'Do I freeze my eggs or not?' The questions a fertility counsellor actually answers.

Recently, I've been forced by both age and an apparently dwindling supply to consider freezing my eggs. 

It started with vague conversations with my partner about the possibility of having children, which naturally progressed to fertility tests and ultimately landed me in a doctor's office, trying to weigh up my options with as much pragmatism as I could possibly muster.

I appreciate that I'm far from alone in exploring the opportunity to freeze my eggs. In fact, Australian and New Zealander women have taken so readily to the idea that the number of egg freezing cycles rose 860 per cent between 2010 and 2018. 

Pressed by financial, relationship, and future considerations, more and more women are entering their 30s and concluding that they need to – quite literally – put plans for having children on ice.

Watch: At 31, a woman decided to travel 9000kms to freeze her eggs. Post continues after video.

However, as much as this may seem like the straightforward, logical thing to do, much like anything else related to fertility, egg freezing comes with a lot of hidden complexity.

For a start, at around $8000 per cycle egg retrieval is not an insignificant expense, and committing to the process means wading through questions for which there are no particular clear answers: Do we actually want children? Are we financially stable enough? What age would we be looking to go through IVF? Do we even have time for this? The list goes on. 

I've caught myself wasting a lot of my GP's time trying to voice the ongoing conflict between my partner and I about committing to egg freezing. However, as much as my doctor is unquestionably hardworking and (probably to her own detriment) extremely empathetic towards me, she's not the ideal candidate to help me try to seek the answers to these concerns.

Friends and family – regardless of their personal experiences – are also not impartial sources of help or particularly well-equipped to guide you in this kind of life-changing decision-making.

Even therapists don't seem like the obvious choice, as these questions don't necessarily lie in the domain of mental health concerns. 

So, who are you supposed to turn to? 

Enter: the fertility counsellor. 

Fertility counsellors are psychologists or social workers who have specialised training in understanding the complexities of fertility treatment and can help to guide individuals and couples in their decision-making. 

Claire Byrne is a senior psychologist at Monash IVF and tells Mamamia that counselling can be incredibly helpful for people who are undergoing fertility treatment.

"Obviously our loved ones and the people that are close to us know us well and they can comment on things and give advice from that perspective. But also I think there's great benefit in speaking to somebody who's out of your circle of loved ones, and the people that are invested in you and your life and your decisions," Byrne says. 

The crossover between mental health practices and gynaecology first began in the 1930s as doctors saw an increasing need for support for women who were diagnosed with infertility. 

Although, fertility counselling as it exists today is a relatively new discipline in the universe of psychology that has grown alongside IVF over the past four decades. 

Counsellors are now considered as vital team members in fertility treatment clinics and while the Australian legislation differs from state to state, all registered fertility clinics are required to give consumers access to counselling support. 

Byrne says that fertility counselling differs from traditional therapy or counselling because it focuses on implications. This means that the sessions will focus on treatment processes, the logistics of fertility treatment, typical responses and emotions, as well as past experiences that can increase the distress associated with fertility treatment. 

"Certainly we know from the research that there can be higher rates of things like depression and anxiety in patients undergoing fertility treatments, so if they have a history of those things, then they might be more likely to have those issues triggered during the treatment process," she says.

Byrne explains that fertility counselling can provide women (and their partners) with the right support to answer the litany of questions that can accompany thinking about undergoing egg freezing or IVF. 

"Depending on their age and circumstances, they might be deciding 'Do I freeze my eggs or not?' Or they might be deciding 'Do I go ahead as a single person right now and use donor sperm and try to conceive and have a baby?'

We've also seen people choose to freeze their eggs and want to keep their options open into the future but then it's a question of 'Do I want babies in the future? Or is it something I don't want? And at what point do I make that decision?'"

While counsellors can't make personal decisions for consumers, Byrne says that she encourages and supports the decision-making in itself. 

Fertility counsellors can also provide the necessary support when IVF services ultimately cannot help women become pregnant. 

The success rate of IVF can differ due to many different factors but overall, first time IVF success rates sit at around 25-30 per cent and the probability of pregnancy tends to increase after multiple cycles – however, it does not work for everyone. 

Listen to Get Me Pregnant! where fertility specialist Dr Raewyn Teirney shares why freezing genetic material might be the right option for you and to explore them all. Post continues after podcast.

Byrne explains that it's important for women to have access to counselling in order to assert boundaries and know when to ultimately exit treatment. 

"We see lots of people who aren't successful and come to the end of treatment... Obviously, when people enter into treatment, we kind of know one endpoint, and that's having a baby but the other endpoint is kind of unknown," she says.

Medical advice, financial advice, and the physical and emotional cost of multiple IVF cycles all need to be taken into consideration when people are considering stopping treatment, Bryne says, and it can be difficult to draw the line. 

"People are often grappling with the grief that they know will come in treatment without success. And they will have to grieve the loss of the plan that they had and they often don't know what to do – limbo sometimes feels better than the grief but at some point, the limbo becomes too much of a burden itself and they want to move on." 

Elfy Scott is an executive editor at Mamamia. 

Feaatured Image: Canva/Mamamia.