From Cancer to Motherhood
Today’s guest post is a subject very close to my heart. Special thanks to Dr Sonja Kristiansen MD, a board certified Reproductive Endocrinologist Infertility (REI) specialist, for providing us with her expert advice.
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As an OB/Gyn resident, my career was transformed by the habit-forming experience of a new mom-to-be’s smile — especially since she thought that day would never come.
For many women with cancer, dreams of motherhood can be heart-breaking. Frequently they must choose between life-saving chemo and radiation therapies or a chance at becoming a mother. I’ve heard them talk about how time seems to move faster when so many difficult and final choices are on their shoulders.
What I do is about more than just baby-making. For women with cancer, reproductive medicine represents not just surviving a disease, but going on to have a fulfilling life.
There are options to preserve fertility prior to undergoing cancer treatment. It’s important for patients to understand this fact up front, because they’ll often have to advocate for themselves. Oncologists are focused primarily on saving the life of the person in the exam room, not so much their potential offspring.
The successful use of frozen sperm is many decades old, going back to the 1950’s, but the pace of technology picked up great speed about 30 years ago, from the first in vitro fertilization (IVF) birth in 1978 to 1983 when the first child who resulted from a frozen embryo was born. More firsts quickly followed: the use of another woman’s egg cells (donor eggs) and gestational surrogates, the ability to select a single sperm and inject it into an egg (intracytoplasmic sperm injection, or ICSI,) the ability to preview an embryo in vitro and determine its viability before transfer to the womb (preimplantation genetic diagnosis, or PGD.)
Each of those technical advances was met with worry — by physicians, patients, and the general public. Today’s questions swirl around oocyte cryopreservation, or egg freezing.
In 1997, the first US baby was born from a frozen egg cell that had been thawed, injected with a sperm cell for fertilization, and the embryo then transferred to the mother. In 2006, the first cancer survivor used her eggs, frozen prior to chemotherapy, to have a biologically-related child with the help of a gestational surrogate.
Still, many fertility experts are slow to embrace the technology. Some simply do not offer it to any patient, whereas others have policies that determine which patient can access the treatment.
Oocyte cryopreservation is a simple concept with tremendous potential in both application and implication. And it is not the only option — some patients may opt for IVF or intrauterine insemination after cancer surgery but before chemo or radiation. Many choose to use IVF to create and freeze embryos for use down the path, after they’ve been cleared by their oncology team.
All of the fertility preservation options allow women cancer-survivors to move on to fully reproductive lives. If your oncology team doesn’t mention the topic of future pregnancy, bring it up yourself.
Dr Sonja Kristiansen MD, is a board certified Reproductive Endocrinologist Infertility (REI) specialist, for She has been practicing in the Houston area since 1995.
Thanks so much for posting this information- it comes too late for me sadly, but I just know it will help other young women who have concerns about their fertility when diagnosed with breast cancer.
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What a terrific post – great info and very accessible.
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Infertility is a devasting side-effect in young patients having cancer treatment and my heart goes out to anyone who is dealing with this.
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I am always so pleased to see your posts on fertility – again like you it was the thing that distressed me most about my treatment and the infertility experienced as a result the hardest thing for me to deal with
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When I was dealing with the double whammy of a breast cancer diagnosis and the prospect of impaired fertility as a result of my treatment, I just didn’t know where to turn for advice. This has come too late for me, but hopefully will help others facing a similar diagnosis
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Just another example of how you must be your own advocate. Also, I’d like to add that younger women who have tested positive for BRCA mutations, sometimes must face reproductive decisions, too, if they choose preventative surgeries. Oocyte cryopreservation certainly comes into the picture here as well.
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Good information, although I admit that reading it brought back all my old feelings of frustration, fear and sadness when I was diagnosed with breast cancer.
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This is a very emotive subject and it was this aspect of my own diagnosis and treatment – the potential for infertility inherent in breast cancer therapy that caused me the most anguish throughout my treatment and indeed in the years beyond.
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Sadly, it is a common occurence that many young women (and men) diagnosed with cancer in young adulthood are not fully informed about the consequences of their treatment on fertility until it is too late. Consequently, they face periods of uncertainty that can last from months to years as they work through what is available to enable them to achieve parenthood- I find this heart breaking.
Of course, it is vital that doctors hold treatment in such high esteem, but at the same time, quality of life post cancer should also be considered. Fertility for some people, is crucial to their quality of life, and therefore when impairment occurs, it has been reported to be as painful as the diagnosis of cancer itself.
Sometimes all it takes is a thorough conversation….come on guys……give these people their lifes back- IN FULL- all it takes is a conversation and a referral prior to treatment.
Just my pennies worth 🙂
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Lesley, you are so right in what you say. While the doctors emphasis is quite rightly on saving our lives, with more and more of us thankfully living and living well after a diagnosis of breast cancer, it becomes for us about how we live our lives and knowing that we have done all we can to preserve our fertility can make such a difference to the quality of life we will live. Thanks Lesley for sharing your pennies worth – it’s worth more than pennies to hear the voice of someone else who understands 🙂
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[lives]
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With your help we can overcome the shortsighted treatment plans by empowering women to ask questions about fertility preservation before initiating treatment.
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