These Are The Fertility Questions I Wish I Asked When I Was Diagnosed
It was exactly one year ago this month that I was diagnosed. I can still remember sitting in the waiting room, two weeks before my 32nd birthday, telling myself that I was just being cautious. It was probably nothing, right? I was about to start teaching my first undergraduate class and worried about balancing this new responsibility alongside my full-time profession. Little did I know; the next 12 months were nothing I had ever anticipated.
When I heard it was National Infertility Awareness week, my mind immediately jumped to all of the questions I wish I had asked my fertility specialist. The questions that, in the whirlwind of a cancer diagnosis and surgery, I hadn’t had the clarity to even process. But now, sitting down to reflect on the past year, I’m thinking more about the questions I wish I had taken the time to ask myself.
1. Eggs or Embryos?
In jest, the thought of freezing my eggs at 30 crossed my mind. So many media articles made it sound easy. As it turns out, eggs are not a very viable product (this also depends on your age and additional factors), and it can take multiple cycles to generate enough eggs that could statistically yield a successful pregnancy. Multiple cycles require time, and that is one luxury a cancer patient doesn’t have.
Whether you’re in a relationship or not, the thought of losing your fertility and entering early menopause at 32 is terrifying. That fear is compounded by the unknown of what’s to come. So, when my doctor asked me the reproductive autonomy question, eggs or embryos, I didn’t know what do to. We requested a 15-minute coffee break in the middle of our appointment. We needed to process all of the information, and reassess our gut reactions. So, ask questions, take your time, and a break if you need it.
2. What about neither or both?
“Either/or” options can be deceiving. Often, there are other possibilities. In addition to freezing eggs or embryos, there are medications available that may be able to help preserve your fertility. These could allow you to potentially conceive naturally, or perhaps undergo IVF post-treatment. Unfortunately, the data on their effectiveness is limited. For an added cost, and depending on how many eggs are retrieved, freezing both embryos and eggs may also be possible. Egg donors and adoption are options we explored as well.
3. How important are genetics?
I was eligible for genetic testing when diagnosed. As only 5 – 10% of breast cancers are caused by a genetic mutation, we didn’t have the pending results top of mind while simultaneously proceeding with fertility preservation treatment. There is a 50% chance of passing down the mutation, and while genetic testing of embryos is possible, there are risks associated with the thaw, biopsy and refreeze process. A customized test also needs to be developed, which ideally requires your family member’s results. These steps take time and bear a significant cost. There is the added option of carrier screening for other genetic conditions to consider too. From our experience, ask as many questions as possible regarding what options are available to you as these may vary based on your federal, provincial and even clinic specific policies. And, while there is no right answer, we continue to ask ourselves what knowledge would lead us to make different choices.
4. How risk-averse am I?
This is the same question my financial advisor recently asked me, and it’s a question I’ve asked myself many times throughout the treatment process. Navigating the decisions that need to be made can be overwhelming, and the choices around fertility are no different. Understanding the options and the associated risks can be complicated. For example, the number of eggs or embryos you freeze is much smaller than the initial number retrieved as this depends on the quality and maturity of each egg which can only be determined after the procedure. We also found that the statistics provided were based on specific samples or studies, and varied depending on the demographics of a clinic’s clients.
5. Is timing really everything?
The term ‘biological clock’ has taken on a new meaning this year. As my treatment plan has evolved, we’ve learned that we must wait at least 21 months to conceive. Given my genetic results, it is also recommended that I have my ovaries removed around 40 or 45. Both of these timelines leave a relatively small window of opportunity for us to grow our family, but we feel lucky that it’s there at all. This experience has caused us to re-evaluate all aspects of our lives, and prioritize what we value most. – Kristin M.