After facing betrayal in her marriage, which ultimately led to a separation, behavioural scientist and habit-change researcher Dr. Gina Cleo found herself on a path she wasn’t expecting. She had dreamed of starting a family; however, after the breakdown of her marriage, she found that her egg count had dropped significantly, prompting her doctor to advise her to freeze her eggs.

Gina decided to embark on her fertility journey alone while also managing the end of her marriage. She had to learn as she went along, all the while dealing with the complexities of her previously diagnosed conditions, endometriosis and adenomyosis. Despite the challenges, Gina successfully underwent two retrievals and gained a lot of knowledge in the process.

We spoke with Gina about her experience undergoing fertility treatments alone, exploring the ups, downs, and valuable lessons learned along the way.

‍When did you start thinking about your fertility?

“I had my first egg count when I was 34 because I had just gotten married, and we had talked about starting a family. I have endometriosis and adenomyosis, and I take the contraceptive pill continuously to avoid period pain. I wanted to check a few boxes off – including getting my AMH and my partner's sperm tested – to make sure we weren’t going to be trying in vain.

Medical Note: Adenomyosis occurs when the tissue that normally lines the uterus grows into the muscular wall of the uterus. Symptoms can include heavy or long lasting menstrual bleeding, painful intercourse, and severe cramping pain.

After my ex and I separated due to betrayal in our marriage. I tested my AMH again and my AMH levels had gone from 13 to 0.4 within six months. My doctor then suggested that I freeze my eggs."

‍What were your expectations before beginning your fertility journey? 

“I didn’t go into the process with many expectations because, aside from daily injections, I didn’t know much about what egg freezing would involve. I was managing my separation at the same time so I didn’t have much time or capacity to research or process the information.”

‍What did your fertility journey look like?

"In March 2021, my ex-partner and I separated, and my GP sent a referral for egg freezing. I saw a gynaecologist that same month and immediately began treatment. From then onwards until September of that year, I underwent a 6-month-long induced menopause treatment to suppress my endometriosis, followed by two weeks of IVF injections.

I had my first egg retrieval on September 9th. Then, on the 15th, I met with another gynaecologist for a second round of egg freezing. In October, I started my second round of injections and had my second egg retrieval in November.”

Medical Note: Endometriosis can affect the responsiveness to ovarian stimulation. Some fertility specialists might choose to suppress the endometriosis for 3-6 months prior to treatment to improve outcomes as was the case here.

‍Can you identify any moments during your journey that clashed with your expectations?

"The main hurdle for me during my IVF journey was feeling uninformed about the process, including what to expect physically, mentally, and emotionally. Unfortunately, the communication I received from the clinic was minimal. Although I did receive some generic emails, they were mostly about embryos, which I didn't have. It would have been helpful to receive more detailed information about the IVF process. I felt defeated, alone, and exhausted, but I also looked forward to finishing it and having the process behind me.” 

‍What was the most surprising thing that happened to you during this time?

“I was surprised to learn that I needed more than one round of egg retrieval to have a high enough chance of conceiving one child. There was no follow-up with my gynaecologist, and it was only because I saw a different specialist for my endometriosis that I was advised to undergo a second round of egg freezing. This made me feel like I was experiencing whiplash, as I had thought the process was already complete.

I was surprised that it took me two weeks to recover from the egg retrieval procedure. Everything I had read suggested that the recovery time was only two to three days, but I experienced a lot of pain for a much longer period. Later, I found out that women with endometriosis can experience prolonged and worsened symptoms. If I had known this earlier, I could have been better prepared for the post-procedure recovery."

‍What was the best or most rewarding thing that happened to you during this time?

“Getting ten eggs in my first egg retrieval was really rewarding because the journey was so tough and according to the AMH results, my egg count was insignificant.”

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Medical Note: hormonal contraception can artificially suppress your AMH levels and this could have been the case for Dr Cleo. Some fertility specialists will order a baseline pelvic scan prior to your egg freezing cycle which can give a clearer indication of your ovarian reserve if you are using hormonal contraception.

‍What do you feel is the biggest misconception surrounding fertility?

“That conceiving a subsequent child may not be as easy or difficult as the first. This misconception is potentially harmful as parents may encounter different challenges than what they anticipated, leading to heightened stress and anxiety.

Also, if you’re healthy, you don’t need to think about fertility till you’re ready. I recall wanting to get an AMH test in my late 20s and being told by a few doctors that I didn’t need it because I was healthy. Despite having endometriosis, adenomyosis, cysts and fibroids.” 

Medical Note: Fibroids, also known as myomas, are non-cancerous growths that sit in the muscle layer of the uterus.  Symptoms can include heavy menstrual bleeding, prolonged periods and pelvic pain. For some, they can experience no symptoms.

What was the most helpful thing you did for yourself during this time?

"I am usually the type of person who benefits from regular exercise, healthy eating habits, a consistent sleep schedule, strong social connections, and being productive. However, during my experience with IVF, what helped me the most was actually taking time to rest. I allowed myself to veg out when I needed to, avoided making too many social plans, took time off from work, and didn't feel guilty about it. Resting reduced the expectations I put on myself to show up mentally, emotionally, and physically."

Medical Note: Recognising the need for rest and self-care during fertility treatment is crucial for managing stress and reducing the pressure to perform at peak levels mentally, emotionally, and physically.

‍What advice would you give anyone who hasn’t yet gone down their fertility path? 

“Don’t expect too much of yourself. You may experience brain fog, difficulty sleeping, low mood, hypermobility, physical pain, heightened emotions, insatiable hunger and more. IVF can feel like a very lonely process, even demoralising at times. Reach out to others who have walked the path while being mindful that your experience may be different to theirs.

I would also suggest asking plenty of questions. I am still unaware of where my eggs are stored, how long they can be stored, or the process if I ever decide to use them. I recommend finding a nurse to guide you through this journey or refer you to useful and relevant resources. 

And finally, if you’re undergoing IVF alone, expect to see couples in waiting rooms and pamphlets/emails about embryos.” 

Medical Note: After a person's eggs are collected at surgery, they are usually stored at the fertility clinic where the eggs were collected. They can be transported to another clinic at the request of the patient/s.

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