BOSTON —

Since the start of the pandemic, Adjoa Anyane Yeboa's day-to-day schedule has changed.

"I was able to find more flexibility in my work life in order to take time and finally take time and do something for me," Yeboa said.

More work from home means more time to make plans for the future. For Yeboa, who's in her mid-30s, that means family planning.

"I've been thinking about egg freezing for a long time and only recently I finally decided to take the leap," Yeboa said.

Fertility experts say egg freezing has spiked about 20% during the pandemic.

"I see so many people settling for their partners or rushing to find somebody and to get engaged and get married because they're beating a clock and I didn't want to have to do that," Yeboa said. " I wanted to do things on my timeline."

Dr. Rachel Ashby, a reproductive endocrinologist and fertility specialist at Brigham and Women's Hospital in Boston says there are key COVID-19 reasons more women are making the personal decision to freeze their eggs, including how isolation impacted relationships.

"The pandemic has delayed a lot of social interaction, so for people who were dating and planning on dating and looking for partners," Ashby said. "There were a lot of patients I've seen that were in a long-term relationship with this idea that this person I plan to build a family around, and the relationship did not survive."

There's been more time to think and for many, to turn to science.

The egg freezing process takes about two weeks and involves daily injections of FSH hormones to stimulate the ovaries to grow as many eggs as possible.

Then, the eggs are retrieved and preserved in a lab in subzero temperatures to be used at a later date.

"The biggest thing for women to know is that travel is not easily accomplished because you're coming in every few days, usually at 6:30 to 7 a.m. for bloodwork or ultrasound," Ashby said. "Over that two-week time frame, the follicles go from very small to mature."

Ashby says women who are thinking about doing this should focus on getting all the information first, to see if it makes sense for them.

The process can run anywhere from $5,000 to $10,000 to freeze your eggs.

Ashby says more and more companies are including egg freezing in their health insurance but you should make sure your coverage also includes medication.

She cautions there are no guarantees, so potential patients should ask a lot of questions about fertility and see what's best for them.

Reproduction as we've known it for millions of years could look very different in a few decades due to revolutionary science.

You've likely heard of the fertility process called In Vitro Fertilization in which an egg and sperm are joined in a lab to produce a fertilized egg called an embyro.

There's a new process Japanese researchers have discovered called In Vitro Gametogenesis, or IVG, in which any cell from a person's body, say a skin cell, can be turned into an egg or a sperm. It doesn't matter whether the cell is from a male or a female.

Brown University professor of medical science Eli Adashirecently attended a workshop at the National Academy of Medicine focused on the latest findings of IVG.

"You can take a male skin cell and convert it not to a sperm, but actually to an egg," Adashi said. "In other words, imagine two men were unable at this point to father a child that is genetically their own, and with that technology, in principle, they could now be the parents of a genetically-related child. "They will, of course, need a surrogate to carry the embryo and the and the pregnancy to term. It's a breakthrough the likes of which nobody could envision as recently as a few months ago."

Not only would IVG make it possible for two men or two women to reproduce, it would allow infertile men and women to have children with their own DNA instead of relying on donors. Moreover, women could reproduce at any age, rendering the biological clock irrelevant.

There's even talk of the possibility of what scientists are calling "uni-babies" in which a baby is made with just one person's genes.

So far IVG has only been done successfully on mice. Adashi says social and legal questions need to be answered before this can be done on humans.

He also notes there are many more possibilities for this science beyond reproduction since the stem cells can theoretically be guided in any direction.

"What if you were blind because one particular cell type was missing in your retina?" Adashi said. "Could we produce that cell in vitro and then inject it into your retina and thereby reestablish normal vision?"

Thanks to candid conversations from influencers like entrepreneur Anna Victoria and public figures like Senator Tammy Duckworth and former first lady Michelle Obama, the concept of using in vitro fertilization or IVF to achieve pregnancy is becoming more of an open conversation.

According to the latest data from the Society for Assisted Reproductive Technology, or SART, 77,256 babies in the U.S. were born via assisted reproductive technologies in 2019, increasing more than 2600 from the year before.

Here’s how it works fundamentally: during IVF, mature eggs are united with sperm in a lab. At some point, those fertilized embryos are then transferred to the uterus in hopes of producing a pregnancy.

The technology has opened up new possibilities for families — but it's not without its issues.

A recent mixup turned the now common practice into a nightmare for one couple when their fertilized embryo was swapped and inserted into the uterus of another patient.

“We never even knew that something like this could happen," said Alex Cardinale. "It wasn't even on our radar. How could this happen? But now we realize that the fertility industry is a mess."

Dr. Emily Jungheim, a professor at Northwestern University’s Feinberg School of Medicine, says occurrences like these are rare. But the growing trend of freezing embryos for future use can increase the potential for mix-ups.

“When you think about the inventory and the attention to detail and how careful you need to be due to the risk of having all of those things in storage, you could imagine how these types of things could happen," Jungheim said.

The industry has been called out before for lack of federal regulations. But it isn’t completely void of oversight.

For nearly two decades, clinics have been bound by the Fertility Success Rate and Certification Act, which requires embryo labs to be certified by an approved non-federal program. It also requires clinics to report their success rates.

The FDA also binds clinics for matters of drug and device safety.

But federal oversight of the industry as a whole doesn’t exist. Instead, it’s more self-regulation where some clinics work to meet the guidelines set by the non-profit, SART.

SART members must follow industry standards created in part by SART and a group of their peers from the American Society for Reproductive Medicine. They are also monitored to ensure things like honesty in marketing and advertising.

According to SART, as of 2018, 86% of IVF clinics were members of their organization.

Still, mistakes can happen. Jungheim says there are ways patients can be their own best advocates.

“What is the certification of the physician that I'm working with there?" She said. "Are they board certified in reproductive endocrinology and infertility? Do I have friends who've gone there who feel strongly about their docs and comfortable with them?”

She also says incidents like this can cause doctors and labs to ask vital questions and make changes for the better.

Amber Strong at Newsy first reported this.

The questions that can come with any pregnancy can be overwhelming; add the COVID-19 pandemic and a new vaccine into the mix, and -- whether a woman is already pregnant or in the process of planning a pregnancy -- the unknowns can seem to outnumber the knowns.

"We've been trying to conceive for three and a half years now," said Anamarie Waite. Waite and her husband, Kevin, want to give their daughter, Amora, a younger brother or sister.

They've been through five rounds of infertility treatments.

"I'm not going to get [the vaccine] if we're back in treatment and actively trying to conceive, but if we do end up getting pregnant, I would like to get the vaccine if it's available to me while I'm pregnant," Anamarie Waite told WCPO.

It's delicate timing to balance for the Waites, one experts say will require careful discussions with their doctor.

No (known) reason pregnant woman shouldn't vaccinate

For Dr. Tina Sosa, pediatrician and new mom, deciding to get the COVID vaccine was a matter of weighing the risks of contracting the virus against the unknowns that still surround the vaccine could impact the woman, her pregnancy or the baby postpartum.

She got her vaccine when she was 34 weeks pregnant. Weeks later, she delivered a healthy baby boy, Leo, and said she hasn't observed any complications.

"I had to weigh the risks of getting COVID while I was pregnant to getting the vaccine," she said, pointing out that pregnant women who contract the virus are at a higher risk of severe illness and hospitalization.

The World Health Organization in a Jan. 8 post on its website said it does not recommend pregnant women receive the Pfizer-BioNTech COVID-19 vaccine but later said on Jan. 26 that it does not "have any specific reason to believe there will be specific risks that would outweigh the benefits of vaccination for pregnant women" to receive the Moderna vaccine. The agency recommended that pregnant women who are at high risk of contracting the virus -- healthcare workers like Sosa, for example -- should receive the vaccine.

Dr. Emily DeFranco, OBGYN and maternal-fetal medicine specialist at University of Cincinnati Medical Center, agrees there's no indication either vaccine poses additional risk to women who are pregnant.

"There's no scientific reason to think it would be harmful. We certainly have reason to believe it would be very beneficial," she told WCPO. "With that being said, it hasn't been studied for safety in pregnancy, and you should understand that before you make a decision to take the vaccine."

When it comes to pregnant healthcare workers, specifically, DeFranco said she hasn't encountered one yet who has declined getting the vaccine.

Don't plan growing family around vaccine

As for those planning a family, Dr. Abby Loftus-Smith, an OBGYN with St. Elizabeth Healthcare, says the vaccine is safe to receive while trying to conceive.

"There is no increased risk in early miscarriage in those groups of women; there's no increased risk of infertility in those groups of women," she said.

DeFranco agrees there, too: "I would not advise that there's any reason to feel that you would need to delay attempting to get pregnant," she told WCPO.

Sosa said the decision ultimately is a personal one.

"It needs to be a personal decision for every woman and a discussion with their doctor," she said.

Beyond making the personal decision to get or not to get vaccinated against coronavirus, whether or not there's available supply is another matter. And for a family like the Waites, waiting becomes a less and less acceptable option each day.

"We're already three and a half years into this; we're not getting any younger and my egg quality isn't getting any better. So we just, waiting for the pandemic to end, waiting for the vaccines to be available is just not something that's an option for us."