Written By Robin Warshaw, Contributing Writer
Reviewed By Andrea Mechanick Braverman, PhD
Ready to become pregnant at age 33, Ryann Chamberlain began taking prenatal vitamins. She and her husband figured they would “actively try” to have a baby about 3 months after Ryann started taking the vitamins.
Just before reaching that point, she noticed nipple discharge from her right breast.
“At the time, not knowing how prenatal vitamins work, I thought maybe my body was kicking into gear,” says Ryann, who lives in Portland, Maine, and works as a self-employed caterer and as a waitress in an Italian restaurant.
That nipple discharge led to a breast cancer diagnosis at a local hospital. Because Ryann found the diagnostic process there disorganized, her mother suggested she go to a larger cancer center in Boston, about 100 miles away.
Ryann’s new oncologist told her that before beginning breast cancer treatment she needed to consult with a fertility specialist about methods of fertility preservation that would protect her ability to become pregnant at a later date. Chemotherapy and other treatments can damage eggs and cause early menopause.
Her providers back home had not discussed anything about treatment-related infertility with her. “It was the first time it had dawned on me,” Ryann says.
Saving Fertility Before Treatment
If Ryann chose fertility preservation, her doctor would remove eggs from her body before breast cancer treatment, fertilize them with her husband’s sperm and freeze healthy embryos for use later. (Women without a male partner, or whose partner is infertile, may use donor sperm. Freezing unfertilized eggs is also now an option and becoming more available.)
Ryann needed to see a fertility specialist before her next menstrual cycle, and met with one 2 days later, but her period started on the drive home. It was a Friday, so the doctor phoned in a prescription for an injectable medicine to stop her period until Ryann could see her on Monday.
Ryann and her husband wanted time to think about whether they could afford the estimated $12,000 for one fertility preservation cycle,which their health insurance did not cover. With her period starting, they were suddenly under pressure to make a big decision quickly.
“We decided it was better to resent the cost of preserving the ability to have children than to resent not having children,” Ryann says.The big question was: How would they fund that decision?
Quick Help With Costs
The fertility specialist’s office told them about Fertile Hope, an initiative of LIVESTRONG. The group’s Sharing Hope Program for Women provides financial assistance with fertility preservation for women whose cancer treatments could cause infertility.
Fertile Hope arranged for a discounted fee, reducing the charges by $5,000. The couple paid the remainder, about $7,000, with credit cards.
Ryann was put on medicine to hyperstimulate her ovaries so several eggs could be extracted at once. After fertilization with her husband’s sperm, six viable embryos were then frozen.
“I call them ice babies,” says Ryann. “We joke that they’re already named Chase, Visa, Discover, AmEx, MC and Citi.”
Waiting for Treatment Break
In just a little over one month, Ryann went from diagnosis through fertility preservation to surgery for stage I, hormone-positive, HER2 positive breast cancer. She wants to breastfeed, so had a single mastectomy instead of the double she originally considered.
After surgery, treatment included trastuzumab (Herceptin), chemotherapy, leuprolide (Lupron) and a painkiller for joint and muscle pain. She felt “very manic,” had severe temperature changes and other side effects, some of which she thinks were due to the painkiller. She was taken off all medicines, supplements, and vitamins for one month and then went back on tamoxifen and a different pain medicine. Her side effects have since lessened.
Ryann’s doctor wants her on tamoxifen for at least 3 years before stopping to have a baby. Tamoxifen can damage a fetus, so treatment must stop a few months before becoming pregnant.
Now, 2 years after diagnosis, pregnancy is still on a back burner. “I don’t allow myself to think deeply about it,” she says. “It’s very hard when you finally decide you’re ready to have a family and then your world turns upside down and you might not be able to.”
She says it’s a “huge relief” to have the six frozen embryos holding hope for parenthood to come. “I think it would have weighed a lot heavier on my heart if we hadn’t gone through that process.”
But she has met several young women who were diagnosed with breast cancer and not told about fertility preservation before their treatments began.
“I just want to go yell at their doctors,” she says. “There needs to be a shift in patient care from just trying to eradicate the cancer itself to caring for the patient as a whole. Having cancer at any age poses its own challenges, but for young women, fertility issues need to be addressed. It has to become the standard.”
This article was supported by Cooperative Agreement Number DP11-1111 from The Centers for Disease Control and Prevention. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention.