There are options to preserve your fertility after a cancer diagnosis. Anna Crollman shares her experience with embryo freezing and IVF during and after cancer treatment.

I was 27 years old, newly married, and ready to start a family when I was diagnosed with breast cancer. My husband and I thought we had the rest of our lives ahead. The farthest thing from our minds was sickness.

Cancer just wasn’t in the plan. It wasn’t the happy next step we expected to take in our relationship. We were heartbroken.

I’d been focused on becoming a mother for as long as I could remember. My husband and I both wanted kids. We felt we were “ready” for that next stage after dating for four years and being married for one.

Cancer changed everything in the blink of an eye. We were forced to readjust our plans.

Instead of preparing for a baby, we mapped out my treatment plan.

Fertility was the number one thing on my mind when meeting with my cancer team. I knew that treatment may impact my fertility. Yet, there are options, and most cancer survivors can have kids.

Though it wouldn’t happen as we’d planned, I took every step possible to optimize my chances of having a family.

Deciding whether to freeze eggs or embryos

The first step was exploring fertility preservation options. These procedures had to be done before chemotherapy, so we urgently needed to educate ourselves and make a decision.

We first talked to my oncologist and a fertility specialist. Then my husband and I underwent testing to determine our baseline fertility. We learned that we had the option to freeze eggs or freeze embryos.

Our doctors told us that egg freezing and embryo freezing take approximately the same length of time. Both involve many of the same procedures, impacting your body with drugs, hormones, and outpatient surgery. However, with embryo freezing, my husband's sperm would fertilize the eggs before they were frozen.

As we learned, frozen embryos may survive better than frozen eggs. We were already in a committed long-term relationship and decided that was our best path.

Keep in mind that different cancer treatments impact fertility differently. Every person’s decision depends on their chemotherapy regime, diagnosis, finances, and whether a long-term partner is in the picture.

The decision to freeze our embryos was emotionally, physically, and financially difficult.

I felt fortunate to be informed and supported by my medical team, family, and partner during this process.

The embryo freezing process

The embryo freezing process requires several steps:

1. Hormone treatments

First came a variety of hormone shots and pills to help my body grow as many egg-containing follicles as possible in one cycle.

It’s impossible to know how many mature eggs you’ll produce. I visited the doctor frequently to monitor the follicles and how many eggs might be harvested.

This was the most grueling part for me. I saw every follicle as a potential child. I worried that the stress from the procedure and cancer would impact my results. I was ultimately able to produce around 12 follicles.

2. Egg harvesting

I received a trigger shot to release the eggs when the timing was right. This usually happens about 10 to 14 days after starting hormones.

I then had an outpatient procedure where the doctors retrieved my eggs. The doctor inserts an ultrasound probe and a needle into the vagina to find the follicles and remove the eggs. The procedure can cause cramping and a few weeks of pelvic pressure or fullness.

3. Fertilization and freezing

If you choose to preserve eggs rather than embryos, the fertility team freezes the eggs they retrieve.

If you choose embryo preservation, healthy-looking eggs are fertilized with sperm. The embryos are sometimes “hatched” and tested for genetic abnormalities. The viable ones are frozen.

Not all eggs can be successfully fertilized. Doctors were only able to fertilize six of our 12 eggs. Only three successfully grew to the necessary stage and quality for freezing.

How to get through the fertility preservation process

Infertility treatments can be psychologically harsh. In fact, they are widely understood to be one of the most stressful events of a person’s life. The medications used in IVF procedures can cause mood swings. I was disappointed at the number of embryos that survived.

During treatment, I was also put on drugs that temporarily suppressed my ovaries to preserve and prolong my fertility. Cue the hot flashes, painful sex, and mood swings. But I was willing to try anything for preserved ovarian function.

Hope and passion for starting a family got me through the fertility preservation process, cancer treatment, and three years of hormone-blocking therapy.

My tips:

• Look toward the future. I always believed that I would be a parent someday.
   
• Grieve the “easy” route to parenthood. I envisioned a completely different path for having kids before my diagnosis. I had to keep telling myself that motherhood comes in all forms.
   
• Refocus on cancer care. The crucial first step was getting through treatments. I kept in mind that I could revisit my desire to become a mother when I was done.
   
• Find other things that fulfill you. Giving back to the breast cancer community and sharing my experience via blogging brought me a great sense of purpose and fulfillment. Creating art, mentoring others in my community, and blogging about my experiences helped me redefine myself beyond motherhood.

Trying naturally for a baby

Hope carried us forward when my oncologist finally agreed for us to try for a family. My doctor suggested we try naturally for a few months after my cancer treatments were complete. I was lucky that my cycle and fertility naturally returned.

My period resumed three months after I stopped taking hormone-blocking drugs. I sat in the bathroom at work crying. I’d never been so grateful for a period in my life. It represented so much hope for my future as a mother.

I’ll never know whether the return in my cycle was attributed to the ovary-suppressing drugs I took or my body just bouncing back. I don’t care.

I was pregnant naturally three months later. I devastatingly lost the baby in an emergency ectopic pregnancy. One of my fallopian tubes also had to be removed.

We never gave up despite the grief, pain, and loss. We tried naturally for three more months. Then we decided to attempt an embryo transfer.

The embryo transfer process was quite similar to fertility preservation. We went through shots, drugs, and weekly checks to ensure my body was optimally prepared to accept the embryo.

Following the embryo transfer, the nine-day wait was the hardest part of the process for me! I tried to distract myself with self-care, pampering, and lots of time with friends and family. I made sure they knew NOT to ask about the results.

Our embryo transfer was a success. Our sweet baby became a living being.

It seemed things were finally looking up after everything we had been through. Our baby was growing each week. I finally relaxed after being on high alert and bracing for pain.

We heard the dreaded words “there is no heartbeat” at the seven-week appointment. Our world came crashing down again.

We had almost two months to become attached to this little one this time. I didn’t know how I would carry on. The hope I had carried for years was dwindling.

Don’t give up

Little by little, I learned to live again. Blogging about my miscarriage story opened doors to a new community of support. Along with my cancer tribe, these people helped me find the strength to get up each morning, go to work, and believe that someday I would still be a mum after all the pain.

In November 2019, I gave birth to my sweet baby boy. He was conceived spontaneously three months after my miscarriage.

I know that all I went through led me to this point. I am stronger because of what I endured.

I never like to say that things happen for a reason. It’s all about what you make of the hurdles and pain you face.

You never know what the future will hold. If you want to be a parent, there are many ways to get there. Even if the path is long and twisted.

Never give up hope. Your season of joy is waiting around the corner!

The information presented is solely for educational purposes, not as specific advice for the evaluation, management, or treatment of any condition.

The individual(s) who have written and created the content in and whose images appear in this article have been paid by Teva Pharmaceuticals for their contributions. This content represents the opinions of the contributor and does not necessarily reflect those of Teva Pharmaceuticals. Similarly, Teva Pharmaceuticals does not review, control, influence or endorse any content related to the contributor's websites or social media networks. This content is intended for informational and educational purposes and should not be considered medical advice or recommendations. Consult a qualified medical professional for diagnosis and before beginning or changing any treatment regimen. 

NPS-ALL-NP-00782 JANUARY 2023