The Mom Who Wasn’t Sure How Cancer Would Affect Her Fertility

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K was 26, newly engaged, and figuring out her next career move, when she started having severe headaches. She was in and out of doctors for about a month before one decided to do a blood test, the results of which led very quickly to a diagnosis: leukemia. For K and her fiancé, questions that once seemed far in the future suddenly became very real. She discusses reckoning with her fertility, undergoing fertility preservation, the difference between being in the hospital as a cancer patient and a woman giving birth, and what she’ll tell her son about cancer someday.

A life-altering diagnosis in her mid-20s. The idea of becoming a parent didn’t really become real to me until I was diagnosed. The diagnosis came about in kind of a traumatic way — I’d been in and out of doctors for a month, with severe headaches. One doctor thought I looked kind of pale and did a blood test; they called me the next day and told me to go to the ER immediately. I was diagnosed with leukemia very quickly.

One of my first questions was whether it would affect my fertility. I’d just gotten engaged and wanted to know how it might change that part of our lives. For us, kids always seemed very theoretical — we’d been together since our early 20s and had never had to take that question seriously before. Once we were faced with the reality that it might be more of a challenge, it became a lot more real.

On taking steps with a future family in mind. After I was diagnosed, I was in the hospital for about a month. For leukemia, the goal is to blast it out of the body very quickly. One of the first things that a leukemia doctor does to gauge your prognosis is to test the genetic profile of your disease and look for markers that mean it’s more or less likely to be responsive to treatment. The kind of leukemia I had meant a 20 to 30 percent chance of five-year survival.

Once that month of treatment was done, I had a little bit of time to recover. But I had to make a decision: Do four rounds of less-intense chemotherapy, or do a bone-marrow transplant. We saw two different doctors who had completely different opinions. One thought I should definitely have a transplant, the other thought I didn’t need to. Bone-marrow transplants can be incredibly taxing and have a fatality rate of their own; on top of this, they usually mean that you won’t be able to have children. In the end, I decided to opt for the four rounds of chemotherapy.

It was during the break between treatments that I did fertility preservation, just in case I did relapse and had to be thrown into the hospital for a bone-marrow transplant. Because I wasn’t married and had no income at that point, I was able to get some funding, which covered most of the process. You do essentially the first part of IVF: All the shots, the extraction, fertilizing. We have six embryos on ice, waiting, to be used at some point, if we want them.

Compared to chemotherapy, the fertility preservation process felt like no big deal. The needles and appointments didn’t bother me, the way I know they bother some other women.

Once we did that, we sort of thought, Okay, that’s done. We don’t need to worry about this for a while. That was partly because we just weren’t ready to become parents, and partly because I wanted to wait until the five-year mark. It’s a little bit of an arbitrary number, but with leukemia, it’s very rare for people to relapse after five years. The longer you’re out, the less likely you are to relapse. I wanted to wait until those five years passed until we even started thinking about it.

On discovering a treatment may have affected her fertility. After the less-intense chemotherapy, I was put in a clinical trial that my doctor was part of, with a bunch of other doctors. It was pretty easy — shots that decreased in frequency over the course of about a year. I’d have shots of this very thick goo, which introduced a protein that spikes before a leukemia relapse — the idea was that your body would learn to recognize the protein and fight it off before a relapse. It was for people like me, who’d decided not to have a bone marrow transplant, or for people who weren’t eligible for one. At that point, I think I was one of 15 people who completed the trial. Some people passed away, others relapsed.

Then, I put the idea of kids out of my mind for a while. We were settling back into life; I was getting used to a new job. Right around the time our friends started having kids, I started to worry, just a little bit. So I went to the doctor to have my fertility tested, and found out about my ovarian function — I was 30, and they said mine was like a 33-year-old’s. I was pretty reassured by that, but not completely. At that point, I started seeing a therapist, which I hadn’t done during my treatment. The anxiety of not knowing whether I’d be able to have kids was just really getting to me.

In the context of my disease, I could roll with the punches and not worry. But I couldn’t do that with this. It sounds horrible, but I had thoughts, when it seemed like it might not work, like, Well, I won’t be around to deal with it. I’ll be dead, and I won’t care. This, though, was something I’d be living and dealing with. It seemed more daunting, in its own way.

When I brought up the possibility of kids to my oncologist, his reaction surprised me: His tone really changed, and he said this was something we really needed to consider. He explained that they didn’t know what kind of effect the clinical trial might have on fetal development. The protein they gave me was also involved in embryo development, so they didn’t know how that might affect getting pregnant or carrying a pregnancy. It didn’t sound like there was someone they could point to as someone who’d had a child after undergoing this kind of treatment.

On gingerly enjoying a healthy pregnancy. My oncologist said that I should be seen by a high-risk doctor, and my friend had had a high-risk pregnancy and a doctor that she loved. Within a month of meeting that doctor, I was pregnant. It was a complete surprise.

I went to the high-risk practice the whole time. I was under more maintenance and surveillance than most people my age would be. But everything, after all that, turned out to be fairly routine: I didn’t have high blood pressure, the development was normal. Still, my husband and I went back into disease mode: We took every day one at a time, never looking too far into the future.

Judging by some of the reading I did about pregnancy, I think my cancer experience made me trust my doctors more than some people seem to. I had no interest in something like a natural birth. I was familiar with statistics and risks and hearing numbers because of my disease. I wasn’t afraid of hospitals, I didn’t want to sweat the small stuff. To me, getting to the finish line was the most important part.

On being shocked at how she was treated while giving birth. It was sort of a shitshow. At the very end of my pregnancy, I started losing fluid. It was very close to the due date, just about five days before, so they decided to induce me. I went into the hospital thinking, Everything will be fine. They know how to take care of people here. But that’s not how it was at all.

You hear horror stories about how women are treated, and you think it’s the exception, and maybe it is — but I had a lot of those experiences. We waited for seven hours in a waiting room, watching the Paris attacks on the news. I didn’t make it into a permanent bed until midnight.

The induction didn’t go very well, which isn’t that unusual for low fluid. But no one at the hospital was very helpful — I asked for a heating pad, they said no. I asked for another pillow. No. It seemed to be clear that the baby wasn’t going to come naturally. We started talking about a C-section, which was fine with me.

But then they left me for a few hours, and all of a sudden, I was having an emergency C-section. It was stressful — my epidural was wearing off, I was starting to be able to feel, and they really had to scramble. The baby was fine, right from the start; he peed all over the table. My husband was left alone with the baby for quite a while while they tried to get me into a room.

Friends that I shared the experience with told me that it definitely did not seem normal, that some of what happened was completely unacceptable. They actually sent someone, a higher-up hospital administrator, to talk to us about what had happened. You’d think, as a cancer patient, that going through chemotherapy would be the worst possible hospital experience. But when I was in treatment, it was so much better than giving birth! People were invested in my welfare, in helping me to get comfortable. It’s just strange, since giving birth is a lot more common than having cancer.

On early parenthood. When I was going through treatment, I had people around to help me. My husband didn’t have any leave, really, and has a really demanding job with long hours — so after my parents went home I was alone with the baby all day, relatively quickly. It took a couple months before we really settled into our new routine, but we did. Becoming parents made us sort of no different from anyone else, in a way. It was weird, but refreshing.

Having cancer definitely made me realize how temporary everything is, that each step gets you somewhere else. Parenting feels similar to me: They’re little for such a short time. Every phase feels so slow while you’re going through it, but then you realize — he’s almost 2. We’re done with the tiny-baby phase, the early-toddler phase. I don’t worry very much, when it comes to my son, which is not what I would have expected of myself as a parent, if you’d asked me ten years ago.

On the future with her family. My husband and I continue to ask ourselves what we’ll tell our son about my cancer. I think it will be somewhat similar to kids who are adopted — this is something kids know, learning a little bit more as they get older, explaining how they came to be. I certainly don’t want to hide this from him, but I don’t think it will come up in everyday conversation. We hope it sparks an interest in science for him — it’s just the truth that if I hadn’t had that treatment he wouldn’t be here and I’d be dead.

We’re still getting used to having one kid, but we do think about having more. The first pregnancy was fairly easy, so I’m not dreading that part. I’m still enjoying this one, though. I think we will have another, if we can.

The Mom Unsure How Cancer Would Affect Her Fertility