Egg Freezing Monitoring Appointments: What You Should Know

As you embark on your egg freezing journey, you'll quickly become familiar with a big aspect of the process: monitoring appointments. These regular check-ins during the 10-14 day egg freezing cycle are essential for ensuring the success and safety of your cycle. While the prospect of frequent medical visits might seem daunting, understanding what to expect can help you approach these appointments with confidence. Let's dive into the details of monitoring appointments during your egg freezing cycle.

The purpose of monitoring appointments during egg freezing

After you begin your fertility medications, your body will start producing multiple eggs. This is where monitoring appointments come into play. These visits serve several critical purposes:

• Tracking your response to medication
• Ensuring multiple eggs are developing properly
• Determining the optimal time for egg retrieval
• Preventing overstimulation and the risk of Ovarian Hyperstimulation Syndrome (OHSS)

Egg freezing medications are not one-size-fits-all. Every woman's body responds differently to fertility drugs, which is why individualized monitoring is so important. Your doctor will use these appointments to fine-tune your treatment plan, adjusting medication dosages if necessary and pinpointing the ideal moment for egg retrieval. These visits also provide an opportunity to address any concerns or questions you may have. 

During these appointments, your care team will work to ensure that you are neither overstimulated nor understimulated. Overstimulation can potentially lead to ovarian hyperstimulation syndrome (OHSS) while understimulation may result in a lower yield of mature eggs. Through monitoring, your healthcare team will optimize your chances for a successful outcome while also prioritizing your health and well-being above anything else. 

Location and frequency of egg freezing monitoring appointments

Typically, these appointments take place at your fertility clinic. However, if you're not located near your primary clinic, arrangements can often be made for monitoring at a local fertility clinic or monitoring center like an OBGYN office.

As for frequency, be prepared for regular visits. Monitoring appointments usually occur every 2-3 days during your stimulation cycle. However, depending on your individual response and your doctor's assessment, you might find yourself at the clinic more or less. On average, you can expect around 5-6 appointments during your cycle.

What to expect during monitoring appointments

Your monitoring appointments will primarily consist of two key components: transvaginal ultrasounds and blood tests. Let's break down what you can expect from each:

1. Transvaginal ultrasounds

The star of the show during monitoring appointments is the transvaginal ultrasound (some folks in the fertility world jokingly call this “dates with Wanda”). This imaging technique uses an ultrasound wand to allow your doctor to visualize your ovaries and uterus, providing crucial information about your progress. 

When you arrive for your appointment, a nurse will escort you to a private room. You'll be asked to undress from the waist down and lie on an exam table with your feet in stirrups. The ultrasound technician or doctor will then insert a thin, wand-like device called a transducer into your vagina.

The word “transvaginal” means the ultrasound transducer goes in the vagina. Now, let's address the elephant in the room: does it hurt? While the sensation can be uncomfortable, most women describe it as pressure rather than pain. The procedure is generally quick, lasting only a few minutes.

During the ultrasound, your doctor will be looking at several key factors:

• Follicle count: Each follicle is a fluid-filled sac that contains an egg. The number of follicles present indicates how well you're responding to the fertility medications.
• Follicle size: Your doctor will measure the size of each follicle. This measurement helps determine the maturity of the eggs within. As you continue your medications, these follicles will grow – typically about three millimeters every two days.
• Uterine lining: Although not directly related to egg freezing, your doctor will also assess the thickness and quality of your uterine lining.

The goal is for most follicles to reach a size between 18 and 20 millimeters before egg retrieval, though this can vary based on individual circumstances.

2. Blood Tests

In addition to the ultrasound, you'll likely have blood drawn at some or all of the monitoring appointments. These blood tests primarily measure your estrogen levels, which rise as your follicles grow and produce more estrogen. Your doctor will use these results, in combination with your ultrasound images, to assess your progress and make any necessary adjustments to your medication protocol.

The blood draw is typically quick and straightforward. If you're someone who gets nervous around needles, don't hesitate to let the staff know. They're experienced in working with patients who have a range of comfort levels with medical procedures.

Interpreting your results

After your ultrasound and blood tests, you might be eager to know what it all means. While your doctor will provide personalized feedback, here are some general guidelines:

• Follicle count: A higher number of follicles generally indicates a good response to the medication. However, quality is just as important as quantity.
• Follicle size: Your doctor is looking for consistent growth. Ideally, most follicles will be growing at a similar rate.
• Estrogen levels: Rising estrogen levels typically indicate that your follicles are developing well. However, if levels rise too quickly, your doctor might adjust your medication to prevent overstimulation.

Remember, these results are just snapshots in time. What matters most is the trend over multiple appointments. Don’t be afraid to ask questions so you can understand how your egg freezing cycle is progressing!

Tips for egg freezing monitoring appointments

To ensure your monitoring appointments go smoothly and provide the most accurate information, consider the following tips:

1. Schedule wisely: Most clinics will try and schedule your appointments first thing in the morning. This allows for the most accurate hormone measurements and can help you avoid disrupting your work day.
2. Stay hydrated: While you'll need an empty bladder for the ultrasound, staying well-hydrated in general can make blood draws easier.
3. Wear comfortable clothing: Opt for easily removable bottoms to make the ultrasound process more convenient.
4. Take notes: Jot down any questions you have between appointments so you don't forget to ask your doctor.
5. Be flexible: Your body's response to the medications might necessitate last-minute changes to your appointment schedule. Try to maintain some flexibility in your calendar during this time.

Monitoring appointments can be a lot. The frequent medical interventions, the uncertainty of each appointment's outcomes, and the general stress of the egg freezing process can take a toll.

Remember, it's entirely normal to feel a range of emotions during this time. Some women find it helpful to bring a friend or family member to appointments for support. 

Leading up to the egg retrieval

As your monitoring appointments progress, your doctor will be looking for signs that your eggs are nearing maturity. When most of your follicles reach the target size, and your hormone levels are appropriate, your doctor will schedule the exact day and time for your egg retrieval.

You'll be given specific instructions for this final stage, including when to administer your trigger shot – a medication that prompts final egg maturation and sets the stage for retrieval.

If you do decide to cycle multiple times, there are some benefits to repeating the process. Each cycle provides valuable insights, helping your care team identify the most effective type of care and medication regimen tailored specifically for you. This personalized approach can enhance the efficiency and success rate of subsequent cycles.

Summing it up

Monitoring appointments are a big part of the egg freezing process. While they require time and commitment, they're important for ensuring the safety and success of your cycle. By understanding what to expect, you can approach these appointments with confidence and use them as opportunities to stay informed about your progress.

Remember, every woman's egg freezing journey is unique. Your experience may differ from others, and that's perfectly normal. Trust in the process, communicate openly with your medical team, and don't hesitate to ask questions. You're taking a proactive step towards your reproductive future, and that's something to be proud of.

Freeze your eggs with Cofertility

We’d love the opportunity to support you on your egg freezing journey.

Through our Split program, qualified freezers can freeze their eggs for free when donating half of the eggs retrieved to a family who can’t otherwise conceive.

Through our Keep program — where you keep 100% of eggs retrieved for your own future use — we offer exclusive discounts on expenses, such as frozen egg storage. Keep members also still gain free access to our Freeze by Co Community, a safe space for those engaging in the egg freezing process (or gearing up for it) to connect and lean on each other.

By making egg freezing easier and more accessible, our programs further strengthen the American Society of Reproductive Medicine (ASRM)’s Committee Opinion that egg freezing can help promote social justice and strengthen gender equality.