When my husband, Jim, and I were married in 2007, we knew immediately that we wanted to have children. A little over a year into our marriage, we found out we were pregnant. We did not have any trouble conceiving and I had an easy pregnancy. Our first son, Liam, was born in August 2009. Only a few months after Liam was born, we began to talk about having another child. We were ready to add to our growing family!
An Unexpected Diagnosis
On a Sunday morning in February 2010, I found a lump in my breast during a routine self-exam in the shower. Six weeks later, at the age of 34, I was diagnosed with invasive ductal carcinoma, or breast cancer. At the time of my diagnosis, my husband and I were already planning to have another baby. When my surgeon gave me the diagnosis, one of the first things I said to him was "but I want to have another baby, I can't have cancer." I was truly devastated – not only by the diagnosis, but also by the unexpected change of course my life was taking.
The type of cancer I had was estrogen receptor positive invasive ductal carcinoma and since it presented as highly aggressive, my medical oncologist recommended chemotherapy, radiation and endocrine therapy. During our first meeting with her, she told me that the chemotherapy drugs could stop my periods, put me into menopause, and cause premature ovarian failure. Before starting treatment, I contacted Shady Grove to find out about fertility preservation options.
We were concerned about the cost of fertility preservation- even with insurance, cancer treatment is costly. We needed to find out if embryo preservation was even a financial option for us. During our consultation with Dr. Saffan, we learned more about insurance coverage and the Fertile Hope organization. Because of my cancer diagnosis, our insurance covered 50% of the treatment and Fertile Hope helped us with the cost of drugs. Our total cost for one round of embryo preservation was roughly $5,000.
Overcoming Cancer and Starting Again
Because I was part of a clinical trial, I could only go through one round of egg harvesting. My oncologist worked closely with Shady Grove Fertility staff to ensure that my hormone levels did not go too high because my cancer was fueled by estrogen. After one round, we were able to preserve 10 embryos.
After six rounds of chemotherapy, my bloodwork showed that my hormone levels were post-menopausal. After another 2 years of taking Tamoxifen to prevent recurrence, my levels continued to show that I was post-menopausal. In January 2013, I celebrated my second anniversary as a breast cancer survivor. At that time, with the permission of my medical oncologist, I decided to take a break from Tamoxifento see if I could get pregnant on my own.
In March 2013, my hormone levels were tested again. Blood work and ultrasounds confirmed that I was not ovulating and had a low ovarian reserve. I was in permanent menopause. I was devastated and felt my body had failed me again. My only option was to use the frozen embryos we created in 2010 to achieve pregnancy. My oncologist was worried that my estrogen levels could trigger a recurrence. Dr. Saffan and my medical oncologist worked together again, this time to find the right medication and balance to achieve a pregnancy through a frozen embryo transfer.
Trying for Baby # 2
Knowing that the chemotherapy drugs used to save my life had made me infertile was heartbreaking. At 37 years old, I felt like I was in the body of a 60-year-old woman. Not only was I infertile, but I also had osteoporosis and a host of other issues associated with menopause. I had to put all my hope in those 10 embryos! It was an emotional roller coaster every time I went into the Annandale office for an ultrasound and bloodwork. I honestly felt like going through fertility treatment was harder emotionally than cancer treatment. I felt like my body was constantly failing me.
In April 2013, I started an estrogen and progesterone protocol for the frozen embryo transfer. After two weeks of estrogen, the ultrasound showed that my lining was good and my levels were in check. The thaw began on April 23rd and at first, the embryos looked like they were doing well. But by day 3, several had stopped growing and the two that remained were questionable. I was devastated and afraid that we wouldn't have any quality embryos to transfer.
On day 5, we transferred two embryos. The transfer was one of the most emotional days of my life. I cried when I saw the two embryos on the screen right before the transfer. I was told the next day that the remaining embryos were not good enough to refreeze so that was it. All our hopes were riding on those two embryos. On day 10 after the transfer, I had some telltale pregnancy symptoms - my sense of smell was heightened and I felt nauseated every time I smelled food. I took a home pregnancy test on day 11 and it was positive. It was confirmed through bloodwork 3 days later that I was pregnant!
On January 6, 2014 I gave birth to our second son, Gavin. Our family is now complete. I also celebrated four years of living cancer-free. Infertility is probably the hardest medical issue to cope with. It is even harder when you know that the treatments used to save your life had a devastating effect on another aspect of your life. It's a feeling that your body has failed you. For me, exercise was key to getting through those dark days. I used to look at the “Endurance” sign in the gym and think “I will make it!” every time we faced a disappointment in our fertility journey. Whenever I look at my son, I feel like we were given a miracle.
An important aspect of survivorship for me is to give back to the community that got me through my cancer treatment. The Young Survival Coalition (YSC) played a huge part in my emotional recovery after treatment. In 2011, 10 months after finishing treatment, I rode 200 miles over three days in my first YSC Tour de Pink. My team, named the Pink Outliers, raised over $10,000 for YSC. We rode in the Tour de Pink again in 2012, raising even more funds for the organization. In 2013, I was unable to ride in the Tour de Pink because I was pregnant with Gavin. Instead of participating in the ride, I became a SurvivorLink volunteer for YSC to help women with emotional support during and after treatment.
As a SurvivorLink volunteer, I am paired with young women who have similar diagnoses or treatment plans to provide them with emotional support through their breast cancer journey. Knowing that I am able to support a young woman facing a breast cancer diagnosis also helps me to emotionally deal with the ups and down of long-term survivorship. I feel like all of this happened to me for a reason and that reason is to advocate, support, and push for more research that will help eradicate this disease. Giving back to YSC helps me turn a negative into something positive.
Recently, I got accepted into the National Breast Cancer Coalition (NBCC) project lead training program for breast cancer advocacy. While I haven't started this new chapter in my journey yet, I am very excited to work with this amazing organization on their 2020 deadline to end breast cancer.