Coming to terms with the loss of my fertility has been one of the most difficult parts of my breast cancer diagnosis. My cancer is estrogen-receptor positive, which means that any estrogen in my body fuels tumor growth. Unfortunately, a pregnancy creates a tremendous amount of estrogen in a woman’s body. After my original diagnosis, I was told that I would be on hormone therapy to limit estrogen production for 5 years following surgery and chemotherapy, but at that point, I would still be able to try for another child. However, once we met with Dr. G at the Cancer Center, she informed us that newer protocols indicated that 10-15 years of hormone therapy would be in my future. Assuming that I finished treatment by the time I was 34, that would mean hormone therapy until I was at least 44, and possibly older than that. She said point blank that she did not think it would be likely or wise for me to ever carry another child. At those words, I broke down and wept in her office. I was stunned. A cancer diagnosis is a challenging enough world to navigate, but to have the possibility of a second child taken from us as well has been an incredibly tough pill to swallow.
When we first received my breast cancer diagnosis, we had been actively trying to become pregnant with a second baby. We have discussed at length the possibility of having another child in whatever way possible. In the first few weeks following my initial diagnosis, I was set on freezing either eggs or embryos. I had been told that it was a fairly quick and easy process, and would not cause any further harm to my body. In addition, I could complete the process prior to surgery or starting chemotherapy. As a mother in her early 30s, it made total sense to me to make sure I took whatever steps I could to have a second baby.
I quickly set up an appointment with a well-known local reproductive oncologist (an onco-fertility specialist) to discuss fertility preservation options. After a bit of back-and-forth, we determined that I had no insurance coverage for either the egg retrieval or for future implantation. The retrieval itself was going to cost $12,000 total, which included all of the medications, procedures, exams, and the out-of-pocket consultation fee. I spoke to several other local onco-fertility specialists and they too gave me a five-figure quote for embryo retrieval, not even taking into consideration the annual cost for egg/embryo storage fees, which were also close to $1,000 per year. WOOF. That was completely unrealistic for us, knowing the deluge of medical bills we would be facing over the next few months and years.
We also discussed surrogacy as a way to expand our family. This would involve using Christian’s sperm and the surrogate’s egg or by implantation of a fertilized embryo into a surrogate. However, this option felt like the least appealing to us. I loved being pregnant with Felix, and had a wonderful birth experience, and I was incredibly fortunate to have been able to nurse him for 18 months. We also both felt uncomfortable with the idea of someone else carrying our baby. There are people who have had incredible experiences with surrogates to help them have children, however, it did not feel right to either of us.
Lastly, we explored the possibility of adoption. While I think adoption is an incredible means of expanding one’s family for those who choose to explore it, we did not feel like it would be a realistic option for us at this point in time. Adoption is an incredibly intense and emotional process that does not end once the papers are signed. There is a tremendous adjustment period for both the parents and the child – much like there is with any addition to a family, and our family is already going through so much. Further, adoption agencies tend not to want to adopt children out to people with diagnoses of incurable cancer that provide such uncertain prognoses.
Now that we know that my cancer has metastasized, having another child biologically is completely off the table. I have already started receiving Lupron shots that artificially induce menopause to help shut down estrogen production in my body. In addition, at some point in the future, I will likely have my ovaries completely removed. While I did identify a number of grants available to help offset the cost of fertility preservation for young women and families dealing with cancer, none of them seemed either appropriate for us or would come through in time to cover expenses prior to the start of my treatment.
At the end of the day, we decided that our family was complete with Christian, Felix, and me. We are tremendously fortunate to have our one wonderful son, and struggled to imagine the possibility of adding to our family in the face of such uncertainty. It’s been an immeasurable sadness to me that I will never give my son a sibling, but I also have found a measure of peace in the fact that it’s largely out of my control. I hope that Felix grows up knowing that our decision not to expand our family was one made out of love for what we have, and out of the hope that we hold for the future.