Losing my Fertility

02 Oct 2019

Oh, Nan, my world is falling apart. My head is spinning, and I can’t think. The surgeon said I need chemotherapy. It’s supposed to begin as soon as I recover from my lumpectomy, so I’m running out of time. They’ve recommended I speak to a fertility specialist about preserving my eggs for future IVF. I had no idea that the fertility appointment I'd already scheduled two months ago would serve a whole other purpose. Now it’s my only chance to have a baby.

Throughout my cancer treatment, I wrote letters to my Nan who’d died four years earlier, partly to feel connected to her and partly to process the whirlwind my life had become.

As if being diagnosed with cancer isn’t enough, as a single, childless 37-year-old woman, preserving my fertility seemed to have become as urgent as my life-saving cancer treatment.

I worried endlessly about being alone for the rest of my life, because who could possibly love me if I had no breasts, no hair and couldn’t give them children? With time, those fears were disproven but that didn’t help the intense grief and anxiety I felt whilst on the cancer train.

I remained blissfully unaware of my BRCA status at the time, not realising that I needed to also consider the impact it may have on my future offspring. Instead, I grappled with the recommended five-year timeframe between cancer diagnosis and pregnancy, making me 43 before I could even begin to try to become a mother for the first time. My disillusionment grew after also being presented with the statistics around the lack of successful cryopreservation of eggs alone versus the more successful freezing of embryos at a time when donor sperm was in shortage.

We had one month to harvest my eggs before chemotherapy began in another state. I’d just had a lumpectomy on my left breast. We were about to discover the second primary cancer in the right breast as I prepared to move my life interstate, just after the end of my marriage.

The countdown had begun.

Certain tests needed to be carried out first. Unfortunately, an internal ultrasound revealed a giant cyst on my ovary that prevented the initiation of the hormone therapy required to stimulate egg production. Several days passed before I could be tested again. Days that felt like months.

My body no longer belonged to me. My breast ached from the surgical scar. A drain tube feeding into a clear plastic bag sitting inside my large cardigan pocket came from a small hole in the skin under my breast, dripping blood and other fluids. I’d already had an internal examination and too many needles to count.

The internal ultrasound revealed that the cyst remained too large.

The fertility specialist explained, ‘There is no possibility of injecting you with hormones as they’d potentially increase the size of the cyst, causing it to explode. I’m afraid there’s no way we can harvest eggs from you this month. It may be a possibility if chemotherapy can be delayed another month.’

When you have cancer living inside of you, the thought of getting it out of you becomes an obsession. Every choice I made revolved around ridding my body of every cancer cell as quickly and as effectively as possible. Cancer made my decision for me. I had tried, but time was against me, and harvesting my own eggs was no longer an option for me.

A few months later after my BRCA1 status was revealed I began the process towards accepting my childless future. It made the decision to have a risk-reducing hysterectomy a little easier, but not the actual procedure.

The grief still comes in waves, but it came in earnest after that surgery, grief not only for myself, but for my family who would never know a grandchild, niece, nephew nor cousin from me.

For a little while, surviving cancer had been enough - being alive compensated for being infertile, but that has changed with time. Even now although less frequently, ten years later at 47, I still hold my hand to my stomach and wonder what it would’ve been like to carry my own child.

The What-ifs are frequent visitors. Sometimes I wonder if I’d only known about my increased cancer risk, how different my life choices might’ve been. Would I have worked harder to make previous relationships work? Would I have had children earlier? Would an earlier pregnancy have protected me from ever getting breast cancer in the first place?

My daydreams of rewinding the clock motivated me to share my BRCA results with my family so that perhaps they would be able to make the choices I never had the luxury of, but also so that they might choose to be screened for early detection because as so many of us know first-hand, early detection saves lives.

As for the grief… it never leaves, but it does change so that life is able to be filled with joy once more.

Dr Jodie Fleming is the author of the breast cancer memoir A Hole in My Genes, a book filled with her professional and later personal candid, raw experiences of being diagnosed with two primary breast cancers at the age of 37 and later discovering she is BRCA1 positive. A Hole in My Genes is filled with all of the psychological tools Jodie used to navigate her way through her own cancer treatment with a healthy amount of family dysfunction to boot. You can find A Hole in My Genes in all your usual online bookstores in hard copy and eBook. You can also join Jodie on one of her international Wellness Retreats. For more, visit her websites drjodiefleming.com.au or thepsychologyofit.com.au.