I was 27 years old, newly married, and ready to start a family when I was diagnosed with breast cancer. My husband and I thought we had the rest of our lives ahead of us. The farthest thing from our minds was sickness.
Cancer just wasn’t in the plan. It wasn’t the happy next step we were expecting to take in our relationship. We were heartbroken.
I’d been focused on becoming a mother for as long as I could remember. My husband and I both wanted kids. We felt we were “ready” for that next stage after dating for 4 years and being married for one.
Cancer changed everything in the blink of an eye. We were forced to readjust our plans.
Instead of preparing for a baby, we were mapping out my treatment plan, surgery, chemotherapy, and years of hormone-blocking drugs.
Fertility was the number one thing on my mind when meeting with my cancer team. I knew that chemotherapy may impact my fertility. Yet, there are options, and most cancer survivors can have kids.
It just may not happen exactly as we had planned. I took every step possible to optimize my chances of having a family in the future.
Deciding whether to freeze eggs or embryos
The first step was exploring fertility preservation options. These procedures have to be done before chemotherapy. Thus, there’s the urgency for the education and decision-making.
We first talked to my oncologist and a fertility specialist. Then my husband and I underwent testing to determine our baseline fertility. We learned that we had the option to freeze eggs or freeze embryos.
Our doctors told us that egg freezing and embryo freezing take about the same amount of time. They involve many of the same procedures and have the same impact on your body in terms of drugs, hormones, and outpatient surgery. But with the embryo freezing, my husband had to give a sample of his sperm that was used to fertilize my eggs before they were frozen.
We learned that frozen embryos survive a bit better than frozen eggs. We were already in a committed long-term relationship and decided that was the best path for us.
Keep in mind that different cancer treatments impact fertility differently. Every person’s decision depends on their chemotherapy regime, their diagnosis, their finances, and whether a long-term partner is in the picture.
The decision to freeze our embryos was not easy emotionally, physically, or financially. Fertility preservation is often not covered by insurance, though many states are changing their laws.
I felt very lucky to be informed and supported by my medical team, family, and partner during this process.
The embryo freezing process
The embryo freezing process requires several steps:
I was first pumped full of hormone shots and pills to help my body grow as many egg-containing follicles as possible in one cycle.
It’s impossible to know how many mature eggs you’ll produce. I went to the doctor frequently to monitor the follicles and how many eggs might be harvested.
This was the hardest part for me. I saw every follicle as a potential child. I worried that the stress due to the procedure and the cancer would impact my results. I was ultimately able to produce around 12 follicles.
When the timing was right, I received a trigger shot to release the eggs. This usually happens about 10 to 14 days after starting hormones.
I then had an outpatient procedure where the doctors retrieved my eggs. The doctor inserts an ultrasound probe and a needle into the vagina to find the follicles and remove the eggs. The procedure can cause cramping and a few weeks of pelvic pressure or fullness.
Fertilization and freezing
If you choose egg preservation, the fertility team directly freezes the eggs they retrieved.
If you choose embryo preservation, healthy-looking eggs are fertilized with sperm. The embryos are sometimes “hatched” and tested for genetic abnormalities. The viable ones are frozen.
Not all eggs can be successfully fertilized. Doctors were only able to fertilize 6 of our 12 eggs. Only 3 successfully grew to the necessary stage and quality for freezing.
How to get through the fertility preservation process
Infertility treatments can be tough psychologically and are widely understood to be one of the most stressful events of a person’s life. The medications used in IVF procedures can cause mood swings. I was disappointed at the number of embryos that survived.
I was also put on drugs during chemo that temporarily suppressed my ovaries to hopefully preserve and prolong my fertility. Cue the hot flashes, painful sex, and mood swings. But I was willing to try anything for preserved ovarian function.
How do you get through the fertility preservation process and chemotherapy? Hope and passion to start a family got me through the process, cancer treatments, and 3 years of hormone-blocking therapy.
- Look toward the future. I always believed that I would be a parent someday.
- Grieve the “easy” route to parenthood. I envisioned a completely different path to kids prior to my diagnosis. I had to keep telling myself that motherhood comes in all forms.
- Refocus on cancer care. The most important first step was getting through treatments. I kept in mind that I could revisit my desire to become a mother when I was done.
- Find other things that fulfill you. Giving back to the breast cancer community and sharing my experience via blogging brought me a great sense of purpose and fulfillment. These passions as well as art and building relationships within my community as a mentor helped me to redefine myself beyond being a mother.
Trying naturally for a baby
Hope carried us forward when my oncologist finally agreed for us to try for a family. My doctor suggested we try naturally for a few months after my cancer treatments were complete. I was lucky that my cycle and fertility naturally returned.
My period resumed 3 months after I stopped taking hormone-blocking drugs. I sat in the bathroom at work crying. I’d never been so grateful for a period in my life. It represented so much hope for my future as a mother.
I’ll never know whether the return in my cycle was attributed to the ovary-suppressing drugs I took or my body just bouncing back. I don’t care.
I was pregnant naturally three months later. I devastatingly lost the baby in an emergency ectopic pregnancy, which included the removal of one of my fallopian tubes.
We never gave up despite the grief, pain, and loss. We tried naturally for 3 more months. Then we decided to attempt an embryo transfer.
The embryo transfer process was quite similar to fertility preservation. We went through a host of shots, drugs, and weekly checks to ensure my body was optimally prepared to accept the embryo.
The 9-day wait following the embryo transfer was the hardest part of the process for me! I tried to distract myself with self-care, pampering, and lots of time with friends and family. I made sure they knew NOT to ask about the results.
Our embryo transfer was a success. Our sweet popsicle baby became a living being.
It seemed things were finally looking up after everything we had been through. Our baby was growing each week. I finally began to relax after being on high alert and bracing for pain.
We heard the dreaded words “there is no heartbeat” at the 7-week appointment. Our world came crashing down again.
This time we had almost two months to become attached to this little one. I didn’t know how I would carry on. The hope I had carried for years was dwindling.
Never give up
Little by little, I learned to live again. Sharing my miscarriage story on my blog brought me a whole new community of support. These people along with my cancer tribe helped me find the strength to get up each morning, go to work, and believe that someday I would still be a mom after all the pain.
This past November I gave birth to my sweet baby boy. He was conceived spontaneously 3 months after my miscarriage.
I know that all I went through led me to this point. I am stronger because of what I endured.
I never like to say that things happen for a reason. I think it’s all about what you make of the hurdles and pain you face.
You never know what the future will hold. If you want to be a parent, there are many ways to get there some day. Even if the path is long and twisted.
Never give up hope. Your season of joy is waiting around the corner!
For more information on how to manage a cancer journey, reach out to your doctor or healthcare team.
NPS-US-NP-00589 MARCH 2020