Fertility and Breast Cancer

I think that one of the greatest challenges of having breast cancer in my 20s is the issue of fertility. I was never one of those girls who dreamed of being a wife and mother. I was more focused on finding a career I loved and having fun with my friends. In my teens, I was convinced I would never have children and then when I was in my early 20s, it definitely wasn’t a priority. Because I was diagnosed around the same time I met my now husband, the decision about whether or not to have children is very confusing.

Since there are so few cases of breast cancer in women young enough to have not yet had children, the data on whether pregnancy can increase risk of recurrence is inconclusive, at least according to my oncologists. Logically, it would seem to me that since I had an estrogen-receptor positive tumor, pregnancy would not be the wisest choice. I also chose to freeze my eggs before chemotherapy, just in case, so I could always choose to have a surrogate carry my baby. And of course, there is always adoption.

Marc and I don’t know if we want to have children. We’ve been married a year and a half, and are in our early 30s. If I hadn’t had breast cancer, I don’t think I would stress about this. We could decide in a year or two (or five) to try to start a family. However, under these circumstances, it seems like the choice is so much harder. Neither of us is particularly comfortable with the idea of my carrying a pregnancy because of the perceived risk of recurrence. This is in addition to the fibroid issue I have, and also the fact that I am on tamoxifen and would have to wait two more years at least before getting pregnant to avoid birth defects caused by this drug.

For adoption, and even surrogacy, planning is important and long wait time is to be expected. I feel like I would need to decide right now to start the process of adoption or surrogacy to be a parent within five years. Obviously there are never any guarantees with natural conception, but these factors make the process seem tedious and exhausting for both my husband and I. And there is also the financial burden of adoption and surrogacy. We wonder if our circumstances were different if we would think differently about having children, or if our hesitation would have been there anyway. We can’t know of course, and I am left feeling unsure and confused. As Scarlett O’Hara would say, I’ll think about that tomorrow.

I won’t be blogging next week – I am going on vacation! Details to follow.

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