infertility

Hello

I was diagonosed with BC a month ago whilst i was pregnant. unfortunately because the cancer was hormone sensitive, it was recommended to terminate.

After much soul searching, i went ahead with it - a decision i am constantly questioning. But i am blessed with a 2 year old boy and a wonderful husband and had to give myself the best chance.

I am having my second lumpectomy next week before chemo in September. I’m terrified firstly that the chemo will make me infertile and secondly if it doesn’t if i fall pregnant again the cancer will return.

I’ve tried talking to my cancer care nurse about it and was given a leaflet on fertility but it doesn’t seem to answer my questions, just to speak to my oncoloist.

I’m looking for experiences and answers, i know no one can tell me for definately but i’d like some odds to play. I’m told because of the hormone sensitive part IVF and egg harvesting are not really options … has anyone gone ahead with it with hormone sensitive BC.

Are there things i should be asking my oncologist before the chemo starts - believe me this will be a major subject. But anything anyone can offer me is gratefully received.

But truth be told i really need hope xxx

I am so sorry I can’t help with this - but bumping you up in case someone else can.

finty xx

lots of women with hormone sensitive tumours do go on to have children.

for some people having the opportunity to have children or another child is more important that the risk of cancer but only really you can decide that.

the older you the more likely chemo would put you into the menopause and that can mean anything over the age of 35… the nearer the menopause the more likely… however we dont know whether you would go into a natural menopause at 45 or 55.

you can ask to have embryos stored before starting chemo… depending on your age and existing children you may have to pay for this yourself… it is an option if you want it to be… these things varies up and down the country and what one consultant says is a definite no another may say its inconclusive… if they are giving you definites you can ask them for the relevant research to back this up… some of them just ‘think’ things are for the best despite evidence to the contrary.

here are some research articles which relate to IVF and breast cancer i havent read them and they are just abstracts but i can probably get full text articles through myathens if you want them…

(by the way FSH is follicle stimulating hormone… it stimulates the egg to mature)
humrep.oxfordjournals.org/cgi/content/abstract/18/1/90
jco.ascopubs.org/cgi/content/abstract/23/19/4347
jcem.endojournals.org/cgi/content/abstract/91/10/3885
jcojournal.org/cgi/content/abstract/26/16/2630
biomedcentral.com/content/pdf/bcr1991.pdf

Lx

Hi Sniffer

I don’t know how old you are, but I was told the same as Lulu says, that the nearer you are to the menopause, the more likelihood the chemotherapy will make you infertile for good. But you can take Zoladex, a drug to shut down and protect your ovaries while you have chemotherapy. It doesn’t always work, but sounds worth a go.

I didn’t have any children when I was diagnosed with BC 5.5yrs ago. I was desperate for a family, which is mostly why I decided against further treatments and - with the agreement of my partner - to have the surgery, wait a couple of years to get past the highest risk time, then try for children. I have to say it was a very early cancer, only 7mm, no sign of it in the nodes.

That’s what we did, rode the risk… and paid for it. We now have a daughter, 26 months, and another on the way, alongside a recurrence in the nodes. It isn’t easy to live with and I feel horribly guilty, especially having chemotherapy while carrying a baby. Maybe if I could turn back the clock I’d have stopped after one child. But we didn’t, I particularly wanted to give her a sibling, and it is amazing how you learn to live with a situation.

There was no sign of recurrence after my first pregnancy - I had scans when our daughter was 14 months. And my cancer scored 7/8 on the ER+ front, so pretty sensitive.

Please don’t be put off by my history, there are many many women who go on to have children after cancer without a recurrence. And remember I had no adjuvant treatment. If I’d had axillary clearance and radiotherapy, perhaps I wouldn’t now have a recurrence. The benefits of chemotherapy were so small for me first time round - much less than 1%, so it might be worth discussing with your onc. I don’t know your pathology.

Very good luck, and I hope you find a way forward to having the family you want. xxxxx Jane

Hi Sniffer

As well as the support you are receiving from the other forum users you may find it useful to read the information booklet on fertility issues. If you would like a copy or to read it on line just follow this link:-

breastcancercare.org.uk/upload/pdf/BCC28_fertility_issues_09_web_pdf.pdf

If you would like to talk things through please give the BCC helpline a call on 0808 800 60000. Here you can discuss your concerns with a trained member of staff who will offer you a listening ear as well as support information. The lines are open Monday to Friday 9 to 5pm and Saturday 9 to 2pm.

I hope this is helpful.

Best wishes Sam, BCC facilitator

Fertility is an issue with me too and I raised the question of an egg-donation pregnancy with my oncologist. She wasn’t wild about the idea but didn’t rule it out as a possiblity. In such cases, the medical team would look at a woman who had a similar diagnosis (or several women) and track her record in terms of recurrence. I believe that in Spain embryo donation involves much less hormone treatment.

Although I didn’t have chemo therapy I had Zoladex and Tamoxifen for two years and am now on just Tamoxifen. Both drugs - and there’s an irony in this I think - are also used to treat infertility.

Hi Sniffer, just thought I’d share what I was told. I am pre-meno and do not yet have a family - and do want one, my cancer is ER+ - I was told by onc that freezing embryos or zoladex wasn’t a safe option as both contain large dose of hormones that would feed my cancer. After much soul searching and many late night chats with my other half, we decided that my health was ultimatly more important - we will tackle fertility once I am recovered and healthy again - and if its not to be, then there are more options out there in terms of having a family.

Having said this - everyone is different with their own priorities. Its such an awful situation to be in for us all - hugs, Carly x

Hello all,

First of all Sniffer, so sorry to hear you had to have a termination … as if the bc itself isn’t enough to cope with.

My story, as it’s relevant for you and gives a different perspective: I was first diagnosed in 2003, aged 37. Been married just a year, no kids. In fact we were just starting to talk about trying for a family, given my age, when I was diagnosed. It was an aggressive cancer, so there was no time to consider fertility issues before chemo started, although we did see a fertility specialist who, in view of the timescale, told us there was nothing much she could do. So I went ahead with chemo and radiotherapy, finishing in March 2004. I was then told we could go ahead and try for a family. I went back to the fertility specialist who monitored my FSH levels, which were low (?), but still basically said that, for various reasons, there was nothing much she could do and that my chances of conceiving naturally were about the same odds as fertility treatment being successful. So she wished us luck …

Wonderfully I got pregnant a year later, but miscarried within 6 weeks. Another year went by and I got pregnant again, and my daughter was born in December 2006. She was hard work, not a good sleeper and I breastfed her for 18 months. In October 2007 I went back to work full time and immediately began to feel unwell, lots of chest infections, fevers, even got pneumonia, more chest infections well into late spring of following year, and in Jan 2008 I started to get bad pains in left leg, sometimes in hip, sometimes in knee or ankle. Anyway, to cut a long story short, I was finally diagnosed in May 2008 with bone secondaries, so am now a mother of a three and a half year old, with incurable cancer.

I have thought about it all a lot, of course I wonder if the pregnancy fuelled the cancer, but despite everything I wouldn’t change the fact that I have given my daughter life. There are things we have had to contend with as a family, like a second round of chemo, my fatigue and pain, and last summer I had to have a hip replacement operation, and of course I feel terribly guilty at having brought this on my husband and daughter (even though I know in my head it’s not due to anything I have or haven’t done). And I am immensely sad that I won’t be around for her growing up and adulthood. I am now two years post secondary diagnosis, the treatment is keeping me stable and I have every reason to be hopeful. There are some women on here with bone secondaries who have survived for many years, but I know that the statistics give me another two to four years. Very difficult to live with.

My daughter had not had a ‘normal’ childhood, she will not have any siblings (not unless/until my husband remarries at least), but she is very loved by us both and I hope we will be able to give her the emotional resources to survive my death. She is very bright, physically robust, and although I find it exhausting looking after her (I don’t even do that every day as she goes to nursery some days) I think she is the best incentive I could wish for to keep going.

Anyway, that’s my story. No advice, just my own experience. Yes I got pregnant after chemo, but it hasn’t been a completely happy ending. I dread what will happen when my current treatment fails and I have to have more chemo, as I know that this will impact big time on my family.

Best of luck to you in what we all know is a terrible situation to be in.

Alison x

Alison, I was so sorry to read your post. It is the fear I have of trying to conceive in the future, after I’ve got through this period of treatment.

I start my chemo on 16th August and over the next couple of weeks am undergoing egg collection to enable us to freeze some embryos. My cancer is triple negative and so the hormones wouldn’t necessary be an issue in my case. I am wondering why I am putting myself through this though as I’m not sure I am brave enough to take the risk later on. However, we will hopefully have a choice and will decide then.

There are so many decisions to make,and none of them are easy ones. You have to make the decision that is right at the time I think.

Sending much love to everyone having to make difficult decisions at this time.

xxx

Hi Sniffer
I am really sorry for the situation you are in. It is a really difficult balancing act to accept you have cancer and all that entails, and try to live the life you want for yourself. I think it was Maya Angelou who said “cancer may change me but it will not reduce me”
Anyway to my point. I know all onc’s are different but I am 38 and I was worried about being shunted into early menopause by chemo. (I already have children) but I know the side effects on my bones and hot flushes etc. She said in normal circumstances they would suggest HRT . But even though my cancer is NOT hormone responsive they would never suggest that I do anything to increase my hormone levels at all. In her opinion I am more likely to get another cancer. Other onc’s may disagree. Debx