“We now know that the cause of the pain in your chest is cancer. You will be undergoing six months of intense chemotherapy treatment and perhaps radiation. We will need to do a bone marrow extraction immediately after this meeting to check if the cancer has spread. Now, let’s talk about fertility…”
The oncologist continued by saying that I should consider having children soon after completing treatment. My boyfriend of six months had to sit in a chair as his face turned from white to grey. We were just starting to get to know each other and now we were confronted with discussions about fertility and children. Due to circumstances unrelated to cancer, we decided to part ways. I was single again but this time I ventured into the dating world very much changed. I was bald, scarred both inside and out, and was now looking for the father of my children. I was a fun first date.
I do understand that my situation is not unique. Many single women dream about meeting someone, settling down, getting married, and having kids. However, cancer took away the option of waiting and made fertility preservation and children a crucial priority in my life. Receiving the news that I had cancer then discussing fertility immediately after was also incredibly difficult to process.
A year post chemotherapy, as a single woman in her thirties, my parents asked if I had considered the oncologist’s advice to start a family. This question caught me off guard- it seemed so soon after treatment and I was just beginning to regain my strength and make sense of the cancer diagnosis. I also had another major problem, I was still single. Telling a potential date that you had cancer usually results in the “stonewall” effect. They often stare at you blankly, not knowing what to say next making us both feel uncomfortable. When the shock subsides, they usually involved a lot of questions or the apathetic “head tilt” expressing pity for what I had been through. I rarely got past a few dates let alone get to the point where we could consider children.
Discussing the situation with my physician, she arranged a meeting with a fertility specialist. I sat in the waiting room with couples who wanted children of their own. I felt very alone, like I did not belong there. Was I still able to have children? CouldI still wait to have children? Would someone want me if I couldn’t have children of my own? Could I handle being a single parent on a graduate student income?
The fertility doctor was very patient and provided me with ample information. She discussed my options for future motherhood. Fortunately the type of cancer I had carried a low risk of infertility. However, during treatment I went through an early menopause that puts me at higher risk for an early onset of infertility. Age was also a factor. Women after the age of thirty-five have a greater risk of their child being born with a physical or developmental issue. I have three years to achieve my life goals and have children.
At the moment two options are available. If my fertility level is low, I have the choice to preserve eggs or embryos. Preserving eggs means I would hopefully meet someone in the near future. Preserving embryos means I would need donor sperm. Timing is crucial with these invasive procedures; much like chemo, you have to be dedicated to the process for an undetermined outcome. Words such as medication, hormone injections, blood tests, preservation, and multiple appointments all whirled by during the short interview. The thought of being poked and prodded, taking medication and needles was all too familiar. Did I want to go through that again? After I silently stared at the pamphlets on egg and embryo preservation following cancer, I asked her my first question:
“How do I do this on my own?”
She offered words of reassurance and asked that I weigh my decision based on how much I want to have children. I felt scared and guilty. Do I want children enough? Do I want to be a single parent? As she spoke I noticed the diamond wedding band on her finger and the visible baby bump underneath her white lab coat. I felt cheated out of these experiences. Cancer had made certain decisions for me. My life had to be put into fast-forward. I felt selfish for wanting to bring a child into the world and yet I wanted to wait, finish my degree, meet someone special, and have children. My family doctor also asked me to weigh a few decisions. She said to consider the importance of children in my life, if I wanted to go through the whole process, and whether I was emotionally and physically strong enough to take care of a child.
Unfortunately I am not able to answer any of these questions at the moment. I am still struggling with these decisions as another birthday approaches. This is a work in progress. There is no right answer out there; there is no decision that is perfect. I am grateful that my doctors discussed fertility, but felt it was rushed and I was unprepared to make a decision. I am also humbled by the knowledge that children may still be an option for me, when so many young adult cancer survivors are no longer able to have children of their own. I am still trying to find that balance and hopefully one day will have the answer. For now, I keep calm and carry on.
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Jennifer K.M. Cogswell was diagnosed with Stage 2B Hodgkin’s Lymphoma in February of 2011. Her cancer status remains at “good”. She is currently in her second year of the PhD program at the University of Ottawa. Fertility is unfortunately an under-researched, under-funded, and under-discussed topic among health care professionals and their young adult cancer patients. This article was written in the hopes that discussion will be opened up and other young adult cancer survivors will share their stories.
Jennifer has reached the milestone of five years being cancer free, which is both scary and liberating at the same time. She is currently working on her PhD in history at the University of Ottawa. In her spare time she teaches vocal music lessons and is working to get her campus smoke-free.