Fertility Preservation

crs003 · April 2015

I was recently diagnosed with IDC in the right breast. They have staged it at 2A, grade 3, Ki-67 70%, no nodes, triple negative. I am 36, single with no children, and the most devastating part about the diagnosis has been the possibility that I will never have the opportunity to have a family. That is not acceptable to me. Because my tumor is a bit larger, 3.5 cm, it looks like I may not be able to have a lumpectomy, and may have to lose the breast. The other option is doing chemo before surgery to shrink the tumor. All of this has been secondary to me (I know its crazy, I should be focused on surviving). But I am trying to work my treatment around fertility preservation options which has consumed all of my energy since diagnosis. I want to delay chemo to go through a round of IVF to retrieve eggs which will take two weeks. I would like to hear from anyone else who has frozen their eggs before treatment. I would also like to hear from anyone who has used Lupron to shut down the ovaries as a method of fertility preservation through chemo, because that is an option that I have also considered, even though it is still experimental.

Moderators · April 2015

Hi Crs003-

First, we want to welcome you to our community here at BCO. We're sorry for what brings you here, but we're glad you've found us, and hope you find it to be a supportive and informative place!

We certainly understand your concerns, and it doesn't sound crazy at all. If having children is important to you, then that's all that matters. Have you discussed some of your options with your doctor? If you're considering delaying treatment to undergo IVF, it's important that you discuss this all with your doctor. Considering that your cancer is triple neg, and chemo is one of the only treatment options available to you, delaying too long could be problematic. One cycle should be safe, but again, this is definitely something you'll want to work out with your doctor.

We have some information on our main site that you may find interesting, including some info about Lupron: http://www.breastcancer.org/tips/fert_preg_adopt. And other members will undoubtedly share their stories and advice with you here. Please keep us posted on how you're getting on, we'll be thinking of you!

The Mods

Viceroy · April 2015

I did fertility preservation before neoadjuvant chemo. They only got a few eggs but they are now on ice. I was 37 and single at diagnosis. My tumor was about 3.1 cm before chemo and it shrunk to about a third of that size and I had a lumpectomy which went really well. I am almost done with radiation now.

My oncologist was the one who brought up fertility preservation and was not concerned about waiting to start chemo until it was done. Overall it didn't delay things that much because of all the testing and other stuff that has to go on before starting chemo. My attitude might have been different if she wasn't supportive of it. She also referred me to some programs to reduce the cost of the procedure.

I started chemo a day after having my eggs retrieved, which was a mistake. Give yourself at least few days to recover.

crs003 · April 2015

Viceroy, Thank you for sharing your experience. I actually had two opinions about delaying treatment for fertility preservation. My first MO was not too big on the idea, but referred me to a fertility specialist anyway, second MO and SO said no problem. My diagnosis was about a month ago, my tumor was about 3 cm, but is now a bit bigger, so I was concerned about an additional two weeks. I just got two big boxes of medication, and am wondering if I really want to go through all this. Do you feel like it was worth it? Did you get your period back after chemo, if you don't mind me asking.

Fitbit · April 2015

My tumor was very small - 6mm and I chose to do a BMX. My oncologist advised not to get pregnant ever, as the hormones during pregnancy and the surge could cause a recurrence. I checked into saving my eggs before a short course of chemo and was too afraid to put off chemo and also afraid of all the fertility hormones going into my body that would be needed for egg retrieval, etc. that I decided against it. There is conflicting research how fertility induced hormones can cause cancer in itself. (Elizabeth Edwards did fertility to have her twins, Joan Lunden also did fertility to get her eggs for surrogate are a few examples that come to my mind) I was told it would be a 3 month process to do the hormones for the egg retrieval. 3 months delay waiting to begin chemo was too long for me, I wasn't comfortable putting it off that long and with no guarantees for good eggs. It was a tough blow on top of a BC diagnosis, as I (we) had hoped to have a child when I was diagnosed. There is adoption and surrogates, but ... none of that is easy either and is also costly. I also have not had my period return since chemo and I only had 4 treatments and its been over a year. I also didn't want to have a child and then worry about dying - if I'm going to have a child, I want to be around to be their mom. None of us know what tomorrow will bring (even those without cancer) ... but for me, I knew I'd be possibly risking my health and survival by getting pregnant (according to my oncologist) and then not really knowing what the future holds was too much known risk for me that I chose against the whole fertility process.

windgirl · April 2015

hi - I am in a similar situation with you. I was 37 when diagnosed last summer, had a tumor of 3.3 cm, and wanted to do fertility preservation (I don't have any kids and want in the future). I am a triple positive. About the surgery, nowadays they do chemo before surgery to reduce the tumor size. Your tumor, as it is aggressive, should reduce significantly with chemo based on my understanding. Mine reduced to about 1 cm, and while the entire tumor bed was taken out, it still made lumpectomy possible when before it was not. Chemo before surgery also shows if the chemo worked, which I would imagine is very important data ffor a tripple negative tumor as you do not have hormonal therapy option afterwards. A large piece 3.5x4.5x4.5 was taken out of the tumor site, and you cannot really notice much of a difference in size or shape. I would highly recommend going the chemo ffirst and surgery after route (regardless of whether you choose lumpectomy or mastectomy), but obviously I am not a medical professional.

On the fertility, I started chemo about 2 weeks later than I would have otherwise as I did the egg freezing. Since my tumor is hormone positive it was risky ffor me due to putting more hormones in the body, which would not apply to you. 2-3 weeks in a breast cancer I was told is nnot really much of a time difference, but again check with your doctor. I also had the Lupron shots during chemo to shut down my ovaries with hopes of not spending my life on menopause afterwards. My periods have not come back yet (4.5 months out of chemo) but even if they do my oncologist told me he will be suppressing it to put me on menopause with shots (guessing Lupron again) as he wants minimal hormones floating around. Again, since you don't have the hormone problem, go for it. While I had to pay for the first shot myself (it was extremely rushed), insurance approved the rest. You have to put it through your medical insurance not prescription.

One thing I asked about the Lupron shot was whether it shutting down the ovaries will prevent the chemo from doing its job there and put me at additional risk. I was told that chemo targets fast dividing cells, and Lupron hopefully makes the ovaries themselves not as fast dividing but if there were any cancer cells there they would still be targeted with the bloodstream. They told me this is similar to a woman in menopause getting chemo, and they are not at more risk as their ovaries has stopped working.

Viceroy · April 2015

I don't actually feel like it was worth it for me. I did get my period back after chemo. I found out that I have a BRCA 2 gene so now I am questioning having kids of my own or not.

Fertility Preservation

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