**Rachel Bland has kindly given Cancer and Fertility UK Permission to reblog here. If you would like your blog post featured too (as long as on topic of cancer and fertility) please get in touch!**
Rachel recently talked about fertility on the BBC 5 Live Podcast #YouMeBigC
PUTTING THE CAN IN CANCER
“Babies are probably not the first topic that springs to mind when you think about cancer but they were one of the first things I thought about after my diagnosis. It’s another aspect of getting cancer that’s unique to being diagnosed when you’re young – the issue of what to do if you’ve not started or finished having a family.
I had my son Freddie at the relatively ‘advanced’ age of 37. This was not by choice or design, it was just a result of circumstances. Steve and I had just started trying for a second baby when I got my diagnosis. So, my second question for the doctors after ‘Will I lose my hair?’ was ‘Will I be able to have any more babies?’ Fertility and getting pregnant had taken up so much of my headspace over the previous few years I just didn’t want to have to deal with the grief of being told I couldn’t have any more children as well as dealing with the shock of having cancer at the same time.
There are so many emotions to process when you’re first diagnosed and thinking about IVFas well might seem like a bridge too far. But my advice would be to ask about fertility preservation, as you can give yourself some insurance pre-chemo but afterwards it may be a struggle.
You see, cancer treatment plays havoc with your fertility. Chemotherapy targets fast-dividing cells, both the good and the bad and some of the fastest dividing are of course in your ovaries. As a result, chemotherapy can leave you infertile and going into an early menopause. Especially if you’re knocking on 40 like I was.
As I’d looked into IVF before eventually falling pregnant naturally with Freddie, I knew what it entailed and so pushed to be allowed a cycle before starting chemo. For me, keeping that dream alive of expanding our family and carrying on with life plans after cancer, was worth delaying the start of chemo by what turned out to be just a week. I was ‘lucky’ in that my cancer isn’t hormone driven. For women with hormone positive cancers there’s another risk to think about with pumping a load of hormones into the body.
Fertility preservation provision does vary between NHS areas, as I understand, and I was very fortunate that where I live the health authority would pay for a round of IVF (as far as the egg collection and storage point) for young women diagnosed with cancer.
GOING THROUGH IVF
Typically for me, the timing right before Christmas wasn’t great. IVF is a very regimented process, you have all sorts of tests first then give yourself hormone injections for a number of days to stimulate your ovaries to produce lots of eggs. You have to go into the hospital to be monitored every couple of days so they know when your ‘follicles’ have grown to the right size. Unfortunately, due to my age my eggs were not as quick to grow to the right size as average. I’d turn up to be scanned every two days hoping for the equivalent of a giant Easter egg but kept being sent home with a bag of mini eggs. We’d hoped to get the egg collection procedure out of the way on Christmas Eve before I started chemo on the 28th December but in the end, it had to be done on Boxing Day. This really rained on my Christmas day booze parade where I’d planned to drown my cancery sorrows in a vat of prosecco. Instead I had to stay sober all day so as not to pickle my already fragile and slow growing eggs!
I turned up at the clinic on Boxing Day, sober and moody from all the hormones ready for the egg collection, which is done under sedation. It was good sedation as I knew absolutely nothing about it – just how I like it! The consultant came to see me afterwards as I was desperate to know how many eggs they had managed to collect. The average is around 10, some people get up to 20 or more. I was devastated when she told me they’d only managed to get 5. However, as so often in life, it is quality not quantity that matters. A few days later I could hardly breathe as the call came to let us know if any eggs had fertilised to become embryos. They told me that of the 5 eggs, 4 were mature and of those all 4 fertilised.
I was over the moon, it would have been so hard to have gone through all of those invasive procedures only to end up with nothing but a delay to my chemo. But in the end, it worked out ok and our 4 little embryos – the remainder of our potential Bland 5-a-side squad – were sent off to chill out in the freezer for the foreseeable.
In the interests of taking charge of my fertility I also asked to be given a drug called Zoladexthat I’d been told by a doctor friend, could help to preserve my ovarian function during chemo. It’s used as a treatment for women with oestrogen positive cancer (and men with prostate cancer randomly!) as it shuts down the ovaries and stops them producing eggs. There has been some research showing that stopping the ovaries working during chemo means they sustain less damage. The penalty to pay was being put into a chemically induced menopause but I wanted to try anything that would give me another chance at having a baby.
There then followed times, as I was sweating from every pore in my body and nearly fainting from the burn of the hot flushes that I questioned this decision! The monthly injections of the Zoladex implant with a needle so big it requires a local anaesthetic are also a bit of a downer.
RISKS OF PREGNANCY AFTER CANCER
Unfortunately, my carefully orchestrated plan I’d mapped out in my head – to finish treatment last August and wait a year before trying for a baby – was scuppered by my cancer’s inability to piss right off. Instead of celebrating the end of treatment in August came the horrible news that I’d be having more chemo, swiftly followed by the news that cancer had spread to other lymph nodes.
I hope that’s being dealt with now but living though the cancer immediately recurring was a reality check about the possibility of it coming back again further down the line. Plenty of young women have babies after cancer treatment but it is a very personal decision as it’s a bit of a game of Russian Roulette. Can I get through 9 months of pregnancy without any tumours showing up? Because your treatment options are limited (though not non-existent) while pregnant for obvious reasons.
As well as pondering the dangers, I ask myself all the questions about whether it is selfish to have another baby when my life expectancy may be limited? Or would it be better for Steve and Freddie to have another member of Team Bland if I weren’t around – they say there is safety in numbers after all.
These are all conundrums I may never work out the answer to. But whatever happens those 4 little frozen embryos chilling out in a freezer somewhere in Manchester represent 4 frosty little grains of hope. And a little bit of hope is what you need to get you through.
Original Link: https://www.bigclittleme.co.uk/blog/cancer-fertility/