker 2: I'm over at Emily a body at Hurdle Podcast another
• 1:08:06
  Speaker 2: Hurdle Conquered.
• 1:08:08
  Speaker 3: Catch you guys next time.
• 1:08:18
  Speaker 1: H