Fertility Docs Uncensored Today’s episode of Fertility Docs Uncensored is hosted by Dr. Carrie Bedient from the Fertility Center of Las Vegas, Dr. Susan Hudson from Texas Fertility Center, and Dr. Abby Eblen from Nashville Fertility Center, with special guest Dr. Annie Martini, a reproductive endocrinologist from the Fertility Centers of Illinois, practicing in their Milwaukee, Wisconsin office. In this episode, the doctors dive into planned oocyte cryopreservation (egg freezing) and why more women are choosing fertility preservation. What are the benefits of freezing eggs, and who should consider it? Many patients pursue this option when they are unpartnered, allowing them to preserve younger eggs that do not age. The discussion explores how egg quality changes after age 35, increasing the risk of chromosomal abnormalities and impacting success rates. How many eggs should be frozen, and what outcomes can patients expect? Often, 10–12 eggs may yield only one to three embryos, depending largely on age, and some women may need multiple cycles, especially with lower AMH or egg counts. The episode also walks through the egg freezing process step by step. What does ovarian stimulation involve, and how many monitoring visits are required? Patients typically undergo 5 to 7 visits, each requiring bloodwork and an ultrasound, before a 30-minute egg retrieval procedure. The physicians discuss risks, including ovarian torsion, and why activity restrictions, such as limiting exercise and sexual activity, are essential during stimulation. They also cover recovery expectations, the importance of having a trusted person for transport after retrieval, and how long frozen eggs can be stored. This podcast was sponsored by the Fertility Centers of Illinois at Milwaukee.

Episode Transcript:

Susan Hudson (00:01)

You’re listening to the Fertility Docs Uncensored podcast, featuring insight on all things fertility from some of the top rated doctors around America. Whether you’re struggling to conceive or just planning for your future family, we’re here to guide you every step of the way.

Susan Hudson MD (00:22)

Hello everyone, this is Dr. Susan Hudson from Texas Fertility Center with another episode of Fertility Docs Uncensored. I am here with my amazing co-host Dr. Abby Eblen from Nashville Fertility Center.

Abby Eblen MD (00:36)

Hey everybody.

Susan Hudson MD (00:37)

and Dr. Carrie Bedient from the Fertility Center of Las Vegas.

Carrie Bedient MD (00:41)

Hello

Susan Hudson MD (00:43)

We are so excited today because we have Dr. Annie Martini from Fertility Centers of Illinois and she’s going to be joining us today.

Annie Martini (00:52)

Hi there, thank you so much for having me.

Susan Hudson MD (00:55)

We are very happy to have you. We understand that you recently joined Fertility Centers of Illinois and you are at their newest location in Milwaukee.

Annie Martini (01:04)

I am, yes, it’s Fertility Centers of Illinois, but in Wisconsin.

Susan Hudson MD (01:08)

Good stuff, good stuff. Well, before the show, you were telling us a little bit about that you have an interesting history of being in a competitive show choir. Is that true?

Annie Martini (01:24)

Yes, it is true. If you ever watched the TV show Glee, it’s essentially what that was based off of was the type of show choir I was in. So we traveled to local and also national competitions. Our biggest competition we performed actually at the Grand Ole Opry in Nashville. Uh-huh. Yep. So I got to perform a couple of times on the Grand Ole Opry stage, which was amazing.

But yeah, it was, it was pretty cutthroat too. especially.

Susan Hudson MD (01:55)

Did you do this in high school or did you do it in college?

Annie Martini (01:58)

So I did it in high school. That was primarily when I did that. But then I also, in college, attempted to start up a competitive show choir there. Didn’t quite take off, though.

Abby Eblen MD (02:08)

So tell me, what is a competitive show choir? How do you get people together and who are you competing against? Other groups or like within the choir itself?

Annie Martini (02:17)

So you’re competing with other show choirs from other schools. So us as a collective at my high school, we would practice and rehearse and it was intense because it was singing and dancing. You would leave the practices just sweating, ⁓ but it was so much fun. But you would compete against these other show choirs from other schools. I know there’s certain areas where it’s more common to be a part of a show choir. And I think the Midwest is one of those areas where there’s a good group of us to compete against. So was really fun.

Carrie Bedient MD (02:48)

What was your favorite performance? Did you guys do themes? I know our show choirs would do, they did Queen one year, they went on some classical binge one year and did all these madrigals and things that you don’t normally associate with show choirs. But what was your favorite performance?

Annie Martini (03:02)

Yes. Yes. So we didn’t have one show that was all one theme, but one of the numbers that was my favorite was definitely the Bon Jovi number. Shot through the heart. That was our closer. He had to finish with that one.

Carrie Bedient MD (03:17)

So do you serenade your staff when you’re doing egg retrievals at, six in the morning? Do you guys have the radio playing? Do you sing for them?

Annie Martini (03:26)

Sometimes I do. I don’t belt it out. I’m a little bit under-rehearsed at this point. ⁓

Carrie Bedient MD (03:33)

I don’t recall that ever being an issue with any of the show choir friends that I had. Under-rehearsed, over-rehearsed, they were still singing.

Annie Martini (03:40)

Sing it all the time. Yes, that’s true. That’s true. But I always have music playing in my OR. Absolutely. It feels like there’s something off if there’s not music playing.

Abby Eblen MD (03:45)

And what are you sing? Soprano, alto, what’s your?

Annie Martini (03:52)

I was a soprano.

Abby Eblen MD (03:54)

Okay. We may get to see. I think you should sing something before you leave, know, to prove you’re really.

Annie Martini (03:59)

Putting me on the spot here.

Susan Hudson MD (04:01)

Just a little bit, just a little bit.

Abby Eblen MD (04:01)

Okay. For those of us who have no vocal talent, we would love to hear just like a little snippet.

Annie Martini (04:03)

Maybe, we’ll see, we’ll see. ⁓

Susan Hudson MD (04:10)

The only singing we ever get is Carrie, and I’m pretty sure, no offense Carrie, that you’re gonna be better than her.

Abby Eblen MD (04:13)

Yeah, I’m pretty sure you’re probably nothing against Carrie.

She has her own talents, but maybe that’s not the best one.

Annie Martini (04:19)

How about you harmonize with me? Then it’ll sound real good.

Abby Eblen MD (04:22)

No.

Carrie Bedient MD (04:22)

No, that’s gonna be a harmony that makes dogs yell.

Annie Martini (04:26)

Hahaha!

Abby Eblen MD (04:27)

When I’m listening to the radio, I can carry a tune. I’m not a good singer at all, but I love to try and harmonize and about 90 % of the time I can’t do it, but I would love to be able to do that. That seems so fun.

Annie Martini (04:40)

Yeah, no, it was a great time.

Abby Eblen MD (04:42)

All right, well, no music. We’ll move on then.

Susan Hudson MD (04:42)

That’s neat. That’s All right.

Susan Hudson MD (04:46)

If IVF has been living in the I’ll deal with it later category, summer might be your window to change that. Schedules shift, things slow down just enough and suddenly you’ve got the space to actually figure out what comes next. At Fertility Docs Uncensored, we’ve spent years helping patients cut through the noise and understand IVF for what it really is. Not overwhelming, not mysterious, just a series of steps you can learn and navigate. That’s exactly why we created the IVF Blueprint. It’s a straightforward, no-nonsense guide to the entire IVF process. What happens, what decisions you’ll face and how to think through them without second-guessing every move. Whether you’ve just started to seriously consider IVF or you’re already in it and want to feel more control, the IVF Blueprint helps you move from, I think I should, to, I know what I’m doing. You can find it in print, ebook, and audiobook with a bonus conversation from us at the end, wherever books are sold, and at Fertilitydocsuncensored.com.

If you’ve been waiting for the right moment to get clarity, this might be it.

Susan Hudson MD (05:52)

We will go to our question of the day. Our question is, I’m 30. We started trying to conceive last year and got pregnant on our first cycle. At eight weeks, the heartbeat was strong and everything measured normal. At 12 weeks, an ultrasound revealed a missed miscarriage. The fetus measured 10 weeks and three days. I had pregnancy symptoms until the very end. I had a D&C. Microarray showed normal chromosomes.

My provider said no further testing is recommended. I know miscarriage is common, but these circumstances feel rare. Based on the literature, I estimate my actual risk of loss was closer to 1%. Should I push for a recurrent pregnancy loss evaluation after just one loss? I want to try again, but I’m concerned about an unevaluated maternal factor. What are your thoughts?

Annie Martini (06:42)

Yeah, yeah. So that’s a great question. I think typically after one miscarriage in the first trimester, it doesn’t necessarily meet the definition of recurrent miscarriage, which is two nonconsecutive losses. Knowing that this loss happened a little bit later, Certainly it wouldn’t be unreasonable to consider antiphospholipid testing because of that slightly later loss after 10 weeks.

And also too, having done a D&C, may want to consider just checking the uterine cavity to make sure everything healed okay. I don’t think it would be unreasonable to advocate for yourself there and do a little bit of additional testing, especially since it was a little later in the first trimester.

Carrie Bedient MD (07:22)

Maybe consider that insurance won’t cover it if there’s only been one documented miscarriage and that’s worth knowing. know, those, those labs add up relatively quickly and can be very expensive. Not that that’s not a reason to do it, but it’s certainly a reason that you want to think about before having your doc order all those things that very reasonably may not be covered by insurance.

Abby Eblen MD (07:47)

I’d just like to add, this miscarriage is not as uncommon as you might think. Lot of people have very early losses and don’t even realize that they were pregnant. It’s kind of nature’s way sometimes of taking care of things. I think we focus a lot on genetics and I’m glad that we know it’s a genetically normal embryo, but there’s lots of genes we know that have to be turned off and turned on at the right time in order for pregnancy to implant and grow. And I always use the example of your hand.

All these genes have to turn off and on in order to create fingers because otherwise you’d have just a big paddle for a hand. There’s probably lots of other things that go on that we just don’t have tests for. And, it’s really frustrating for patients certainly and upsetting and also for physicians. I just wish we had more tests, but I think there’s a lot more that we just don’t know about implantation and pregnancy early on.

Susan Hudson MD (08:32)

I think a couple of easy things to do are check your prolactin level, check your thyroid hormone, make sure that that’s working fine. But as Abby was mentioning, there’s more to a normally developing pregnancy than just chromosomes. So it’s possible that maybe baby was not fully developing some sort of vital organ, whether it be the liver or the kidneys or who knows what it could have been.

Highly recommend, realistically, your best chances of conceiving are shortly after a loss, take advantage of that little bit of a running start. And don’t let this loss be the thing that keeps you from trying. Because we see this so often in our practices, people will have an unexpected negative event like this, and people get kind of stuck on it. And it’s like, we got to figure this out before we do anything. And before you know it, three months turns into six months, six months turns into a year. And I would say more than half of our patients who come to see us have actually been trying to conceive for more than two or three years, not just six months to a year. We see this over and over again and we understand life gets in the way sometimes, but don’t let this be the reason you don’t keep on going.

Susan Hudson MD (09:51)

All right. We are going to talk to Dr. Martini today about fertility preservation. So Annie, tell us a little bit about why is fertility preservation, we’re going to be talking about elective fertility preservation today. Not fertility preservation strictly related to people who have things like a cancer diagnosis, but why is elective fertility preservation something that we’re even talking about.

Annie Martini (10:20)

We know that women are born with all the eggs that we will ever have. And over time, the number of eggs that we have decreases, unfortunately, and we can’t regenerate new eggs. We also see that the quality of our eggs declines over time. And doing fertility preservation specifically with egg freezing may be a way to combat that age-related egg quantity and quality decline, especially for someone who may not be ready to start building their family.

Carrie Bedient MD (10:50)

So I’m curious about what you all call non-medically indicated related fertility preservation in your practices. Because I’ve heard quite a variety of things. And it’s interesting how I see patients react to that. What do you all call it in your practice? Is it primarily elective or social or preventative or how do you guys phrase it within your practices?

Annie Martini (11:16)

I think technically ASRM calls it planned oocyte cryopreservation. So that’s often what I use because it’s something just to help you plan and shape your reproductive future. So I do like terming it that way.

Susan Hudson MD (11:29)

I generally leave off all of those descriptive words off of it. And we’re just talking about egg freezing or embryo freezing and whatever this situation happens to be. I think the label on it, as you mentioned, Carrie, sometimes can get a little awkward in describing the importance to an individual of this type of medical care for their fertility. I try honestly to leave off some of those labels.

Abby Eblen MD (11:56)

In our meetings when we’re talking about patients, we usually use the term elective egg freezing. And I think that and planned oocyte cryopreservation is the correct term that ASRM uses. I think anything that doesn’t make people feel bad about it, I think social egg freezing to me has always had a bad connotation. I think a lot fewer people use that term now and I think that’s a good thing.

Carrie Bedient MD (12:16)

So what do you see are the primary characteristics of patients who come to you for planned egg cryo? How are they the same? How are they different than the fertility patients who walk in our doors?

Annie Martini (12:29)

Typically patients who are seeing me for egg freezing, and I see patients of a variety of different ages, and I think that now that it’s becoming a more commonly discussed topic, we are seeing patients who are coming earlier where the success rates of being successful if they needed to use those eggs go up. But oftentimes these patients are unpartnered and not ready to necessarily build their family. They don’t often have a specific timeline in mind, but want to plan ahead. I also see patients who have an underlying diagnosis that could potentially impact their fertility. Someone who previously had an endometrioma removed and has a known diagnosis of endometriosis or someone who has known PCOS that they’ve been managing with birth control pills, but understanding that they could face fertility challenges when it does come time to get pregnant. But oftentimes I see patients that are roughly in their mid thirties where we know that the egg quality really does start to more precipitously decline. And they’re trying to lock in the age of their eggs at the age that they’re at.

Susan Hudson (13:32)

Finding the right fertility care starts with feeling supported and informed. At Fertility Centers of Illinois, you have access to advanced fertility treatments, IVF refund options, and flexible payment plans, making high quality care more accessible across Chicagoland and now Milwaukee. Take the next step toward parenthood with our expert team. Visit fcionline.com to schedule your consultation because your miracle is FCI’s mission.

Abby Eblen MD (14:01)

Annie, I find that when patients come to see me for egg freezing invariably they’re usually surprised by something I say in the consult because I think it’s so out of the realm of normalcy for most people. They don’t normally talk about egg freezing, don’t understand it. So what do you think is the biggest surprise that they have when they first meet you and what do you think the biggest surprise is that they have after they’ve done their egg retrieval and they’ve come back for a post egg retrieval consult with you?

Annie Martini (14:27)

Hmm. That’s a good question. One of the biggest takeaways that I try to emphasize with my patients that I think can come as somewhat of a surprise is that the process of egg freezing and freezing your eggs, unfortunately, is not a guarantee and that it takes a lot of eggs

to be able to potentially make a baby. And there’s the number of eggs that it takes to yield a genetically normal embryo varies based on your age. So I think when we break it down and there are some really helpful tools and calculators that I use in my counseling, I think the statistics surprise people that 20 eggs for someone who is younger than 34 can give them reasonable chances of having at least one child, but for two and three kids, the stats go down even for someone who’s young and has 20 eggs in the freezer.

Abby Eblen MD (15:14)

Yeah, I think that’s a big shock for patients. I was hoping you would say that, because that’s what I seem to experience too, that people are just so surprised when they get eight or 10 eggs and they’re like, but I thought I would get more. And you mean, I only have this chance of having one child and a really small chance of having two children. But yeah, I think the egg, overall the egg number is the biggest surprise for most people that you need to have a healthy baby.

Susan Hudson MD (15:36)

Can you describe a little bit how egg number can vary if you are coming to freeze your eggs in your upper 20s versus early 30s versus late 30s versus early 40s?

Annie Martini (15:51)

Yeah, absolutely. Because we know egg quantity declines with age, the way that that shows up is that there’s fewer eggs available in any given cycle to be able to retrieve. And that’s something that we discern through that initial testing and kind of help to set those expectations. But certainly the number of eggs that we are capable of retrieving in one given cycle is usually higher in someone in their late 20s, early 30s versus someone in their late 30s and 40s. But also, the quality and the capability of those eggs is much greater in someone who is younger. So not only can we get more eggs from someone who is younger, but those eggs go further and have better capabilities.

Carrie Bedient MD (16:37)

What are the extremes of age that you would say, I wouldn’t do elective or planned oocyte cryopreservation younger than this age or older than this age? How do those numbers play in?

Annie Martini (16:49)

In terms of older ages, I am very cautious at recommending oocyte or egg freezing in someone who’s 40 or older. And the reason is that when your eggs are older, again, they have much higher chances of creating genetically abnormal embryos.

And if you’re planning to freeze eggs at that age, but not use them for a few years, you’re not testing the capability of those eggs for another few years. And if those eggs don’t work out for you, your options are pretty limited in terms of using your eggs. So an option I discuss is the option to create embryos. Because when you create an embryo at age 40, you’re testing the viability and capability of that egg,

and you have the ability to genetically test the embryo that stems from that egg. So you get a lot more information from an embryo. So that’s usually the age where I start to bring that into the discussion. But of course that isn’t aligned with everyone’s plan. But that’s usually when I discuss it. In terms of young ages, I don’t really have an age cut off necessarily on the younger end where I wouldn’t necessarily recommend egg freezing, but I talk about that.

In terms of egg quality, the quality should be quite good throughout the bulk of time in your 20s and early 30s. So there wouldn’t be necessarily a huge rush.

Susan Hudson MD (18:12)

Is there a shelf life on the frozen eggs?

Annie Martini (18:16)

That’s a fantastic question. So this is an area of research that is very understudied. But what the data that is there says is that we do not believe there is an expiration date on the eggs. The difficulty is that right now, in order to study this, there is a low number of patients that actually come back to utilize their eggs. So this is a hard question to answer.

Right now we’re having more patients that are coming in with plans for egg freezing to potentially use five, sometimes even maybe eight, 10 years later. And that is just an area in the data that we are lacking in terms of the longer duration of time between freeze and thaw.

Abby Eblen MD (18:54)

If you had a couple that came to see you and say, lifetime partners, engaged, serious relationship, would you ever consider having them create embryos versus just the female partner freezing eggs? And if so, why would you recommend that?

Annie Martini (19:10)

Yeah, so if a patient comes to me in a serious partnership, I do discuss the option of creating embryos for similar reasons that I mentioned before is that you get a lot more information from an embryo. It gives you more certainty, but I also present the option for still freezing eggs in the setting you want more flexibility. If there’s any question, and I have this discussion openly, if there’s any question that you think that you want that female partner wants to keep her eggs just as eggs and not lock them in to combine with that sperm, then I always encourage the option to freeze eggs. If there’s any question about that.

Susan Hudson MD (19:48)

Do you ever discuss doing a split cycle where you freeze some of the eggs and create embryos in case somebody’s kind of like, well, I kind of like the idea of this one part, but I also want to freeze my eggs just in case, life happens and this ends up not being forever.

Annie Martini (20:05)

100%, yes. So I talk about it, I talk about split cycles as an option, but really kind of gauge it based on their egg reserve. So if they have a pretty great egg reserve, then I talk about, okay, maybe we can do 50 % as eggs, 50 % we try to turn into embryos. If the egg reserve is low, I talk to them about maybe doing one cycle as embryos and one cycle as eggs.

Carrie Bedient MD (20:26)

A lot of patients will ask about how do we test eggs individually? Like, how are you going to know that they’re good? What do you tell patients with those questions?

Annie Martini (20:35)

I tell them that unfortunately there is no test for egg quality. When we remove the eggs before the eggs are frozen, the embryologists will look at them under the microscope and they can make some general observations about the eggs, but that’s really it. We don’t know anything about their capability of making embryos. And really the best predictor of that is age. Also, if they have any underlying fertility conditions like endometriosis, I usually recommend freezing more eggs than what I would typically recommend just based on that patient’s age alone, understanding that the egg quality could potentially not be as great as someone who didn’t have endometriosis.

Susan Hudson MD (21:16)

Cost plays a part in all of these decisions. Can you give us some idea of where the different costs in egg freezing are generated and what are potentially some options for helping fund egg freezing?

Annie Martini (21:31)

Yeah, absolutely. So the costs that come with egg freezing, large bulk of it is due to the medications. So depending on how much medication a patient would need, that contributes to a large proportion of the costs. There’s the monitoring visits that the patient would have when she’s seen in the clinic, but then also fees on the lab side, for the actual freezing of the eggs. That’s kind of where all the cost comes in as well as procedure for the egg retrieval and the anesthesia that you receive for the egg retrieval. So in terms of cost, various clinics have certain packages that can be purchased or financing options. So oftentimes, fertility clinics will have a financial educator that you can work with to talk through what those options are.

But I also would check with your insurance because certain insurance carriers will fund planned egg freezing even without a medical indication or have a little bit more flexibility in terms of the medical indication you would use. That’s something I also would just check into the specifics of your benefits.

Abby Eblen MD (22:35)

Can you give the patients an idea of how many visits they would need to have? And if there’s any limitations to the things that they would normally do, that they can’t do when they’re in the middle of an egg freezing cycle.

Annie Martini (22:47)

Yeah, so usually when you start an egg freezing cycle, it started around day three of your period, whether or not that’s a natural period or coming off of birth control pills, which are sometimes used ahead of an egg freezing cycle. And once you start those injections, which most take for about 10 to 12 days, you’re gonna be seen in the office pretty frequently. So that’s the time where we don’t really want you taking any long trips, planning any work travel, because we’re need to be seeing you and your next visit is kind of dependent upon the results from the first. So oftentimes I expect that you’ll be seen about six to seven times potentially throughout the course of your injections, but it just depends on how your ovaries respond. So those are usually the expectations that I set for that. In terms of modifications to lifestyle, when someone is going through ovarian stimulation with the injections, your ovaries are physically getting bigger. So you are at a risk of having something called an ovarian torsion where the ovary can twist. So I usually recommend to my patients to modify their physical activity level, not completely eliminate, but nothing high intensity with running, jumping or bouncing. They could promote those ovaries to twist.

Because the only way to untwist them is with a surgery and you do not want that. And then I usually recommend to avoid intercourse as well.

Carrie Bedient MD (24:08)

How do you talk to patient about disposition of those eggs and what happens to them if they don’t end up using them? patients will ask about all sorts of scenarios, some as simple as I decide I don’t want kids and others as complex as what happens if I get hit by a bus and die, what happens to my eggs? How do you counsel patients for that?

Annie Martini (24:32)

Yeah, that’s a really interesting and good question. So I talk to patients about the option, should they not end up needing to use their frozen eggs, which I do bring up that a lot of women don’t end up needing to use them. So it’s something that they should think about. You have the option to discard them and not use them, but you also potentially have the option to, depending on kind of what your clinic has available, donate them to someone or designate someone as a potential recipient of the eggs should something happen to you. And you also potentially depending on your clinic have the option to donate them to research.

Susan Hudson MD (25:07)

When we have somebody who comes in for an egg retrieval and they’re wanting to freeze their eggs, one of the most common questions we have is, can I take Uber or Lyft to get home? What are your thoughts on this? It’s a real question, isn’t it?

Annie Martini (25:22)

It’s a real question, yes. And I always explain that after an egg retrieval in which you will be receiving anesthesia, we cannot send you home in an Uber or Lyft. You have to have a known designated driver or person take you home just because of the anesthesia that you’ll receive. It’s just not safe.

Carrie Bedient MD (25:42)

Any medical conditions or genetic conditions that you see with people that would make you say, ordinarily I would do one egg retrieval for someone of your age, but given your past history, we want to bank on doing two or three or as many as we can get.

Annie Martini (25:59)

Yeah, absolutely. if someone has a specific, known genetic disorder, let’s use like a, if they’re a BRCA mutation carrier, let’s just say, and they would want to freeze these eggs potentially to use for future IVF, or they’d want to test for this.

Because it is a dominant genetic disorder, we know that 50 % of the embryos that she would make in the future would be affected. So knowing that 50 % of the embryos would be ineligible based on that, not taking the chromosome status of the embryo even into consideration, that’s usually where I’d recommend freezing a higher number.

Other conditions, maybe other genetic conditions, like if someone is a fragile X pre-mutation carrier, these patients are at a higher risk of developing primary ovarian insufficiency or early menopause, but also the potential for passing along that pre-mutation exists as well. These are patients that I would usually recommend freezing more eggs.

Carrie Bedient MD (26:58)

What do you tell your patients when they say, I’m 31 now, my life plan is to move halfway across the country, halfway across the world, what happens to my eggs? Where do they go? What do I do with them? How do I use them?

Annie Martini (27:10)

Yeah, that’s a great question. So I always present the option, the most straightforward option, for some would be to keep the eggs where they are. And depending on where that patient lives, it’s possible that she could come back to have an embryo transfer in the future if her partner was able to provide a sperm sample that could be used to create those embryos. Or if she choose to chose to use a donor sperm, for example. The travel back to the origin of your eggs is an option one. Option two, it’s possible to do international transport of the eggs. It has been done before. It’s something that you could look into. I don’t have any knowledge on the cost of that, but there is always that potential concern about the logistics of coordinating transport of eggs or embryos. The safest thing for your eggs would be to keep them where they are.

Susan Hudson MD (28:01)

Eggs going through customs or embryos going through customs can happen, but I think it gives everybody involved in every way, or form heartburn.

Annie Martini (28:07)

Yes. Yes, yeah, agreed.

Abby Eblen MD (28:12)

I mean, would you be comfortable with any of somebody say like moved to California and wanted to ship their eggs to California from Illinois or something like that?

Annie Martini (28:21)

Yeah, absolutely. Domestically within the US, it’s usually a pretty safe and standard process for transport. But what I will tell patients always if they are planning to move outside of the place where they are freezing their eggs is that your clinic that you establish with may not accept the eggs you froze with us, depending on the technology they use or certain criteria that their lab has for accepting outside eggs or embryos. So that’s just something to take caution with, but worst case scenario in that.

They could just come back to create embryos with us.

Susan Hudson MD (28:51)

Is there a sweet spot of an age that, I’m listening to this, I’m thinking about freezing my eggs, but I don’t wanna freeze my eggs too early, because I know statistically, hopefully I do find somebody that I want to create babies with and that might just happen sooner than later. You never know who’s gonna walk in your path versus I also don’t wanna wait too long and have to worry about not having a enough.

Annie Martini (29:15)

I think the sweet spot’s somewhere between 28 to 32. That’s like the ideal range that I would usually like to see patients in terms of feeling pretty optimistic that we’ll not only get a good egg yield, but that those eggs have a great chance of working for you. But also, I just feel like that’s a timeframe in which I would like to see most of my patients planning this.

Carrie Bedient MD (29:38)

If someone gets eggs and they decide, okay, I either don’t want to use them or I don’t need to use them. And I would much rather donate them to somebody else so that my friend or some anonymous person can use them. What kind of steps need to happen in order to make that a reality? Does the person who’s donating eggs have to go through anything more?

Annie Martini (29:58)

Typically, yes, if it wasn’t done at the time of the initial egg retrieval, like if there was no kind of pre-testing that’s done, often if you’re planning to be an egg donor and use the eggs for donation purposes, there’s a lot of additional FDA required testing that needs to be done that patients who are initially coming in to be an egg donor have to do, but those can be done retroactively to potentially allow that to happen.

Susan Hudson MD (30:23)

Very good. Anything else that you would like to share about egg or embryo freezing?

Annie Martini (30:29)

Yeah, I often see patients coming to me in a time of, a pivotal change in their life, like someone starting a new job and they have this great insurance that finally covers this, or they unfortunately just went through a breakup of a long-term relationship and their whole family building plans have shifted. So I feel, and I really enjoy having this conversation because I feel like it kind of puts the power back into your hands, like, you are getting to shape and own your reproductive future. And so I really love talking to patients about it. Of course, I always emphasize that it’s not a guarantee, but it’s a really powerful tool that you can have to give you the best odds of building your family how you want to.

Abby Eblen MD (31:08)

Very good.

Susan Hudson MD (31:08)

Absolutely. I think this has been a great episode. My heart goes out to women all the time because I’ll see people, even people in relationships that, maybe they’re both not on the same path of wanting to have children at the same time. And waiting, waiting, waiting for the guys doesn’t have nearly as negative an impact as it does for women.

Even if you’re in a relationship and you want to freeze your eggs, you don’t have to be single to freeze your eggs. You can freeze your eggs no matter what. Just like you said, taking control of your reproductive future, this is one of the biggest things you can consider doing.

Annie Martini (31:38)

100%.

Carrie Bedient MD (31:49)

I have one other question that I know we all get on a regular basis, but it’s what are the risks of freezing eggs?

Annie Martini (31:57)

When you freeze eggs, there are procedural and medication related risks. So we know the medications that you’d be taking will cause your hormone levels to go up much higher than they would be in your natural menstrual cycle. So there is a slightly increased risk of developing a blood clot in your leg or your lung. There’s also some general side effects that some patients can experience related to the higher levels of hormones.

There’s that risk of ovarian torsion like I mentioned before just due to the ovaries getting bigger and then risks of the procedure of the actual egg retrieval itself, which overall is a very safe and quick procedure, but there are potential risks anytime we’re doing a procedure that involves a needle going into the pelvis. ⁓

Susan Hudson MD (32:41)

I just thought of another thing that people always ask about regarding risks. Are we using up her future eggs?

Abby Eblen MD (32:46)

Yeah, that’s a good one.

Annie Martini (32:48)

Yes. that’s a great question. 

How I always explain that is that in any given cycle, you have multiple egg contenders that are available for the one that your ovary picks for that month. Unfortunately, the ones that don’t get chosen just die off. So when we’re doing egg freezing, we are seizing the opportunity that your ovaries are giving us and capturing all of those. So all of those that showed up get to be winners.

And we are not negatively impacting your future fertility by removing the eggs in that cycle. But that’s a great question. And I think one of the last risks too is relying too much on the eggs and not understanding that the odds aren’t 100%.

Carrie Bedient MD (33:28)

One question that’s a version of the risk question that I hear frequently is, what is my risk of getting cancer by taking these medications?

Annie Martini (33:34)

Mm-hmm.

The research that’s available shows that for both IVF and egg freezing, we don’t see any increased risk, increased lifetime risk of cancers like breast cancer or uterine cancer over time. So it’s a very safe process to go through without substantial future risk.

Susan Hudson MD (33:54)

And another important thing to know is most of those cancers are the risk of them are going to be decreased if you eventually have a pregnancy. So if this egg freezing is what you need to fulfill your family dreams in the future, it may actually lower your risks of some of those bad things.

Carrie Bedient MD (34:13)

Definitely.

Susan Hudson MD (34:13)

All right, well, thank you, Annie, for joining us today. And again, this is Dr. Annie Martini from Fertility Centers of Illinois in Milwaukee. And to our audience, thank you so much for listening and subscribe to Apple Podcasts to have next Tuesday’s episode pop up automatically for you. And be sure to subscribe to YouTube. That really helps us spread reliable information and help as many people as possible.

Carrie Bedient MD (34:37)

Visit fertilitydocsuncensored.com to submit questions and sign up for our email list. Pick up your copy of the IVF Blueprint today at Amazon, Barnes & Noble, or your favorite bookstore. Check out our Instagram and TikTok for quick hits of fertility tips between weekly episodes.

Abby Eblen MD (34:52)

As always, this podcast is intended for entertainment and is not a substitute for medical advice from your own physician. Subscribe, sign up for emails, and we’ll talk to you soon.

Susan Hudson MD (35:00)

Bye!

Annie Martini (35:01)

Thank you.