Fertility Craze

Image credit: Total Shape

A few months ago, I straddled a stranger named Wesley on the Upper West Side. He was a twenty-something hipster with a tomato-red beard, flawless teeth, and broad shoulders. I was on the cusp of thirty-six and hopped up on fertility hormones. In his apartment, we kissed on his Ikea loveseat, and he slid my tank top over my head. We both looked down at my paper-white stomach, where a constellation of purple bruises framed my belly button. “Just ignore those,” I told him. “I’m freezing my eggs next week.” His fingers brushed over the discoloration. He didn’t ask questions.

Earlier that evening, sitting at the edge of my bed in a denim mini-skirt and the lace bra I’d put on in case drinks turned into sex, I flicked a syringe filled with a cloudy liquid to remove air bubbles before injecting a follicle-stimulating hormone called Gonal-F into my belly. I winced—still not used to the needle—but there was no pain, just a now-familiar sting. I was five days into the hormones and I had five more to go before the egg retrieval, when a doctor would guide a needle into my ovaries, suction the mature eggs into test tubes, then send them off to a lab for what I liked to call the deep-freeze.

I’d decided to freeze my eggs because I wanted the freedom to date without a deadline. After sipping glass after glass of cheap white wine on an endless series of bland first dates, I convinced myself that I’d run out of chances, aged out of choices, and that once I hit thirty-six, I would graduate from single woman to spinster. I knew this was absurd, but it felt true. Whenever I did make it to a second or third date, an electric first kiss or a promising conversation would fuel my harebrained theories that whoever I happened to meet would, in a not too distant future, become my husband. Then the flurry of flirty texts would fade and that dream would dissolve into a cold blank screen.

I wanted to surrender the tired fantasy that what I needed to find happiness was the just-right guy with whom I could settle into a blissfully domestic routine underscored by Sunday walks in the park and a shared Blue Apron subscription.

Which was part of the reason I found myself—charged up by my newfound sense of not giving a fuck—having sex on the Ikea loveseat with the ginger hipster. But something else was happening as well. Within days of starting the hormone injections, the beguiling throb of a familiar euphoria buzzed through my body. I was electrified by brilliant ideas and inventions. Tortured by a ravenous desire for sex. High. The hormone-laden process of jump-starting my ovaries had made me hypomanic, the term doctors use for an elevated mood that’s a notch or two below full-blown mania. I’m familiar with these categorizations because I have bipolar disorder, and at that point in the egg-freezing process, I was flying too high.

To be bipolar is to be forever casting yourself in a role you didn’t know you were trying out for. One day, you’re a creative visionary, skipping around the Technicolor playground of your near-perfect life. A few weeks later, you’re a hulking vessel filled with nothing but the hefty sum of your disappointments and failures.

To be a woman is to be at least in part governed by fluctuating hormones that impact mood on a month-long cycle throughout decades of fertility. Estrogen, for instance, influences dopamine and serotonin levels in the brain. Some women are more sensitive to hormones than others, suffering from intense PMS, postpartum, or perimenopausal mood swings when estrogen levels drop. To be a single woman in your thirties or forties who wants to have children is also to be inextricably tethered to a timeline that can feel like an unsolvable psychological puzzle.

I sobbed on the subway after a pap smear a few years ago. The gynecologist had asked me at the end of the appointment if I wanted to have children. “Yes, I think so,” I said. She replied, “I wouldn’t have said this even five years ago, but the technology has gotten so good, I highly recommend you freeze your eggs soon.” This was pragmatic advice, but it felt like judgment. Especially in light of my boyfriend having recently left me for a twenty-something and her twenty-something eggs, I didn’t want this kind of counsel. I didn’t want a reminder that I wasn’t just single—I was single and short on time.

Biological clocks are nothing new. What’s new is that women with the financial means can cough up ten thousand or so dollars to buy themselves the one commodity that people say can’t really be bought: time. A forty- or even fifty-something woman can in theory carry a child because the uterus doesn’t deteriorate with age. It’s the eggs that dwindle and become unviable. The hormone-injection process for In Vitro Fertilization (IVF) and egg freezing is identical. The main procedural difference is that for egg freezers, fertilization is delayed for an indeterminate period of time, while with IVF, the egg is fertilized in a petri dish, and if the embryo develops, it’s transferred into the uterus. The main emotional difference is that freezing eggs doesn’t necessarily mean you want a baby. It means you want a choice.

There’s something about egg freezing that feels like an expensive act of defiance: you refuse to be a slave to your biology. Another part of it punctuates your sense of loneliness and failure. Like maybe if you hadn’t dumped that college boyfriend because he was too clingy, you’d be out to dinner with your doting husband on a Saturday night instead of injecting yourself with thousands of dollars of hormones before hooking up with a stranger you met on a dating app.

But the pursuit of prolonged fertility isn’t a superficial process. You don’t hand the doctors thousands of dollars one morning and, after an uncomplicated procedure, leave the building with a bunch of microscopic eggs that, for a monthly storage fee, stay tucked away in a freezer. It means supplemental hormone injections that put the body and mind through a significant ordeal. There’s a substantial gap in research on how the hormonal measures women take to get pregnant using In Vitro Fertilization or egg freezing influence mental health. The field is still new. And this is what I came up against in my own experience of egg freezing.

Until 2012, egg freezing was designated “experimental” by the American Society of Reproductive Medicine. The standard slow freezing methods had meant ice crystallization could damage cell membranes and make eggs unviable. After a technique called vitrification—essentially flash-freezing an egg—became standard practice, ninety-five percent of frozen eggs survived de-thawing, in contrast to sixty-five percent with the slow-freezing method.

Egg freezing may no longer be experimental, but the psychological and physiological implications of this endeavor are not yet known. Which means women of a certain age who opt in to egg freezing are in essence beta testing a potentially life-altering scientific practice, one whose full effects on the mother and child are not fully understood. Instead of buying peace of mind from this high-tech insurance policy, I lost my mind. The hormone-induced insanity called into question everything I believed about my ability to live a life not defined by the limitations of my disease.

Ever since I was diagnosed with bipolar disorder, I’ve wondered, does this mean I’ll never have a family? In graduate school, I was so fixated on this question that I wrote my thesis on bipolar women and pregnancy. I found that while having a child is more difficult when you’re bipolar, it is not impossible. I discovered, though more research is needed on the topic, that staying on mood stabilizers during pregnancy can be safer than risking a manic or depressive episode while pregnant.

From the start, I knew freezing my eggs would mean risking a disruption in my mood, but I had a good psychiatrist and a history of deftly regulating the highs and lows of my disease since college, which is when I was diagnosed with Bipolar One. Back then, I was living in Upstate New York, a depressed freshman at Cornell with unwashed hair and a doctor at the health center who detailed how, in response to my suicidal ideations, he’d be upping my antidepressants. “Because your grandfather had bipolar disorder there’s a risk of mania,” he said. “Please contact me if your mood becomes elevated.” In addition to triggers like sleep deprivation and recreational drugs, antidepressants can provoke mania, especially in people with a genetic predisposition for the disease. A week later, awash in an all-consuming euphoria that was a welcome departure from my previous state of despair, I wrote in my journal, “I know I’m manic and I’m not telling anyone.” I drove downtown to a shopping center and charged—to my parent’s credit card—twelve hundred dollars’ worth of mini-skirts, sparkly crop tops, tight dresses, red lipstick. In the dressing room mirror, my flaws faded into distant memory. For the first time in my life, I looked at myself and saw a beautiful face.

The most seductive symptom of mania is something self-help books tell us to strive for: self-love. Except mania means falling—quite literally—madly in love with yourself. And you fall hard. In the beginning of the cracked-out trip you are imbued with a kind of magical charisma that makes the world fall back in love with you. I’d lived my entire life as an introverted wallflower, too timid to raise my hand in class and too shy to strike up conversation with strangers. Now I stomped through parties, talked to everyone, slept with everyone: ex-boyfriends, friends’ boyfriends, a massage therapist I met at the coffee shop, a pretty redhead. For about a week, I rode that wave of unbridled self-confidence—not eating, not sleeping, not slowing down—until my thoughts fired off so quickly I couldn’t hold onto one long enough to finish a sentence.

Eventually, I was hospitalized. Within forty-eight hours of entering Cayuga State Mental Hospital, I became psychotic. Under the spell of a delusion that I was a celebrity, I convinced myself the entire country was rapt by televised updates on my unjust imprisonment. I refused medication because I thought the nurses were trying to poison me. I believed other bespectacled patients were secret service agents, wearing recording devices implanted into their eyeglasses to document “my case.” Finally, after weeks of refusing medication, I agreed to take the antipsychotics, and the delusions dissipated.

After that twenty-eight-day hospitalization, my life cracked in two—a book opening to a page I didn’t choose—and never closed again. In the earlier chapters unfolded the humdrum story of a girl from a rich Connecticut suburb who attended a predictable college and lost her virginity to a square-jawed tenor in the a cappella group. Now the plot had thickened. I returned to college with an exasperating hand tremor and a mind mottled with memories of hysterically flinging myself against the walls of a padded room while screaming the lyrics to My Fair Lady. I took the lightest possible course-load to accommodate side effects of antipsychotics and mood stabilizers. Eventually, I graduated.

One of the most pervasive stereotypes about people living with bipolar disorder is that when we start to feel too good, we stop taking our medication. But because I’d lived locked inside the walls of my own psychosis in college, I took mood stabilizers, without wavering, every day, for almost fifteen years. I became an expert in managing the ups and downs of my disease, so much so that by the time I was thirty, I believed that—with the help of medication and a good doctor—I’d effectively beaten bipolar disorder. My moods would still swing, for sure, but I had adopted strategies to control them. When depression hit, I would fantasize about throwing myself in front of a subway train but keep myself afloat by tweaking medication and repeating the mantra, This will not last. And when the hypomania hit, I would open my eyes before dawn, speed clean my kitchen, have a mini-tantrum at work, buy a three-hundred-dollar handbag I couldn’t afford, sleep with a stranger. And though I longed to stop taking my medication and relinquish my rational mind to the seduction of mania, the memories of the hospital triggered my surrender to the medication. I would email my boss to say I had a migraine and needed to stay home so I could triple my dose of antipsychotics and douse the fire of my mind with twelve hours of drug-induced sleep.
Given these course corrections throughout my twenties and most of my thirties, I had things under control.

The day before the egg retrieval, after the final ultrasound, I texted Wesley—the ginger hipster—something about how I was worried the doctor would be able to detect my poor decisions with his plastic wand. The next day, my friend Emily met me at the clinic before the procedure. In addition to Wesley and a few other strangers, I’d been texting with a married guy who was supposedly in an open relationship. He wanted to rendezvous at a Chelsea Hotel the following week, on a Wednesday. I loved the idea of taking my lunch break to have sex with a stranger. I told Emily: “If I want to act like a prostitute, I should be able to,” my mind rampant with sex fantasies.

A few hours after the egg retrieval, I woke up with stomach cramps and a thick pad between my legs. A nurse wearing green, pastel scrubs stepped inside the pea-green curtain hanging around my gurney. She read a checklist of caveats from a clipboard. Don’t drink alcohol for twenty-four hours. Dial this number if you have a fever. Excessive bleeding is not normal. Then she said, “Here’s what they were able to retrieve.” The number was fifteen, scripted in blue ink. I’d been aiming for ten, and I was elated. Still, for reassurance, I asked her, “Is that good?” She said she couldn’t comment before widening her eyes and whispering, “That’s good.”

My parents waited for me with Emily. The anesthesia hadn’t worn off when I greeted them. I felt accomplished, proud, like all possibilities of the universe throbbed inside those fifteen microscopic eggs. In short: I had rescued my fertility and now I could sleep with whomever I wanted. No rush. No worries. I went home and got into bed. I texted Wesley to tell him I got fifteen eggs. He texted back, “Sweet.” I slept.

The high from the fertility hormones persisted after the egg retrieval. Unlike the hypomanic symptoms I managed in my past, this high obscured any insight I had into how to manage my disease. At work, I churned out spreadsheets, diagrams, gratuitous strategies, frenzied emails. I argued with everyone, unsure of when my colleagues had become so woefully incompetent. I carried my laptop to conference rooms so I could open a private browser and send messages to men I’d provoked on OKCupid with sordid pick-up lines in the middle of the night.

I knew I was at the very least hypomanic, but I believed that because I’d lost my mind in college, I’d recognize full-blown mania—like some familiar ghost—before it cast its haunting spell on me. I wanted to glide across the transom of my life, hypomanic and happy and protected by mood stabilizers and antipsychotics to ward off insanity. A few weeks later, near the end of August, I drove myself to a yoga retreat in the Berkshires, windows rolled down, radio blasting. My first night at the retreat, I sequestered myself in the corner of one of the common rooms and scrawled page after page in my journal until sunrise. I don’t remember making a conscious decision to stop taking my medication, but I do remember writing in my journal: “I finally understand the meaning of life.”

Once I returned home, after the weekend, my sister showed up at my apartment in the early morning wearing a tailored dress. She had been alerted to my potentially manic state by my parents. I’d been up all night, reveling in my discoveries. I was wearing a dress I’d bought in the Berkshires—a grey dress made of “organic materials” best suited for a middle-aged woman carrying a hemp purse to hold her crystals and essential oils. The dress cost two hundred dollars, and I’d bought four of them in different varieties. When the cashier at the gift shop said eight hundred dollars, I didn’t flinch. Overspending is a symptom of mania not dissimilar from hypersexuality. Life no longer has limits, so you go after the high with no regard for the possibility of debt or an STD. Weeks later, when I was in an inpatient program with a muscular fifty-something man named Josh who wore a T-shirt and jeans, his face and neck a dark shade of sunburn, he asked me, “Remember the mortgage crisis a few years ago? Well, I got manic and bought seven houses in Ohio.”

After I was admitted to hospital, I twitched and tremored like a caged animal, crossing and uncrossing my legs, picking skin off my fingers, banging on tables until my arms bruised purple. I asked for milk and then poured it on the windowsill. I was remarkably violent, requiring a one-to-one aid whom I hit repeatedly. I don’t remember the aid; I’ve been told her name was Tracy.

In some ways, mania is easier to treat than depression because if you load someone up with enough tranquilizers, eventually they’ll crash. My case, in the wake of the egg freezing, was what they call treatment-resistant. Despite the highly sedating antipsychotics I was swallowing or receiving by injection, I refused to sleep. I had enough Seroquel, Clonipin, Zyprexa, Benadryl, Thorazine, and Ativan in my system to sedate a linebacker. The doctors eventually recommended Electroconvulsive Therapy, or ECT, to my parents. With ECT, electrodes send small currents through the brain to induce a short seizure that, for reasons that are not fully understood, essentially resets the brain. Within days of receiving the treatment, I had come back to myself. I was ready to leave the hospital.

The doctors discharged me to what’s called a partial hospitalization program, a two-week outpatient program that lasted all day because all patients were either on medical leave or out of work. About twenty-five patients arrived in the morning to participate in various forms of group therapy. My first day in the program I sat in the kitchen eating a stale cheese sandwich—the other lunch choices were saran-wrapped peanut butter and jelly, tuna fish, turkey—and drinking syrupy orange juice. Our motley crew included a former New York City Ballet dancer who, at seventy-four, said definitively that he’d been depressed for forty-five years and he was certain his bipolar diagnosis was incorrect; a handsome man in his forties named Patrick who talked openly about his suicidal depression, wore a navy blazer and carried a leather folio that held his notepad and neatly organized handouts from each session; a thirty-something woman named Angela, who, at seven months pregnant, had become so convinced there was something wrong with the baby she’d stopped sleeping and spun into psychosis.

I fixated on Angela, who, like me, had just come out of the hospital. She’d been pushed to her breaking point by a pregnancy she feared she would not survive. When her eyes welled up with tears in group, she talked not as much about herself as she did focus on wanting to be strong for the baby. She’d been blindsided by her breakdown; she’d never had mental health problems prior to pregnancy. Most women who suffer from mental illness during pregnancy are like Angela: they don’t know they’re predisposed to mental illness until the hormones trigger anxiety, debilitating depression, psychosis.

Angela embodied my greatest hopes and my most deep-seated fears. I froze my eggs so I’d have the chance to have a child someday. Instead of buying myself that peace of mind, the subsequent hospitalization planted question-after-doubting-question inside me. Was this my dress rehearsal for motherhood? The shaky performance that tipped everyone off to how ill-equipped I was to handle the role? And who, really, was right for the role of motherhood?

I suspect there are plenty of people on the planet who are quick to say that the mentally ill shouldn’t have children. I would ask: how do you define mentally ill? There is a broad spectrum of behaviors and actions that fall under the category. Our definitions now are less rigid, more permitting of behavioral diversity. Mentally ill patients used to rot away in asylums, condemned to lives defined by their diagnoses. Schizophrenic and bipolar women were sterilized. Before 1960, roughly sixty thousand people across the United States living in institutions for the mentally ill were sterilized based on eugenics laws, according to Professor Alexandra Minna Stern, author of Eugenic Nation: Faults and Frontiers of Better Breeding in Modern America. And The Center for Investigative Reporting has found that as recently as 2010, California prisons condoned tubal ligation on one hundred and forty-four female inmates diagnosed with a range of mental disorders.

I have no doubt that were I living in another time, or in another income bracket with no access to medication, I wouldn’t survive my disease. But I am treated. Now, more than ever, the “mentally ill” are—like me—people living with a mental illness who are well a great deal of the time. Let’s recognize that the human brain is not simply “well” or “unwell” but complicated by genetics, environment, access to healthcare. A diagnosis of mental illness does not mean a person is destined to live a life of solitude and sorrow. For women who want to become mothers, it means there may be limitations to manage and plan for.

I wasn’t worried about Angela. She’d already fought her own demons to make space for her daughter. I never questioned whether or not she should be a mother. She already was a mother, her belly swollen with an infant that had tested her mind. I gleaned hope from watching her. I, too, might be equipped to become a parent. Perhaps this was the rehearsal I needed. I understood how high the stakes were. I might have to be closely monitored were I to ever get pregnant. Maybe one of my microscopic eggs would in a not too distant future become a child I would have the opportunity to struggle for. Mothers struggle for their children. Angela had already struggled for hers.

Months after I was discharged from the program, Wesley texted me from Hong Kong, where he’d moved for a new job. I’d had dinner with him a month or two after the hospitalization, and told him about my experience. I asked him if I’d seemed crazy that first night we slept together, and he said not at all. Perhaps he was lying. Now he was just texting hello, and he’d tacked on a gorgeous photograph of a beach I couldn’t recognize or name, a blood-red temple of some sort perched on the coastline. The saturated reds and yellows were undoubtedly punched up by iPhone filters, and gave the image a sense of the surreal. The geographic distance between us mirrored my psychological distance from that crazed September. When I got his text, I was sitting at my desk surrounded by colleagues, typing an email. A part of me longed to start my life over somewhere else. Another part of me wanted to be sick again. Not because it was desirable, but because it was honest, the expression of a disease I now knew I’d never outgrow or outmaster. The realization of this had given me a sense of my own vulnerability, yet somehow it was grounding—I knew what I was up against and the parameters of my situation were clearer. While I had lost a belief in my ability to live a life not defined by the limitations of my disease, I felt that I could work with those limitations. And I started to recognize the kind of partner I needed, if I was going to own the kind of mother-to-be I truly was—aware of my shortcomings, in need of assistance.

I was dating again, specifically a guy named Glen who was forty-six and looked like Clark Kent. Despite his good looks and broad shoulders, I wasn’t attracted to him; an impulse that was sealed at the end of the first date when he started talking about the values he was looking to share with a partner. “Someone who is intelligent,” he said, “someone who values family, someone who will be a good mother.”

Later that night, he asked me out again over text. I declined. I kept thinking about what he’d said about looking for a “good mother.” What did that mean, exactly? And why bring this up on a first date? When I pictured a “good mother” I pictured the kind of woman for whom motherhood comes naturally. And I knew, for me, that motherhood—if it ever did arrive—would come with extraordinary effort. I had asked my doctors and they told me that pregnancy could still be in my future. In the hospital, the doctors had shifted my medication from Depakote—a mood stabilizer that leads to fetal deformities—to Lithium. Once forbidden for pregnant women based on a study that showed twenty-seven percent of babies had a congenital heart defect, that figure was later revised to between four and twelve percent, and the defect could also be screened for. The doctors said I could be a mother as long as I was monitored. I would not be able to breastfeed because the medication can be transferred through breast milk, plus breastfeeding means not sleeping for long periods of time. I would need full-time help or a partner equipped to care for the child when I needed to sleep through the night or nap to ward off an episode. From my superficial judgment, this Clark Kent guy appeared to be the kind of guy who wanted his wife to do all the work. And at that point, I felt less pressure to waste my time on a guy that felt like the wrong choice. The egg freezing gave me permission to move on, to feel like I had the time to think about what I wanted for my future instead of feeling driven by fear that I’d missed my chance at one day becoming a mother.

When I think about what happened when I froze my eggs, I see flashes of madness. I see myself tearing through that hospital, ripping up books, spitting out food, coloring my forearms a deep shade of purple, tumbling around a padded room. No one fully understands what happens when a human being goes mad. There are conjectures and theories, but no clear-cut answers. What I know to be true is that my psychotic episode was born out of a crucible of unachieved hopes, present-day loneliness, powerful hormones, and a mood disorder. And the social pressure to have babies before it’s “too late” is a significant source of stress for many women that can, in and of itself, disrupt wellbeing. Ironically, part of the reason egg freezing is becoming so popular is that it capitalizes on that fear and proposes a way to live with less fear and regret. “Egg freezing stopped the sadness that I was feeling at losing my chance to have the child I had dreamed about my entire life,” wrote Sarah Elizabeth Richards for The Wall Street Journal in 2013. But advances in technology should be paired with advances in how we think about the lifecycle of a modern-day woman. The “advanced maternal age” that labels pregnancies over thirty-five doesn’t take into consideration that the body doesn’t begin to shrivel up when a woman turns thirty-five. The body ages gradually. Now that I’m thirty-eight, I do have a little voice inside me that often whispers, “Your eggs are only thirty-five.” The eggs, of course, aren’t a guarantee. There’s no way of knowing if a frozen egg is truly viable until it is successfully fertilized. That said, there’s no way of knowing most things about the trajectory of our lives or our childrens’ lives. Sometimes hope is enough.

Unlike mania or depression, psychosis doesn’t cast you as some brighter or duller version of yourself. Psychosis is an act of creation. A new self that springs up as miraculously as a fetus. A self not confined by expectations. A self freed from the script of a thirty-something woman living a thirty-something life. If you are lucky, you receive the treatment you need and you get better. You go back to work. You go back to dating. And you go back to worrying about why you are still single and alone. And then you remember that worrying about boxes you haven’t checked in your life is a luxury you don’t need to hold on to. Because you are no longer helpless and screaming and out of control. You once shapeshifted into an odious stranger, disappeared, and then managed to come back to life. You are here, living a life of possibility and unpredictability. You do not know your future. What you know, finally, is that you are enough.


Michele Faye Contributor
Michele Faye is a nonfiction writer and journalist focused on mental health. Her work has been published in The Huffington Post, Elle, CNN, and Forbes.

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