Preserving My Fertility Following a Cancer Diagnosis
By Lisa Marzullo
I am, by nature, a planner. I am extremely type A, organized, a scheduler, and I leave little room for error in both my personal and professional life. So when my husband and I decided we were ready to start our family, I took all the necessary steps to prepare. I came off of the birth control pill and gave myself a few months for my body to sort itself out. I looked at the calendar and found the least busy time of the year for us to start trying without needing to worry about big life events. I had the Ovia app yelling at me via notifications on my most fertile days. We were ready!
Instead, on Christmas Eve 2018, I was diagnosed with stage 2 breast cancer. I mean, WHAT!? One of the first questions I had was “Could I also be pregnant right now?” Fortunately (and unfortunately), I was not. All that planning I had done went out the window. We now were faced with a daunting diagnosis and an uncertain future.
One of the first things that my oncologist discussed with us was my fertility. In my case, I needed to start chemotherapy right away before any surgeries. But chemotherapy puts your body into a medically induced menopause, which means no periods, no cycles, no eggs, and no babies. I was connected with an amazing fertility specialist who actually wrote the studies on the effects of breast cancer treatment and ovarian function. After consulting with my oncologist, they agreed that I had just enough time and minimal risk to get one IVF cycle in before starting chemo.
Now, other than being one of Kristyn’s closest friends and knowing about her fertility journey, I had no real knowledge of IVF or what it would entail. Plus, the clock was against me. Every day that I wasn’t starting breast cancer treatment, I was risking it further spreading to the rest of my body. Somehow the stars aligned, and just a week after my cancer diagnosis I started IVF. I would like to think that was the result of me being type A. I had all of this figured out in mere days, while still grappling with the mental aspect of a “WTF” cancer diagnosis.
During IVF, I saw the fertility specialist every other day so he could monitor my follicles and adjust my dosages or medicines accordingly. At one point, he wasn’t liking the speed at which my follicles were growing and wanted to add Menopur to my treatment plan, but I needed to start it THAT DAY, which was a weekend, on my birthday (welcome to 30?). My amazing husband threw me a surprise party, and in the middle of it he had to make a trip to the specialty pharmacy to pick up the Menopur prescription for me. I was literally administering my shots in the bathroom of a bar…no shame!
When all was said and done, they were able to extract 14 eggs, and I started chemotherapy 5 days later. Ultimately, because of my age and my “good health” (this, despite a cancer diagnosis, is what my oncologist told me!), I should come out of menopause and be able to reproduce naturally, but there is also a pretty decent chance that will not happen. Chemotherapy may render me infertile after all this. Take my boobs, cancer, but leave my future babies alone!!!
We wanted to eliminate as many risks as possible for the health of our future children, so my husband and I decided that we would fertilize those eggs into embryos and do genetic testing for any mutations. I don’t carry the BRCA gene, thankfully, so I knew that at least I wasn’t going to pass on a high risk of getting cancer to the embryos. On that note, because I don’t carry the BRCA gene, my cancer is a reason-less mystery. Very uncool! After fertilization and testing, we had 3 completely healthy embryos and 2 with chromosomal abnormalities. We’re happy with having 3 healthy embryos, but we wanted to know more about the others just in case. The specialist said that of my two with abnormalities, one is missing a chromosome, so we most likely cannot use it, but the other has an extra chromosome that ultimately may correct itself before becoming a fetus. My 5 embryos are safe and sound in a cryobank in Midtown Manhattan, literally chillin’, waiting for us!
I feel extremely grateful to the excellent team of doctors on my side who were able to work quickly to protect my ability to have children in the future, but I also feel a little pang of guilt for other women in my situation who aren’t as fortunate. Cancer is tricky. There are a lot of nuances to each person’s diagnosis and treatment plan, and sometimes fertility protection is not possible. In my case, I am able to breathe a little more knowing that despite everything I am going through, someday in a hopefully not too distant future we will be able to use those embryos and start our family, for real this time. Until then, I battle the beast that is breast cancer with positivity, a little bit of humor, and lot of support.