Remember when I said that my oncologists felt there was a pretty good chance chemo wouldn’t completely obliterate my ovaries? Well, turns out that a “pretty good chance” is more or less 50/50. So I decided to go ahead and talk to a fertility doctor about my options for making sure I’m able to pass on my DNA, because aside from this cancer crap, which may or may not be related to it, I’m a pretty big fan of it.
Gordie and I went to the fertility clinic on Saturday, and I immediately realized we weren’t mature enough to be there when we started giggling over the sperm-heart logo and terms like “semen washing” and “post-coital testing.” It was a strange mixture of emotions – half wanting to laugh at the ridiculousness of the whole thing, half wanting to cry over the same thought. Eventually, however, I remembered that I have cancer and cancer is Serious with a capital S so it was time to really buckle down and pay attention.
Luckily, I loved the fertility doc. He was calm, kind and understanding, and said he’d seen plenty of women in my situation. In fact, he said that I was in a better position than many cancer patients he sees, because I’ll only be 30 when all of this is finally behind me – leaving me with a higher chance of retaining natural fertility than someone who would be in her mid-to-late 30s. Admittedly, he has a bias, but he felt that it would be safe for me to undergo fertility treatments even though I have a hormone-receptor positive cancer. Just to be extra-safe, since we’re literally talking about matters of life and death here, it’s still important that I talk to my oncologists about the risks and benefits of fertility preservation treatments, which in my case will be oocyte cryopreservation – or, more simply, egg freezing.
Egg freezing is just the first half of in vitro fertilization. It’s the egg harvesting without the whole resulting pregnancy part. Essentially, if I decide to go through with it, I’m going to be an egg donor for myself. The process begins on the first day of my next menstrual cycle (and when that will arrive is anyone’s guess, since anesthesia, stress and a cocktail of eight different painkillers, anti-anxiety meds, nausea drugs and antibiotics can totally screw with menses), and involves 10 days of self-administered hormone injections using a small needle similar to an EpiPen or an insulin shot. The shots will probably send me into Super-PMS, involving plenty of bloating, complaining and more crying than usual, but they’ll stimulate my ovaries to produce 10-20 mature eggs, which are then harvested in an outpatient surgery where I’m knocked out for 15 minutes, a needle is inserted into my vagina (awesome!) and the eggs are suctioned out one by one, dehydrated and frozen. Later, when I’m ready to become pregnant, the eggs are inseminated in a lab and implanted into my uterus. The success rate for each implantation is about 60 percent, and I’ll hopefully produce enough eggs for 2-3 implantations. I’ll take those odds.
The whole deal is insanely expensive and costs an arm and an egg (see what I did there?), but there are some really cool programs available that can provide lots of funding for young cancer patients like me who barely have the financial resources to support a daily Starbucks habit, let alone the insane burden of quarter-million-dollar surgeries and $10,000 egg harvesting procedures. Did you know that each chemo infusion involves a drug cocktail costing about $20,000 before insurance? Yeah, cancer ain’t cheap.
So, after going over what I can expect if I choose to freeze my eggs, the doctor finished up by saying that he’d like to perform an ultrasound to check out my equipment and make sure that everything is in working order. Having been through a million needle sticks, biopsies and scans, I was thrilled that he suggested something so easy and simple so I leapt at the opportunity. “Oh, by the way,” he clarified, after I’d enthusiastically agreed, “it’s a vaginal ultrasound.”
Fortunately, the vaginal ultrasound wasn’t too bad. It was actually less uncomfortable than a regular gynecological exam and only lasted a few minutes. It was cool to see my uterus and ovaries, since before this I didn’t have any actual, visual assurance that they were in there. Gordie was, understandably, a bit uncomfortable throughout the whole ordeal, but it was over in a flash and I learned that I’m currently quite fertile and I don’t, like I’d irrationally feared, have ovarian cancer in addition to the mammary variety. The doctor even said that if I didn’t have the whole uncontrollable cell division thing going on, I’d be an ideal egg donor!
I am so thankful to live in a time when there are so many ways to start a family, like adoption, but carrying and giving birth to a child has always been something I’ve been looking forward to, as weird as that sounds. The best news I heard in the doctor’s office yesterday was that even if chemotherapy blasts all of my eggs into oblivion and sends my ovaries into premature failure, my ability to carry a pregnancy to term using donated eggs won’t be compromised. Facing the loss of so much of what made me feel feminine and beautiful and womanly – my long hair, my breasts – it was an amazing relief to hear that I’ll still be able to experience the miracle of childbirth, with all of its nausea, weight gain, bleeding and screaming. I’m not sure what I’ll choose when I decide to start a family, but it’s good to know my options are open.