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5 things you need to know if you are considering freezing your eggs

Nicole Diez, a nurse in her 20s, questions Mark Surrey of the Southern California Reproductive Center at an egg freezing “party” in Beverly Hills, Calif., in 2015. (Patrick T. Fallon for The Washington Post)

Brigitte Adams started with 11 frozen eggs. After going through the various stages of thawing, testing, fertilization and transfer required for a pregnancy, that number dwindled to nine, then six, then one. Then the final one also was lost after it failed to implant in her womb.

Almost a year after her heartbreaking experience, Adams — who works in tech marketing and founded the fertility site Eggsurance in her spare time — wishes she could have done a lot of things differently.

[To read Brigitte Adams' full story click here.]

Here's some of her advice to young women thinking about freezing their eggs:

Don't wait. Freeze your eggs in your late 20s or, at the latest, in your early 30s if you can. The chances you'll get a large quantity of high-quality eggs go down every year. ​"I had no idea that there was such an inflection point in egg quality at age 35 — that only gets worse with each passing year,” she said.

Keep track of your AMH and FSH levels. Never heard of these acronyms? You're in good company, because doctors usually only recommend tests involving them if you're already having trouble getting pregnant or thinking about freezing your eggs.

The AMH test (for anti-mullerian hormone) helps you monitor your ovarian reserve or how many eggs you are likely to still have. The FSH Day 3 test (for follicle-stimulating hormone) checks the production of eggs by the ovaries. Both are simple and relatively inexpensive, though doctors usually recommend an ultrasound at the same time to look at the number of small follicles within the ovaries — an antral follicle count — and get a more accurate picture of a woman's fertility window.

Adams's personal recommendation is that women think about getting baselines “when you are ready” and then get tested annually after age 30, even if they have to pay out-of-pocket, with a goal of deciding by 35 whether “to freeze, try get pregnant, not have children, adopt, etc.”

“There is no medical recommendation as to when to start tracking your fertility potential,” she noted, “even though there are three tests easily available.”

Consider the option of creating and freezing a few embryos. One of the first tests of the health of an egg is whether it can be fertilized with sperm. Other tests can only be done after the embryo is created — such as pre-implantation genetic testing to determine if the embryo has the correct number of chromosomes.

While many women are reluctant to fertilize their eggs with sperm because they hope to use them with their future significant others, this step is one of the best ways to look at egg health. More detailed information about the “inverted pyramid” of in vitro fertilization and a calculator that can give you the probability of a successful pregnancy can be found here. Note that the calculator only uses the age when eggs were frozen as an indicator and that not all women of the same age are alike.

Be realistic that you may have to do more than one cycle of egg freezing. “Once I froze my eggs, I thought, 'I don’t need to think about this,' " Adams said. “But had I known I had 11 eggs that were extremely poor quality, I would have gone back and done another cycle . . . or two.”

Educate yourself. Adams said she went to top fertility doctors: “I went to an excellent clinic. But I was not advised that based on my bloodwork and antral follicle count my eggs would likely not be of great quality. There was a real sense of in and out. It was almost like a cosmetic procedure.”

Read more:

Social egg freezing is a numbers game that many women don't understand

Discounts, guarantees and the search for ‘good’ genes: The booming fertility business

The struggle to conceive with frozen eggs: Brigitte Adams was the poster child for egg freezing. But things didn't quite work out the way she imagined.

Get in touch with a reporter: The Washington Post is interested in talking with women about their experiences with the fertility industry, whether receiving treatment — including IVF and egg freezing — or donating eggs.