Fertility concerns with breast cancer

In September 2008 I started chemotherapy treatment for breast cancer. Although my head was swimming from all the information thrown my way, I did remember to discuss my fertility concerns with my oncology team. After stressing that I wanted to have the option of having children after my treatment was done... and after weighing the desire to have kids against the need to begin my cancer treatment right away, I opted to have my ovaries shut down.

As it was explained to me, because I was pre-menopausal, I was a candidate for hormone-suppression of my ovaries. This option was quick and relatively easy to administer. Relatively easy is truly a matter of degrees. That needle I took in my abdomen was extremely long. EXTREMELY LONG. And it wasn't pleasant. But it was tolerable for a good cause.

The hormone suppression had the added benefit of reducing the amount of estrogen in my body which was be a benefit to me since my cancer was estrogen-driven. What I wasn't told -- and I'm not sure that my oncologist knew the answer -- was when or if my ovaries would resurrect and return to full function. Its been a year and a half since that first needle and well... no signs of my cycle yet. I imagine every creak and ache in my body (some days) to be a sign that my "lady curse" is coming back. But nothing so far.

The first surgeon that I met with on this journey was a young asian doctor who was also a breast cancer survivor. Having her on my team helped me immeasurably because I was comforted by the fact that she really knew what my path looked like. She wasn't simply telling me things she learned in a classroom, she was speaking to me from her experience. It made a huge difference. She was open and honest with me every step of the way and I will forever be grateful for her honesty. In hindsight, she set the tone for the way that I write this blog and the way that I speak to others about my journey. Her ability to be open, honest and blunt really was a blessing to me. Her willingness to be available to me at any time by phone was a major blessing as well.

(I remember calling her the weekend after I received confirmation that I did indeed have breast cancer. I called several times and kept reaching her voice mail. She finally called back after a day. And I felt bad because she was on vacation, out of town at her sister's wedding. But I was amazed that she did return my call.)

I remember asking her about fertility concerns in the summer of 2008 (which was just before I started chemotherapy) and she explained to me then that she too had opted to have her ovaries put to sleep. However, when I pried further for an understanding of when I could expect this situation to reverse itself, all she could tell me was that her ovaries had not yet awakened. I believe she was at that time, about 2 years out from her treatment like I am right now. At the time, I hoped that it wouldn't take me as long.

Earlier this evening, I felt a few twinges in my lower back and a familiar nauseating feeling washed over me for a few moments. I actually smiled at the thought that I might be experiencing menstrual cramps. Its been so long that I have forgotten about the misery that comes along with a menstrual cycle. I think my desire for a baby has actually warped my brain into thinking cramps are a good thing.

When you're faced with all of the choices and options you need to consider when mapping out your plan of attack against breast cancer, its easy to become stressed and overwhelmed at the possiblity of making a bad choice. And, if you're a young pre-menopausal woman, fertility may be an issue that you have to deal with sooner or more directly than you wanted. The truth is that you can't make a bad choice. Any choice you make, based upon what you feel most strongly about, what you know in that moment -- is the right choice.

There are lots of ways to try to preserve your fertility -- you can freeze eggs, freeze embryos, shut down your ovaries, opt to use less harsh chemotherapy drugs -- but ultimately, no matter what you choose to do, you are balancing saving your life with bringing a new life into the world. And that is a very difficult choice.

For me, at the time of my diagnosis and the beginning of my treatment I simply did not feel that I had the time or the money to seriously consider cryopreservation options. What's ironic is that prior to my diagnosis of breast cancer, I had researched (a little) cryopreservation options in my area and had pretty much discarded the idea because of the cost. By the time I started thinking about fertility options (before my diagnosis) in a real tangible way, I was in my mid-to-late 30's. A little late to try to preserve eggs or embryos. Considering also, that I lacked a partner to create a child with -- there would have been an added cost of sperm donation to add to the costs of cryopreservation. And if I'm really honest, it just didn't seem like the ideal way to have a family.

I hate to say it this way... but my dream of a husband and then kids just won't let me go. I know that women opt to have children alone all of the time. For many reasons. I know. I know that its possible. I know that I have a good support system with my parents, my relatives and my friends. I know that I would not be alone and that my child(ren) would be loved by many people. But... I have such a hard time convincing myself that I want it by myself. Because I really don't.

Sigh.

So, even though I'm researching fertility options, its really a half-hearted effort.

I don't have the ability to invest thousands and thousands of dollars into the attempt to have a child alone. Now that the urgent treatment is behind me... I'm still faced with the same questions, the same concerns and the same hesitations. After I shared my post yesterday about my baby dreams, one of my best girlfriends posted a scripture reference to help me focus on the fact that none of this is really up to me. And while I know it is true, I still wonder what I am supposed to do at this point. Besides sit and wonder and think. Or make non-heartfelt attempts to do it alone.

I really don't know what to do.

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