fertility tracking

While in theory, the idea of egg freezing would have many raising their hands to give this a try, practically speaking it may be more complicated. There are real-world factors to consider: Do I need to freeze my eggs? Will I actually need them down the line? Am I a good candidate? And if so, would it actually fit into my budget, and are the logistics really feasible?

No need to wonder. Here’s what you need to know to make egg freezing possible in reality and the sort of programs where you can bring this to fruition.

Affordable egg freezing programs

We at Cofertility are dedicated to the idea that egg freezing should be more accessible. To make it possible for more of those who are interested, we have designed two different programs that prioritize different aspects of egg freezing. Take our quiz to see if you qualify for these programs.

Paying for keeps

With our “Keep” program, it’s about maximizing the number of eggs that you freeze, geared to enabling many people to be able to answer the question, “Can I freeze my eggs?” with a big, “Yes.”

As a member in this program, you get access to discounted prices we’ve negotiated with clinics and pharmacies, as well as a community of women also freezing their eggs at the same time. With this Keep program we give more leeway on exactly who can participate. While we are aware that research shows that fertility starts to decrease considerably after age 35, you can still take part in the program as long as you are under age 40.

This is egg freezing with real world families in mind, with steps taken to make fees more affordable. The idea is to lighten the load and to make budgeting for egg freezing that much easier, while bringing a little more joy and positivity to the process

The Split cycle

With our Split program, it’s all about taking budgeting out of the equation altogether, while helping another family. 

As a Split program member, if you qualify, you don’t have to set money aside for these burdensome costs at all – they are free as part of the program, including up to ten-years of storage. In return, you give half of your retrieved eggs from a cycle to someone who would be otherwise unable to conceive. The family receiving the donated eggs pays for all the costs to freeze and store your eggs, for their use to build a family now, and your use in the future. 

But, because we are splitting the number of eggs here, every single one counts that much more. So, we need to be more stringent in determining who can become a Split member. 

Important X factors

One of the factors that we weigh heavily for the Split program is age. In order to participate, you cannot be over age 34. That’s because data shows that, on average, those over 35 may not respond to fertility medication as well and therefore may not produce as many eggs. Also, research shows that, unfortunately, egg quality declines with age. 

Given the amount of time it may take to do initial testing and to match you with an intended parent, we have aligned our policy with ASRM (American Society for Reproductive Medicine) guidance on this and limit membership here to those who have not yet turned 34. This way if there’s a hiccup along the way, you won’t have to miss out — there should still be sufficient time to participate in the program.

Another factor to consider is what’s known as your anti-Mullerian hormone (AMH) levels. These levels signal how responsive your ovaries are likely to be to medication given to stimulate them to produce multiple eggs. If this number is pretty high, it usually means that your ovaries will respond well to stimulation. 

If at the time of initial screening, your ovarian reserve appears low based on your ultrasound and bloodwork, you, unfortunately, will not be eligible for the Split program, although you can still become a Keep member and achieve your goals that way. The ASRM guidance underscores the importance of considering biomarkers that indicate a donor’s potential ovarian reserve as part of the selection process. Scientists have found the AMH serum range of 2.20 to 6.8 ng/ml to be the one that research predicts will show if someone has enough ovarian reserve. This indicates how you will likely respond during an egg freezing cycle. 

No matter your ovarian reserve, you can still freeze your eggs. You just may not qualify for our Split program. That’s because we want to ensure that enough eggs are produced in the cycle to make it worthwhile for everyone after the eggs are divided, without your feeling that you’ve come up short and won’t be happy unless you do another cycle.

If you’re among those who qualify though, as many in their fertility prime may be able, this can be a golden opportunity. Feel free to read more about qualifications for joining our Split program.

Logistics

There is, of course, also the question of where you’ll need to go to make all this happen. 

If you’re a Split member, your initial physical screening takes place after you are matched with an intended parent. This includes some blood work and a vaginal ultrasound, which helps determine if this program will work for you, and will likely take place somewhere between where you and the intended parent’s locale. If any travel is needed though, our team will help you to make this happen, doing the necessary organizing. But monitoring for the cycle itself can be done at a local clinic right in your own area.

Meanwhile, Keep members have the flexibility to do the testing as well as the cycle locally, where it’s most convenient. 

Can you freeze your eggs? 

So, is this something that could practically work for you? Both of our programs are designed to make this feasible for a wide-variety of women. We try to keep costs down for Keep members while offering added flexibility to pursue their egg freezing goals. Meanwhile, for Split members the financial barriers are removed altogether.

Hopefully, this helps you to see how, practically speaking, you too can raise your hand up high and answer the question, “Can you freeze your eggs?” with a giant, yes, to make egg freezing in reality.

You probably never saw yourself using the words cervical mucus, much less pulling down your pants and checking to see if you’ve got any. But here you are. You’re trying to conceive, and your best friend told you that you’ve absolutely got to start checking it out if you want to figure out the best time for baby-making sex.

It might sound like an old wives tale that refuses to die, but it turns out tracking cervical mucus really can help some women get a better handle on their cycle. Here’s why you might want to start paying attention.

What's cervical mucus, anyway?

If it sounds like the stuff that comes out of your nose when you’ve got a bad cold, you’re halfway right…only this isn’t snot, and needless to say it’s not coming out of your nose.

Your cervix is located at the lower part of your uterus, says David Diaz, MD, reproductive endocrinologist and fertility expert at MemorialCare Orange Coast Medical Center in Fountain Valley, Calif.

Dr. Diaz describes the cervix as a sort of bridge between the vagina and the uterus, and as an entry portal for sperm when a heterosexual couple has sex during the female partner’s most fertile time of the month—when she’s ovulating.  

Now comes the mucus part.

The cervical canal, which Dr. Diaz describes as, “a tunnel passing through the cervix,” is lined with glands that excrete a clear, slippery mucus during ovulation. The mucus actually helps sperm make its journey toward the egg for fertilization. Aren’t our bodies amazing?

Because the mucus is only set up for aiding sperm during ovulation, its consistency changes throughout your cycle. So just like the arrival (and blessed departure) of your period can tell you that you’re absolutely not ovulating, the arrival of the right kind of mucus can tell you when you are. Which leads us to…

Checking your mucus

Some folks ovulate like clockwork, and they don’t need no stinking mucus to tell them they’re fertile. But if you’re not one of those lucky ladies, you may not need to run to the doctor to find out if you’re ovulating. You can try to do a check on your own to see if your glands are pumping out that slippery liquid.

Dr. Diaz suggests inserting two fingers into the vagina and feeling for something wet and slippery. Pull them out, and take a look at your fingertips:

• Totally dry to just slightly damp: This is typical of the days right after your period ends, when fertility is at its lowest for most women.

• Mucus that’s slightly thick and sticky and either yellowish or whitish: Although you’re still not ovulating, this indicates your body is either preparing for ovulation or has just finished.

• Mucus that’s almost totally clear and stretchy: If the mucus has the consistency of egg whites and can stretch a few inches between your fingers, your ovulation window has arrived! It’s time for frequent sex, Dr. Diaz says.

Do you really have to?

So all this is well and good, but do you really need to stick your fingers into your vagina and feel around for mucus to help you get pregnant?

Well, that’s up to you, but consider this: When scientists at the University of North Carolina, Chapel Hill and the University of Utah in Salt Lake City monitored more than 300 women on their fertility journey for a 2014 study, the women who opted to check their cervical mucus regularly were found to have a statistically significant increased chance of conceiving over women who didn’t bother to check. And theirs was far from the first study to find a solid link between tracking cervical mucus and conception! The science on cervical mucus is pretty well-regarded by the experts.

So, if you’re having trouble nailing that ovulation window but don’t yet want to take the plunge into ovulation test kits, this could be just the thing you need.

Maybe you’re ready to start trying to conceive, or perhaps you’re just done with taking hormonal birth control. Regardless of the reason, this can be a super big change leaving you wondering what the heck happens next, especially if you've been on it for a while. Will your skin break out like crazy? Will your cycle get wonky? Rest assured, we're here to answer all your questions about going off birth control.

How birth control works

The type of birth control you're quitting will dictate the type of things to expect when going off it. To understand the potential effects, it helps to understand exactly how the different methods work.

A hormonal method, like the pill, Depo shot, hormone patch, uses hormones to trick the body into not ovulating.

A copper or hormonal IUD makes changes to the cervical mucus and the uterine lining that prevent pregnancy.

A barrier method—think condom or diaphragm—blocks the sperm from meeting the egg and really doesn't affect the human body before or after its use.

Why someone might go off of birth control

There are a few different reasons you may go off birth control:

• Ready for pregnancy. If you're ready to start trying to have a baby, you obviously have no need for that IUD or NuvaRing any more.
• Health risks. We are all for birth control when it’s needed. It’s a beautiful thing! But people taking hormonal birth control are at a slightly higher risk for blood clots, migraine, high blood pressure, and cardiovascular disease. It’s important to keep in mind that in the absence of underlying risk factors (ie. older age, high BMI), most of these complications are exceedingly rare. For example, the risk of having a blood clot on birth control for a healthy, young, non-smoker is significantly lower than the risk of a blood clot during pregnancy. 
• Abstinence. Hey, if you're not having sex, then you really don't need birth control. You probably want to have a plan in case you start back up though.

Whatever the reason, talk it over with your doctor if you're taking prescription birth control. You could get pregnant as soon as you go off it, says Lilli Dash Zimmerman, MD, Fertility Specialist at Columbia University Fertility Center. So you should truly be prepared for that possibility. Some patients go off hormonal methods a few months before they want to try, and that's fine, but you'll want to use a barrier method, like a condom, until it's go time, she says.

Birth control side effects, nasties and other things to expect

It's common for people to experience acne, heavier periods, or irregular periods when they stop hormonal birth control, but those aren't exactly side effects from ditching the pill or patch. Rather, they're much more likely to be things that you experienced before you started birth control, that the medication was actually suppressing, says Zimmerman.

Remember: If you're on a hormonal birth control method, you're not actually getting a period, since you're not ovulating. Instead, any bleeding you get every month is not a true period—it's a withdrawal bleed that happens when you take a week of placebo pills.

"I see a lot of patients that say, 'Oh, well, I've been regular for the past 20 years on birth control pills. Then I came off and only for the past year, I've been having irregular periods,'" says Zimmerman. "Well, their birth control may have been hiding issues with anovulation or irregular cycles because they've been on birth control pills for so long."

Do I have to get off hormonal birth control for egg freezing?

Yes, you will need to stop taking the pill or remove the patch before freezing your eggs. That’s because hormonal birth control is intended to prevent ovulation, but during freezing you want to do exactly the opposite. If you’re on the pill or use the patch, some doctors will have you stop during your egg freezing cycle, and some may have you stop for the month leading up to the retrieval. 

If you have an IUD, you can keep it in. Although if you’ve been meaning to take it out, ask the doctor if they can do it during your procedure. 

Do I have to get off hormonal birth control to become an egg donor?

At Cofertility, our donors freeze their eggs for free when they give half to a family who can't otherwise conceive. This means the egg donation procedure is the same as the egg freezing procedure. As stated above, you will need to get off the pill but an IUD is fine.

Trying to conceive after going off birth control 

Now, we bet you're wondering just how quickly you can become pregnant after going off birth control and the answer is it depends on the type of birth control you've been using.

If it was a barrier method, you can start baby making right away, since the only thing preventing sperm from meeting egg was that physical barrier you've removed.

With a hormonal method, it depends—and it can be tough to predict. Some people's bodies need time to adjust to life without the birth control hormones and so they don't ovulate for about the first one to three months. When it comes to the Depo-provera injection, it is given once every three months, so the hormones stay in the body for about three months. Therefore, it is very unlikely to become pregnant until at least three months after your last injection.

As for the progesterone containing and non-hormonal copper IUD, these methods are immediately reversible. 

The best thing you can do, once you're off birth control, is to track your period to ensure you are ovulating regularly. There are several different apps that allow you to log Aunt Flo's visits. You'll probably want to invest in an ovulation predictor kit, too. This is a pee-on-a-stick test that helps you pinpoint when you're ovulating, which is the time each month you can get pregnant.

Be prepared

For some people, the conception process happens fast. "We see a lot of pregnancies within that first month of coming off birth control," Zimmerman says.

But we know first-hand that others may be in it for the long haul. If your periods are irregular, you don't get them, or you just...have a bad feeling, go with your gut and chat with an OB/GYN or a reproductive endocrinologist. We're rooting for you!

Can you test your fertility from the comfort of your own home? The answer is a bit complicated. Isn’t it always when it comes to fertility? Yes, there are some tests that both men and women can take at home to get a better idea about some aspects of their fertility. But are they an acceptable substitute for an individualized appointment with a fertility specialist? 

Unfortunately, no—while these tests are often fairly accurate, that’s not really the issue here, says Dr. Jaime Knopman, a board-certified reproductive endocrinologist. It’s all the medical expertise you’re missing out on when you test your fertility at home. 

“The tests we run in our clinic are much more accurate because our job can’t be done completely by machine,” she explains. “It’s not just the tests, it’s the person interpreting them.”

But you still might not live close to a fertility clinic, have insurance that covers fertility appointments or testing, or even feel like you’re really at the point yet in your fertility journey where you need a formal eval from a specialist. We get that.

So whatever your reason for wanting to take an at-home fertility test, here’s what you need to know about what your options are, how they work, and what you can expect to learn.

How can I test my fertility at home: for women

When it comes to the ladies, there are two main varieties of tests you can do at home: you can check your ovarian reserve and you can do a broad panel screening for several different hormones that play a part in fertility health. Here’s the scoop.

Ovarian reserve tests measure the amount of follicle-stimulating hormone (FSH) in your blood with a pinprick. Typically, you collect a sample yourself and mail it back to the company so they can read and deliver your results. Very high levels of FSH can be a sign that you don’t have a lot of eggs, that they’re poor quality, or both, because your body is working overtime to produce enough FSH to release a healthy egg.

• Taking this test feels like a typical finger prick. It hurts for a sec and then you’re over it. You will have to squeeze out some blood into designated spots on a testing card, though, so if you’re blood-averse be prepared.
• The tests themselves can accurately check your FSH level, but there’s more than one way to figure out what your ovarian reserve looks like. Only measuring FSH will give you a piece of the puzzle...but could also cause you to unnecessarily panic about your fertility. Try not to do that! Remember, these tests are useful, but not foolproof.
• FSH levels alone may not be a great way to assess your fertility in the first place. A 2017 JAMA study found that biomarkers like FSH aren’t the best predictors of future fertility in women with reduced versus normal ovarian reserves.

Fertility health screenings capture your FSH level but also a bunch of other hormones that impact your fertility in one way or another. The exact hormones measured in an OTC fertility test differ between companies, but you can usually find out your FSH level and any or all of the following:

• thyroid-stimulating hormone, or TSH a marker of thyroid health)
• estradiol (helps with ovulation)
• anti-mullerian hormone, or AMH (an indicator of egg reserve)
• prolactin (makes breast milk after birth)
• luteinizing hormone, or LH (regulates your cycle, especially ovulation)
• testosterone (helps make follicles, but too much may mess up your fertility)

These tests all work like the ovarian reserve test: you prick your finger, collect some blood samples, send the samples back to the company, and then wait for your results to come in. Usually, you’ll get factual data (like, “your TSH is off”) but also an explanation of what that might mean for your fertility. 

Most companies allow you to see your results online and consult with an on-staff medical professional if you have questions or don’t understand your results. They’re pretty easy to order online, but many aren’t cheap—they’re usually about $150—and you’ll have to pay out of pocket.

How can I test my fertility: for men

The only kind of male fertility test that can be done at home is a sperm analysis. About half of all couples’ infertility problems can be caused by male infertility, so knowing if your swimmers are strong or not is a good place to start if you’ve been trying to conceive for a while. 

There are actually several different kinds of sperm analysis kits; sometimes you collect a sample and send it through the mail for testing, sometimes you put some sperm on a slide and insert it into a testing device, and sometimes you can even use your smartphone (yes, for real!). 

• Testing at home is private and confidential. You don’t have to worry about being unable to provide a sample at an unfamiliar clinic or doctor’s office. 
• The kits you send off to labs via mail can be more accurate, but at the same time, there’s a lot that can go wrong here—like failure to keep the sperm stored at just the right temp, which can cause damage to the sample. At-home tests, while giving quicker results with no middle-man, have a lot of potential for both user and technology errors.
• Male fertility is about more than just the amount of sperm: there’s motility, shape, concentration...the list goes on. If your at-home kit is only looking at the number of sperm, your results may not be that helpful. Try to choose a test that looks at more than one type of factor—this will give you the most bang for your buck. 

Don’t forget about ovulation!

While ovulation predictor kits only tell you if and when you’re ovulating, this can be very helpful if you’re actively TTC. 

These kits work by detecting the presence of LH in the urine, says David Diaz, MD, reproductive endocrinologist and fertility expert. When your LH rises above a certain level, the test strip you’ve peed on will let you know that an ovary is just about to release an egg. This is a good time to get it on, since there’s a good chance that egg could become fertilized. 

According to Dr. Diaz, these tests are about 85 percent accurate and available as digital and non-digital tests. If you have fairly regular menstrual cycles, an ovulation predictor kit can be a useful tool in identifying exactly when your fertile window is, but if your cycles are irregular (because of PCOS, pre-menopause, or even just your personal biology), it can be harder to rely on them unless you’re taking a test every day.

Next steps

Okay, you took an at-home test and got your results back...now what? Well, you might not like our answer, but here it is: you should probably still go see a fertility doctor. Yes, even if your results are “normal.” Why? 

Because, like we told you upfront, a test you do at home gives you important data — but not the expertise and counsel of a doctor who has met you in person and knows your medical history. You’ll have the info, just not necessarily the context...and the context is super important when it comes to your fertility. At-home tests simply can’t paint the same kind of comprehensive picture that doctor-interpreted lab tests can. 

But you’re here because you want to take an at-home fertility test...and TBH, we kinda don’t blame you! We’re curious, too! Just make sure you know what you’re buying, (Dr. Knopman says that you should make sure any OTC test you buy comes from a legit manufacturer with a fertility doctor on their medical review board), what the tests can tell you, and what you’re going to do with the results. 

“Even if you don’t want to do fertility treatments [right now], there is no harm in coming in to talk to us about it,” says Dr. Knopman. “You can make better decisions when you have that information than when you don’t…[and] the worst thing to do is sit at home and ruminate, trying to interpret your own results or diagnose yourself.”

What’s the takeaway here? After taking an at-home fertility test, you might want to plan to make an appointment with a fertility specialist. It can be a simple introductory or informational appointment, and even a virtual one. But hopefully, it will give you peace of mind and — most importantly — answers. 

Read more

• Female Fertility Hormones: Everything They Didn’t Teach You in Sex Ed
• A Step-by-Step Guide to Freezing Your Eggs