On Cancer and Fertility
(From the perspective of a mid-thirties female cancer survivor)
When I got my cancer diagnosis, the last thing on my mind was fertility preservation. All I knew was that I had at least twenty tumors in my body, they were fast-growing and I was in a great deal of pain. I sought out three oncologists, two in Chicago and one in Houston. I was focused on one thing and one thing only — what is the best treatment for me and when could I start. It was actually my mom (who had been dropping not so subtle hints about wanting a grandchild for years) who brought up the question of egg preservation. I was unmarried at the time and in no hurry for kids, so it didn’t even cross my mind. Plus I had a grouping of very large tumors surrounding my ovaries. This was actually what kept me from exploring the topic further. I couldn’t risk the process of egg preservation because of the tumors. It would be too dangerous to attempt to extract my eggs.
Soon I was in the thick of my treatment and really only focused on surviving (and not throwing up all over the place). It really wasn’t until over a year after my treatment — when I started feeling better and getting back to some version of normal everyday life — that I started thinking about fertility again. Mostly because my mom — ever the optimist — was still hoping for a grandchild (and mentioned this a little too often). It did get me thinking, though. I’m now heading into my upper-thirties and have been married for almost two years. I wouldn’t say I’m ready to have kids now, but if I want them at all, I have to start planning soon. “Tic tok,” as my mom used to say all through my upper-twenties and early-thirties.
The trouble is, I’ve had no idea where to start. I didn’t know what was even possible for me. I had so many questions. I still take oral chemotherapy meds — meds that have only been on the market for around two years. My medications haven’t been around long enough for anyone to really know the dangers they might be for my eggs — and that’s assuming I even have any viable eggs in the first place. I’ve been through intense chemotherapy and radiation. I went through early menopause during treatment and only started having periods again a year ago. There are tests for this, I’ve found out: AMH to test the quantity of your eggs and FFH to test the quality. This, I guess, is step one. Even though I’m not ready for kids at present and I’ve known for a while that having biological children probably won’t be an option for me, it still scares me a little to find out the results of those tests.
After doing a little Googling and talking to some fellow female cancer survivors (one of whom is currently pregnant), I’ve learned a little more about other options: Donor eggs, Donor sperm, Donor embryos, surrogates, etc. And, of course, there are all of the adoption options or fostering. It’s pretty overwhelming and emotional. More emotional than I realized it would be. And expensive! People who are able to conceive naturally have no idea how much money they are saving.
Looking into fertility options feels almost like when I was trying to figure out cancer treatment. It’s confusing and it’s a lot of work. It takes fertility counselors, fertility practices, adoption counseling and organizations, social workers, and potentially even lawyers. You have to figure out insurance and how to come up with anywhere between five to twenty thousand dollars. After my diagnosis, my family and I would say that we needed a “cancer concierge.” I feel the same way about onco-fertility. There should at least be a guidebook of “things to consider” when you get a cancer diagnosis with fertility preservation on the list. I didn’t have many options, but plenty of under-forty cancer patients do — if they know to ask about them early on.
Right now, I feel completely over-whelmed. But I am going to walk through this process and see where it leads. Honestly, I’ve been terrified of becoming pregnant since my period returned. Pregnancy is known to kick-start metastatic melanoma cancer cell growth. The day I got a copper IUD, I felt like a huge weight lifted off of my shoulders. So, thinking about fertility options feels so bizarre. But it also feels like a good sign that I’m healthy enough to be thinking beyond simply survival. It feels like hope.
