Fertility Preservation
Cancer comes with all sorts of surprising little facets you could never have imagined as an outsider. For example, last week, the dentist turned me away from my scheduled cleaning because she didn’t have authorization for my appointment from my oncologist. Delightful.
A much bigger surprise to me was the need for fertility preservation. I hadn’t even considered this aspect going into my first few appointments, but I’m very grateful a few different doctors brought it up.
When undergoing chemo and radiation, the effects on your reproductive organs can be disastrous. And since no one knows exactly how the treatments will affect you, preserving fertility is a vital step. Around 80% of cancer patients will have their fertility affected by treatment, but far from that many are able to do any sort of preservation.
Another surprise was learning insurance companies in most states cover $0 of these procedures. I was heartbroken upon learning this, because coming up with the $15K fee almost overnight seemed impossible. I was so humbled and honored when Livestrong called me the very next day to tell me I’d been submitted to their fertility preservation program, wherein they’d donate the drugs I’d need (around a $5k cost), plus that the doctor who’d submitted the request would be donating her services to me.
The kindness of this organization and the doctor made such an immense impact on my life, and I will never ever forget it.
The first step was a doctor’s visit where I met the delightful Dr. Natalie Burger and talked about the options. They told me because of my age and health (other than the obvious), they felt I was a great candidate and could expect around 15 eggs. When people who need eggs buy them for IVF, they typically purchase around 8, which meant in very vague and uncertain terms that I could, in theory, get two lil eggy kids out of this ordeal.
She performed an ultrasound of my ovaries and saw lots of little “chocolate chips,” which is how they refer to eggs. Kinda similar looking? I guess? Anyway, it was promising and she felt I would do well.
That night, I gave myself my first injection, Gonal F. This is one of the two “LH” hormone drugs, which tricks my body into thinking it’s time to mature the eggs. For the first few days, it was simply one shot a day, at the same time every night. I was SO freaked out to have to give myself the first one. Once I’d done it, I was surprised how minimally it hurt. The Gonal-F pen has to be refrigerated (which caused a SLIGHT problem during a big friend trip to Galveston, thanks for saving my life, Carol! :)) Each time I gave myself an injection, I had to disinfect the area, and connect a new needle, so I have quite the sharps container still sitting on top of my fridge. I did this each night for 11 nights.
The big guns (with small needles)
I had to go back in for ultrasounds every few days to see how my chocolate chips were progressing. By day 4, Dr. Burger saw a lot of progress and moved me on to the next phase, where I had to do two shots a day. The new shot involved some mixing, so I felt like an evil experimental chemist trying to give myself eternal life. This was another LH drug called Cetritide. It was vital I took this at the exact same time twice a day to ensure plenty of eggs were available, so the stakes were high.
With Cetrotide, you shoot the liquid in the syringe into the bottle of powder, mix, pull it back in, attach a new needle, and inject.
A very boring video of me injecting Cetritide — on vacation of course!
During my third ultrasound. Dr. Burger measured each developing follicle (where each egg lives and matures) and counted them out. It was so incredible and weird to hear my potential future children read off by their development phase. Ideally, they’d like eggs to be in the 18-20 mm phase before retrieval, so the more they can get to that phase, the better the result.
19 eggies, sittin in a tree.
At this phase, I was thrilled to see 14 developing eggs. With retrieval surgery just a few days away, I figured they’d all develop nicely and I’d pretty much hit the target.
When surgery day came, I was nervous as hell. So much of my future and potential family depended on this. The procedure was early on a Saturday morning, so even being in a medical office during that time was odd. I signed about 80 papers and laid down in my very stylish garb.
The night before surgery, I had to take the “trigger shot” which is a different hormone, HCG, which lets my ovaries know it’s time to let go. This shot was no big deal to take, but did stress me out as it had to be EXACTLY timed right or retrieval wouldn’t work. Luckily, it was a success!
How I really feel about all of this.
Then, they wheeled me back and made me get up and walk to the operating table. I guess this means when they were done, they had to carry me back to the wheely bed, which must have been quite a task.
I don’t remember anything past that, but I woke up in the recovery room with Rowan and my mom and was confused how they’d possibly done the procedure in like 3 seconds. But apparently it was more like 15 minutes.
The nurse who’d been in the surgery came in next, and told me they’d retrieved 51 eggs! I was so beyond thrilled to hear this. Not all the eggs they retrieve survive the freezing process, but still I knew I’d be covered for all the kids I could want. Later that day, they called to let me know that 39 eggs had been frozen. I was so thrilled to finally get some good news during this process, and it makes me happy to picture my little frozen futures just sitting somewhere cold, but safe. Maybe this means they’ll be more immune to the cold than me?!
The few days after my surgery, I had a belly that TRULY looked pregnant, thanks to the surgery and the common side effect in younger women, Ovarian Hypersimulation Syndrome. This name is pretty indicative of what it is. When your ovaries go into over drive, they get big, fat and swollen. It’s relatively harmless and usually goes away after about 5 days, like mine did.
Reflections
Going into it, I DREADED this process. At first, I flat out refused it. I have heard such scary things about what this process can do to your body – the pain, the swelling, the mood swings, etc. But truthfully, I felt pretty close to zero side effects during the stimulation phase, and the swelling after surgery was miserable but manageable.
Given the fact that I’m really not sure what the future has for me, child-bearing-wise, this was actually an incredibly cathartic and heartening experience. I am SO happy to think about the fact that a bunch of my healthy, 28-year-old, farm-fresh eggs are sitting far away from all the chaos of this cancer nonsense.
For anyone considering fertility preservation for any reason, I would highly recommend avoiding the Googling as long as you can, and speaking directly to a doctor instead. It doesn’t have to be a negative experience, and the good of it all so far outweighs the bad!
