Someone extremely powerful must have read my recent article, Why Being a Pelvic Floor Physical Therapist Inspired Me to Freeze My Eggs…And to Tell You All About It (link to article), because I have an exciting update about fertility treatment. I know, I know…I’m not that vain…I definitely know this law’s not about me. My blog alone can’t take credit for the Department of Financial Services of New York State’s decision, but a girl can dream.
I am happy that many important conversations ensued, both publicly on Facebook and privately, and I am grateful to the many women who shared their personal experiences. The more we discuss and share, the more we can support each other and normalize this process. I am thrilled to report that our voices are being heard and incredible changes are underway.
As of January 1, 2020, the New York State’s budget mandates that large group insurance plans (a group consisting of more than 100 employees) cover up to three cycles of in vitro fertilization for patients with a medical diagnosis of infertility. The definition of “infertility”, according to the Department of Financial Services is “a disease or condition characterized by the incapacity to impregnate another person or to conceive, due to the failure to establish a clinical pregnancy after 12 months of regular, unprotected sexual intercourse or therapeutic donor insemination, or after six months of regular unprotected sexual intercourse or therapeutic donor insemination for a female 35 years of age or older. Earlier evaluation and treatment may be warranted based on an individual’s medical history or physical findings.” The new phrase included this year is “therapeutic donor insemination,” which finally provides coverage to same-sex female couples and to single women, two demographics that were excluded in years past.
The new law also mandates coverage for “medically necessary” egg or sperm freezing procedures. These fertility preservation procedures are deemed “medically necessary” for patients at risk of iatrogenic infertility, or infertility resulting from an unrelated medical procedure (ex. chemotherapy, radiation, endometriosis surgery, or sexual reassignment surgery). The fertility preservation coverage under these circumstances applies to even small group and individual plans.
Insurance companies can require prior authorization, so if you are considering exploring this option, please contact your insurance company to inquire into their specific requirements.
True, certain groups won’t be covered under these laws (ex. women who elect to freeze their eggs without medical necessity and IVF treatment for individuals who do not have a large group employer). So yes, we still have more work to do. But overall, this is massive progress. The new, more inclusive laws are a giant leap for womankind. I look forward to the opportunity to share more positive updates on women’s sexual health and reproductive rights as they develop, hopefully sooner rather than later.
This past week, I froze my eggs. It was the most invasive procedure I have undergone to date. It was a decision that was over two years in the making, and when I finally decided to pull the trigger, pun intended, the entire process was 2.5 weeks start to finish. Fortunately, the timing worked out as such that the moment I decided I was psychologically and emotionally ready, I was able to proceed.
There are many reasons why it took me so long to make one of the best decisions I’ve ever made in my life.
As a young Orthodox Jewish woman, I always dreamed of getting married by the age of twenty-five and starting my own family. I envisioned myself having a similar number of children to my own parents, who were blessed with five. As the years passed and I grew “older” (by my community’s standards), I found myself subconsciously engaging in mental gymnastics and adjustments. By the time I hit thirty, I realized that five children may not be in the cards for me, but still hoped at least for four. By the time thirty-three/four rolled around, the “at least” shifted from four to three. I repeatedly reminded myself that no matter how many children God chooses to grant me, each child would be their own unique blessing (which I still strongly maintain).
Approximately two years ago, a friend several years older than me shared that she had decided to freeze her eggs. I was curious and intrigued, but I told myself at the time that I did not have to worry about that just yet. After all, I was several years younger. I still had time. I postponed the thought of the topic and silenced the nagging voice at the back of my mind which asked, “Should I consider freezing my eggs?” I convinced myself that I did not need to think about it until I turned thirty-five. And then at thirty-five, I delayed forcing the issue until I turned thirty-six. Meanwhile, more and more friends “came out of the freezer,” if you will, and shared the news that they too had frozen their eggs. I couldn’t help but wonder if this was something that I, too, should consider.
While all of this was brewing beneath the surface, I continued to concentrate on the actual “baby” in my life, Revitalize Physical Therapy. With God’s help, I continued to grow and develop my pelvic floor physical therapy practice, and I had the profound pleasure of meeting many inspirational women. I had the opportunity to hear countless powerful stories from my prenatal and postpartum patients. Many of these stories were of courage and hope. Others were of difficulty, pain, and challenge. Unfortunately, there were also stories of grief and loss. My clients’ stories told the tale of determined women who exerted Herculean efforts to fulfill their maternal aspirations. I honor and acknowledge all these women who have shared their stories with me. I share both in your joy and your pain, and it is an honor to play a role in your life.
Your stories have taught me that most things in life don’t come easily. I have learned that ultimately, both every proud and challenging moment of motherhood makes it all worthwhile and that you wouldn’t trade it for the world. I have witnessed the valiant efforts that you have expended to build your families. Thanks to you, I have been inspired to do to the same, and that in part is why I decided to freeze my eggs. Several days of injections, discomfort, and moodiness is worth the hopeful payoff. I strongly believe that ultimately, fertility is within God’s control. However, He has given us the precious gifts of medical knowledge and technological advancements. It brings me a deep sense of joy and relief to have made the decision to join the thousands of other women who are utilizing these opportunities to our advantage.
So that answers how being a pelvic floor therapist played a role in my decision to freeze my eggs…but why am I telling YOU all about it in such a public forum? Believe it or not, the answer to that is also connected to my beloved profession.
As a pelvic floor physical therapist, I encounter countless people suffering in silence. Many patients who first arrive at our office have been struggling with painful and embarrassing symptoms for months, if not years. One of my missions is to educate both the medical and lay communities about the benefits of pelvic floor physical therapy to enable people to receive treatment in a more timely and dignified manner. Bowel, bladder, and sexual dysfunction are regarded by many as taboo topics, as conversations simply not to be had. Ever. However, the longer we propagate this attitude, the longer people will be needlessly suffering. Granted, pelvic floor physical therapy is a very sensitive topic, and the work we perform is intimate and highly private. While I understand and respect any given individual’s reluctance to share their personal story, I applaud those who speak up. Any time a new patient informs me that they were referred by a former patient who benefited from our services, I commend the latter for their openness and bravery.
At present, I have the opportunity to speak up. While physical therapy and egg freezing are very different, and I recognize that I can’t understand what chronic pain feels like, I know what it means to make a very sensitive and expensive medical decision that most people would not feel comfortable discussing so publicly. I have chosen to do this in order to share the wealth, to support others currently or considering undergoing the process, and to normalize the conversation. I celebrate when others normalize a taboo topic (which shouldn’t be); therefore, it behooves me to do the same.
Considering that over the course of two visits I bumped into three different friends, this is clearly en vogue. It’s becoming something that more people are doing yet barely anyone is discussing. I likely would not have done it myself had my friends not shared their experiences with me. They helped me realize that this wonderful opportunity exists, and they shared with me the huge sense of relief they felt afterwards. Others were open with me, and I would like to pay it forward and do the same. Women’s health and reproductive rights are among my passions, and I would be remiss as a pelvic floor therapist if I were to remain silent.
We need to normalize this procedure so that women undergoing the process won’t feel ashamed. We need to eradicate the embarrassment associated with it. We owe it to ourselves to instill pride and hope for the future.
We also need to normalize egg freezing so that insurance companies will recognize the procedure as standard and provide coverage in its entirety, not just the expensive medications (if you are lucky). God only knows they have the money to pay for it considering the high deductibles and premiums that they charge. Why is egg freezing not a fully covered and recognized medical procedure? It is not experimental. It is evidenced based and it is proactive. Why are insurance companies reactive based? “Oh no, you have strep? We’ll pay for your antibiotics. Oops, you tore your ACL? Fear not, we’ll pay for your surgery.” Any woman who freezes her eggs is demonstrating agency and making an intelligent medical decision to create future opportunities.
Yes, we have a lot of work ahead of us. But our cause is worthwhile. Our voices deserve to be heard. We need to advocate on behalf of ourselves and others to make these services more available and mainstream. Please consider this blog the start of a very important conversation that must ensue.
To conclude, I would like to thank all of those who inspired me to make this monumental decision, and who supported me physically and emotionally during the past few weeks. Thank you for reminding me to eat chocolate whenever I needed and to not judge myself for crying openly at the gym on a Thursday afternoon over…basically nothing. For helping me administer my medications and for providing refrigerator space for them when I visited. For reassuring me that I looked beautiful even when my body didn’t feel that way and for helping me remember that this would all be over soon. Every text message, every kind word, and every prayer were greatly appreciated. I hope one day that I will be able to offer the same kindness towards others.