Archive for category: Fertility

Cancer Makes Everything More Complicated

18 Mar 2013
March 18, 2013

For about the last two years, my wife and I have been trying to have a baby. In December of 2011, a small white stick told us that she was pregnant, and we were ecstatic. We started reading books, making plans, talking a lot… all of the things you do the first time “you’re” pregnant. In January of 2012, at a routine doctor’s appointment to see the first ultrasound, we found out that the fetus had stopped developing very early and that there was no heartbeat. We’d had a miscarriage.

We both knew that this wasn’t our fault, and that a pregnancy terminating this early in the first trimester probably meant that there was something wrong with the fetus. We knew that intellectually, but when you’re in the midst of it, the intellectual part doesn’t seem as relevant. We were heartbroken. It was unfair. We started over.1

And then I got diagnosed with a malignant tumor in June.

Right around the time that I had one of my first meetings with a surgeon to talk about the surgery and my prognosis, another small white stick told us that my wife was pregnant again. I can’t tell you how relieved I felt. I had been worried that having and recovering from my surgery was going to make it hard to try to get pregnant again, and that it would get in the way of our plans. It was a huge relief to think that it definitely wasn’t going to be a problem.

And then, another miscarriage, right after I got out of the hospital.

Because I was recovering from surgery and home for less than a week, my wife went by herself to the first ultrasound at the OB’s office. She called me crying from the hospital, because the ultrasound showed the same thing as the first pregnancy: no heartbeat; the fetus has stopped developing early. I can’t even express how helpless I felt. I was supposed to be there. I knew that I couldn’t make everything okay, or even better, but I should have been there. Except that I couldn’t be there, because at the time I couldn’t really stand up for more than ten minutes.

My wife chose to have a D&C, since the doctor explained that they’d be able to test the fetus to see if they could determine a cause for the miscarraige. Despite hearing all sorts of stories about how people go through multiple miscarraiges and then having a healthy child, we wanted to know if there was something that would predict more problems in the future.

When we got the test results back, we found out that there was a chromosomal anomaly in the fetus. Nothing that predicted potential future problems, but exactly the kind of serious defect that causes an early first trimester miscarraige. And again, while that was helpful to know intellectually, it didn’t help make anything better.

And then things got complicated.

A week or so into my recovery, I got the news that my doctor was recommending a course of chemotherapy and that I needed to meet with an oncologist. Immediately, we wondered whether this was going to have an impact on our ability to or likelihood of getting pregnant and having a healthy child. When we met with the oncolgist, it was one of the first questions we asked.

We were told that it was generally not deemed safe to try to get pregnant naturally while undergoing chemotherapy, and it’s not advised for up to a year to eighteen months afterward.

So, now, on top of dealing with cancer and chemotherapy, we make an appointment to meet with a fertility specialist. He tells us that our case is very interesting… thanks, I guess? Most people visiting a fertility doctor are doing so because they have trouble getting pregnant, whereas we were just having trouble staying pregnant and were now being told that we shouldn’t try to get pregnant the old fashioned way.

At the suggestion of my oncologist and the fertility doctor, I went to a cryobank before I started chemo and put some sperm on ice. It’s not worth going into details, but it was definitely an odd experience. And, can someone explain to me why every person working at the cryobank was female?

Once we (well, mostly my wife) had gone through the initial tests and assessments that the fertility clinic required, we were presented with two options: IUI (intrauterine insemination, aka artifical insemination) and IVF (in vitro fertilization).

IVF generally has a higher rate of success, but IUI is less invasive. After talking with the doctor, we decided to try up to two rounds of IUI before considering IVF. So, over the course of a few months in the late fall/early winter, that’s what we did.

Unfortunately, neither round was successful. Now we were left with the decision of whether to proceed with IVF. It was something that my wife had previously ruled out when we had discussed hypotheticals, but based on how far we’d come, was willing to try.

And so, for the last several weeks, my wife’s been injecting herself with various hormones and going to the doctor’s office for ultrasounds and bloodwork. This past Saturday was “egg retrieval” day and sometime in the next few days we’ll have a couple of embryos to transfer. Then, we wait and see what happens.

Some people have asked me if we’re excited. At this point, I think we’re just cautiously optimistic and taking things one step at a time. There’s a part of me that’s also just scared – scared that the IVF is going to be successful, but that it’ll end in another miscarriage. And there’s a completely irrational part of me that feels guilty, like if I hadn’t gotten cancer, this wouldn’t be happening, as if that were something that I could have controlled (I suppose I could have eaten more kale, but who knows if that would have worked).

I’m also incredibly proud of my wife for dealing with this whole process. While I’ve gone to appointments, helped organize the large box of medication and supplies shipped from the pharmacy, and generally tried to be helpful, this is something that is primarily affecting her, and she’s been handling it all.

There’s so many things that people are scared of when the word “cancer” gets raised, but I’ve learned that it complicates your life in ways that you couldn’t even imagine. I suppose if this is all successful, then we’ll have quite a story to tell our kid when they’re older.


1Side note: once we started telling people about our miscarriages (which took a little while), I was astounded at how many people said something like “I/my wife/my sister/my friend went through the same thing.” While I knew that miscarriages were common, it’s something that no one seems to talk about (granted, it’s very personal), and I’m not sure that’s a good thing. It’s something that’s often kept in the dark, and that everyone goes through mostly alone. I hold out hope that that changes eventually, because I think it would ease the pain for a lot of people.

 

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