For the first 4 years of my diagnosis, not one doctor ever mentioned or brought up the topic of fertility. Is this the forbidden “F word” among oncologists? Hmmm. One would imagine that it would at least be touched upon, considering I was just 31….but nada. Did the doctors assume it wasn’t a relevant topic because the cancer was so advanced when they first discovered it, and maybe I wouldn’t be around to bear a child? I can’t help but wonder. But over the years, as I have met more and more younger women with cancer, most have shared with me that fertility was never discussed with them either. Why is this? Kinda pisses me off actually. And since no one ever brought up the issue for me, I had to navigate and uncover options on my own…and boy was it a journey!
As a woman, I personally feel that it is our birth right to have children… I really believed it was my purpose pre-cancer although my perception has drastically changed. I would absolutely love to be a mother, but I also know that there are people who lead and live very fulfilling lives sans children. Whether one wants to have a baby or not is a very personal choice, and there is no right or wrong, but I have always believed it should at least be a choice. I felt like cancer had robbed me of that right/choice. That is, until I froze my eggs. I didn’t even know egg freezing was an option until I did a ton of research, made several calls and went to consultations in order to understand the process so I could make an informed decision.
I ended up finding the right fertility doctor for me, went through all of the steps, and now feel blessed to say that I have my eggs on ice. Now whether or not I will have to use them to have a child in the future is unknown, but knowing that I have them waiting on me provides me so much relief and peace of mind, and makes me feel somewhat whole again, all of which are priceless. Looking back, I wish I had had some information or input to help me navigate through my fertility journey, but I didn’t..and I was totally left in the dark, and it wasn’t easy… it sucked actually. But through my journey I gained a ton of insight and info and my hope is to help you navigate on your journey and provide some answers to questions you may have regarding the process.
Egg freezing is slowly becoming mainstream, for both women with or without health concerns. From a medical standpoint, it’s no longer considered experimental. Companies are starting to offer it as a perk to their employees and egg freezing banks are even throwing “egg-freezing parties” to convince women that it’s a smart way to extend their childbearing windows. So as egg retrieval is becoming more and more popular, there are so many testimonials available online and there’s a plethora of information to make this a much simpler process. As a young woman living with cancer however, here are the 5 most important things I feel you should know as you begin your egg freezing journey:
1. What exactly does it mean to “freeze my eggs?”
The process of egg-freezing, or in medical terminology, oöcyte cryopreservation, is a method used to preserve reproductive potential in women. It involves stimulating the ovaries with hormones to produce multiple eggs, retrieving the eggs from the ovaries and taking them to the lab, where they’re cooled to subzero temperatures to be thawed at a later date. Later, when you are ready to become pregnant, or in some cases have a surrogate, the eggs can be thawed, fertilized and transferred to the uterus as embryos.
Many women are delaying pregnancy until their late thirties and early forties. Often, they are surprised and distressed when they learn they no longer have eggs that will produce a pregnancy because they waited too long. They may be in their early forties, looking great and feeling great, but trying to get pregnant at this age may not be going so great. Egg freezing gives women the chance to preserve their eggs while younger, preserve their fertility and reduce the chances of miscarriage and birth defects associated with “egg age.”
In the case of us women facing cancer, radiation therapy, chemo and surgery can all cause infertility by destroying our eggs. Depending on the type of cancer being treated, egg freezing may be an option that gives us cancer fighters/thrivers/survivors the opportunity to preserve our fertility before undergoing therapy, or in my interesting case, during. (I will share my crazy story at the end of this post).
2. What Does the Process Entail?
The typical procedure goes something like this:
After testing to see if your ovaries are in good health through ultrasound and bloodwork, you are cleared to start the egg production process. (I was shocked that mine were in perfect health considering I was on toxic chemo drugs for four years straight…so there is hope ladies!) The patient receives a round of hormone injections that stimulate the ovaries to produce multiple eggs. Typically you are given the injections to take home and you give them to yourself in the stomach. I know this sounds super erie but it’s actually not that bad. My dear friend Laura graciously gave me my first, but I needed to get over my fear and do them for myself thereafter. I think I sat there for close to an hour totally freaked out, but I finally came to grips and it seriously didn’t hurt at all…I just had to get out of my head and the rest were cake.
Anyhow, this process goes on for about 10 days and during that time you are at the fertility clinic every other day so that your ovaries can be regularly monitored by vaginal ultrasound. Around the time you would normally ovulate, is when you will have your egg retrieval procedure. The process takes about 10 minutes and is done under mild anesthesia or sedation. Using an ultrasound, the doctor guides a needle through the vagina to the ovarian follicle containing the egg. A suction device at the end of the needle removes the eggs from the follicles. Retrieving the eggs is technically not that different from getting blood drawn, a needle goes into the ovary and the eggs get gently aspirated out. Once you awaken from the procedure, you may feel a bit of cramping and bloating but nothing unmanageable. The eggs are then tested so see if they are fertile and are then frozen.
Now, if you have cancer that is fuled by estrogen/hormones like myself, then the injections/meds pre-retrieval will be different, but the process is still the same. I couldn’t take massive doses of egg inducing hormones because I have estrogen positive cancer, but I was given a different drug to take and I still had a successful retrieval yielding fertile eggs.
3. When is the ideal time to freeze my eggs?
As women, our fertility declines as we get older due to aging of the ovaries and eggs. We are born with all of the eggs we are ever going to have, our bodies don’t produce any new eggs during our lifetime. At birth we have approximately two million eggs in our ovaries and when puberty is reached and menstruation begins, only about 400,000 follicles remain. With each menstrual cycle, thousands of follicles are lost. By the time we are 30 years old, 90 percent of our eggs are already gone, and only 3 percent have remained by the time we reach 40. Statistically speaking, it is recommended to preserve your eggs in your early to mid thirties for the best retrieval and outcome. However, ovarian function is not the same for every woman, so it is important to find a great fertility/reproductive doctor and consult with them to obtain or your personalized best time frame.
For those of us whose fertility is jeopardized by a cancer diagnosis or other health challenge, choosing our best time frame is not something we get to determine. If you are younger and without children, or want to have more children, it is best to ask your surgeon/oncologist if you can freeze your eggs pre treatment. If this is possible, and you are able to buy a little time, the fertility clinic will work with you to get the process going quickly. If you have to start treatment right away, you can always revisit the option once you are in remission or are in a stable place if it is approved by your oncologist. It is usually recommended that you are off of treatment for at least three months so that the toxicity from all of the drugs are out of your system, which typically takes 90 days.
4. If I freeze my eggs, how much time do I have to use them?
Research is super encouraging. Although egg freezing is a relatively newer procedure, the practice of storing frozen embryos for later pregnancies has been around longer and can offer insight on what to expect for frozen eggs in the coming decades. Pregnancies have been achieved with embryos frozen for more than 20 years. Therefore it is expected that, the same will apply to frozen eggs.
That is likely more time than anyone would need in determining whether or not they are going to have children in their future. But while your eggs can last for ages, how long can your body wait? Compared to the decline in the quality of the eggs that a woman’s ovaries release each month, it can be said that the uterus is much more resilient and that a woman can carry a pregnancy well into her 40s and beyond. And if you are unable to carry a child due to ongoing cancer or metastatic disease, a surrogate is another option. (I will be covering this more thoroughly in another blog post).
5. Is it affordable? What is the cost?
Freezing your eggs is not cheap! The cost of medication and retrieval for one cycle is roughly $10,000-12,000 and storing eggs will cost about $500 – $800 per year. But freezing your eggs may save thousands of dollars in fertility treatment down the road, and it offers immediate peace of mind. In my own personal opinion, peace of mind is priceless so I was willing to take a loan out no matter the cost to ease the anxiety that fertility was causing me.
However, the good news is, for women with cancer, there are discounts available. Thank God. I was able to get a substantial discount which really helped me financially. Most fertility clinics offer this discount so be certain to ask if it isn’t mentioned to you within the first consultation. There are also sites that advocate for cancer patients and fertility issues and there are grants available to assist in covering the costs. In addition to the discount I received, I also applied for a grant at The Samfund which helped with the annual bill at the egg storage facility. Be sure to check them out.
As I mentioned earlier, I had my egg retrieval done years into my diagnosis. Because no one had mentioned this as a possibility for the first 4 years of my fight, I just assumed my chances were non existent. Right after I learned of my misdiagnosis, I made the decision to move back to Los Angeles from the East Coast to find a better oncologist and be closer to my family and friends. During this transition and cross country move, I was given a small window to be off of treatment, considering I had been on the wrong treatment for close to 4 years. The amazing doctor who uncovered my misdiagnosis in Brooklyn gave me a deadline of April 1, 2015 to be situated with a new oncologist back home and on a new and correct treatment protocol. My last dose of treatment (the wrong treatment that I had been on for years) was at the beginning December of 2014.
This was the first time in years that I would be off of treatment, and when I calculated the time frame, I would be off a little longer than 3 months so this was finally the chance I had been waiting for! I landed in LA on March 17, and had my consultation with the fertility doctor the very next day. Mind you I had about 2 weeks to get this done before my deadline of April 1st, so I wasn’t feeling very optimistic. When I went over my medical history with the fertility doctor, I felt like he was looking at me like I had two heads or like I was a walking hot mess. He told me that first and foremost they had to ensure that my ovaries were healthy and functioning after being subjected to years of treatment and that egg freezing was a very precisely timed procedure…I would have to return on the second day of my menstrual cycle. I sat there for a sec and realized that I had just started my period the day before… so technically that very day was my second day. I told him this and he was a little astonished, as I was and sent me for immediate blood work and testing. What were the chances??!…mind you I had been in menopause because of treatment for years and this was the first period I had in a very long time because I was finally off of treatment. You can’t make this stuff up! God is so good.
Long story short, the tests concluded that my ovaries were healthy (another miracle) and I went from consultation to full blown egg freezing mode that very same day. I went through the process I described above and in roughly 2 weeks I had my retrieval done and now can proudly say that my eggs are on ice. Hallelujah! Three days after my retrieval, I started my new treatment protocol and went straight back into menopause. Needless to say it was nothing short of miraculous that I ended up at the fertility clinic the day I did. Every time I recall that whole ordeal it seems so surreal…the timing of it all.
Overall I have to say that freezing my eggs was one of the best decisions I have made on this crazy journey and if you are contemplating, then my advice to you would be to go for it. This was a very empowering decision for me personally and I hope the same for you. How fortunate we are to live in a time when science is so advanced, that egg freezing is even an option.
I am here to support you on your journey. I hope I have alleviated some confusion or answered some questions you may of had. Feel free to contact me with any questions by commenting below.