Breast Cancer, Fertility

Fertility After Breast Cancer: Balancing Hope & Disappointment

It’s been five months since I updated you on our fertility journey and our attempt to start a family after breast cancer. I am writing this on Mother’s Day and I am forced to face the emotions that have been building over the past few months.

Fertility After Cancer_ Profile Against window

Emotions of grief, sadness, hope and fear. I share our journey with hesitation, but ultimately in hopes that it will help someone else feel less alone in this process. While it is hard to share this intimate side of our lives and open up about the challenges we face, I know we are not alone.

Fertility History

Family Photo_Christmas_Fertility

Photo by Gambol Photography

Back in December of 2017, I wrote a post about Hope for a Family after cancer, detailing my journey thus far and the plan to go off of Lupron and aromatase inhibitors.There were so many unknowns at the time and I was excited to see what my body felt like without the drugs I had become so accustomed to. Discomfort and medical menopause had become my new normal. I had no idea what to expect. Later in January, I shared an update on our decision to not participate in the POSITIVE Clinical Trial. Since that decision we have not felt any regret and I am happy to report that I am actively involved in another study focused on young women and pregnancy after cancer. You can read more about the study in that post and some of the general information about pregnancy after breast cancer.

Starting a New Chapter

Walking Away _Spring Day_Fertility Post

We started 2018 hopeful for a new chapter. Though we had been waiting for this moment for so long, everything had changed. We were no longer innocent and naive about starting a family. Cancer shakes you and leaves you hesitant for the unknown. While we were happy to have the “approval” to begin family planning, a part of us was nervous to take this step again. Three years earlier we had taken this step only to be met with my cancer diagnosis.

Will My Cycle Return?

Breast Cancer Survivor_Headshot_Fertility Post

Photo by Samantha Grace Photographer

During the month of January I was scared to hope for my period to return. Everything hinged on my fertility status and I blocked feelings of hope in order to protect myself. I thought that if I didn’t hope for it to return, I wouldn’t be disappointed if it never came back. Of course this is never the case, even without hope there is disappointment.

When we met with our fertility specialist in early February though, she was very confident my period would return. She ran the tests noted below and called me with the amazing news that I was not in permanent menopause. This was a huge relief and determined it was just a matter of time until my hormones balanced out and my cycle returned. She estimated about 1-2 months.

Pre-Pregnancy Test

Rubella – This is a common pre-pregnancy test.

Vitamin D – Femara and other aromatase inhibitors cause Vitamind D deficiency so it was important to confirm my Vitamin D was at a normal level. I take daily Vitamin D to supplement.

AMH (Anti-Müllerian hormone) – This test gives an indication of your fertility and ovarian reserve. A normal range is 1.5 – 4.0. My fertility specialist indicated that if my AMH score came back very low it could indicate that I was in permanent menopause. Luckily, this was not the case. My test came back showing my ovarian reserve was strong.

LH (Luteinizing Hormone) – My LH level came back lower than my FSH, which many fertility specialist attribute to residual Lupron. LH is the same hormone that indicates ovulation.  In February before my period returned I had other indications that the ovulation process was occurring.  I have not had any additional LH testing aside from drugstore ovulation tests, which I don’t fully trust. After menopause, the LH level will stay very high.

FSH – This came back normal

CBC & Blood Type – The tests confirmed that my blood work was normal and my body is healthy

Cystic Fibrosis Screening – All screenings came back negative (WOOHOO)

Aunt Flow Has Returned

Downtown Cary Playful Photo_Fertility Post

Three months after stopping Lupron (to the day), my period returned. I cried in the bathroom at work thrilled to be given the moment of relief. As crazy as it may seem, I was relieved to have physical proof of my hormones working. For so long, they had been asleep I wasn’t sure if they would come back to life. What has followed has been a roller coaster of hormonal highs and lows. Hormonal acne, oily skin, a host of new emotional challenges, but I try to focus on gratitude. My cycle retuning was proof that the last 3 years of Lupron and subsequent estrogen blocking medication were worth it. All those menopausal systems, discomfort and sadness protected my body and my fertility for this new chapter.

This Cancer.org article explains more about the impact of chemotherapy on fertility and which drugs have the fertility highest risk.

I Forgot What My Body Felt Like Off Drugs

Yoga Pose_ Fertility After Breast Cancer Post

The changes to my body during the past few months have been an amazing surprise. My menopausal symptoms caused by the medications have completely subsided. Most notably, my joint pain is gone and sexual intercourse is not painful for the first time in 3 years and truly enjoyable. I never thought I would say that again. Feeling like a 60 year old women in a 30 year old body is something those of you on endocrine therapy can relate to and it is not pleasant. This temporary relief reminded me that the symptoms truly are medically induced and not something I should blame my body for. I am not my symptoms.

Trying to Conceive

Couple After Chemotherapy_Fertility

While waiting for my hormones to level out, we have been trying to conceive (TTC). While I thought waiting for my period to return was hard, this stage has been even harder.  At first I had no expectations and time was on our side. I was more accepting of my body and the adjustment period. As time goes on though, I have struggled to balance hope, and my fear of disappointment. While I want to hope for this baby and focus on excitement and possibility, I find it hard to trust that my body will cooperate. When you know something like cancer can take over out of the blue, it’s hard to believe that anything else in life will go as you planned or imagined it. I feel like it’s a race against time and I am not sure my body can keep up.

But You’re So Young…

Daniel Wellington watch arm candy_time_fertility

When I express frustration or disappointment, most people want to focus on how young I am. They think I have all the time in the world, but when you’ve had hormone positive breast cancer, it’s a not that simple. My doctors only want me off my Lupron and endocrine therapy for 2 years including pregnancy so our window of time to conceive is truncated. After 2 years I will go back on Lupron and endocrine therapy (Femara) for another 5-10 years to decrease my risk of recurrence.

The increased pressure of this shortened time frame and the dread of  having to go back on the drugs, doesn’t help with my stress level. On the one hand I want to forget about all of this, let go and just focus on my hope for this future baby. On the other hand, having to track my temperature, monitor ovulation and be acutely aware of every bodily change keeps me hyper focused on the present.  I feel like I am fighting against myself, unsure of where to focus my efforts.

Patience is Not My Strong Suit

Jumpsuit outfit at WRAL Azalea Garden, Raleigh NC

For those of you who know me personally, you know patience is not my strong suit. I struggle to accept that my body is still adjusting and getting back to a normal rhythm. Can’t it just hurry up and level out? I guess three years of medical menopause and all my hormones being shut off, does a number on the body.

I am still unsure of how long my cycle is as it’s been different each month. Last month my period lasted 9 days!!!! What a shock compared to my 3 day periods back in the day. Oh the days of birth control. I had no idea back then. All of this hormonal fluctuation makes tracking ovulation and timing quite difficult. We will go into the fertility specialist next week to get an ultrasound and blood work done in hopes of gaining some additional insight about my hormone levels and cycle.

The Checkpoint Approaching

Downtown Fountain Cary NC, Spring

After 3 months of trying, my fertility specialist wants to see us to recheck levels and determine next step.  This approaching checkpoint is only adding stress. I keep hoping I will have a baby growing in my stomach, before that date comes, but there are no guarantees. If only it was easy like those people who get knocked up on their honeymoon or get pregnant on the first try, but I guess those situations come with their own set of challenges. It should not be a surprise that it is more difficult for us. We’ve been through so much already, I should expect this. While I try to limit my level of hope, every time my period returns disappointment washes over me. Disappointment for the situation and disappointment that my body did not reward our desires. I struggle to continue to stay hopeful when the outcome is so uncertain.

Plan B

Mac & Anna at Fashion Show_Fertility After Breast Cancer_

So what is the worst case scenario? Why am I so afraid? While we wish to conceive naturally, we do have 3 embryos on ice. If we are unable to conceive in the 3 month timeframe, our next step will be determined by the results of the fertility tests. Should the fertility tests come back showing normal function then we may continue to try for another 3 months. If the tests come back showing some issues, then we will most likely explore the embryo implantation route.  While our Plan B should be reassuring, it just feels like another unknown, another huge expense and more emotional uncertainty.

Focusing on My Body

Breast Cancer Survivor_Fertility Post_WRAL Azalea Garden

Photo by Samantha Grace Photography

For now, I will continue to focus on caring for myself. I go to acupuncture weekly, fill my body with healthy foods and started seeing my therapist again to help with the emotional side of things. The biggest challenge for me right now is acceptance. Worry, stress and fear for the future will not change the outcome. As with everything in my cancer journey, this stage has been a lesson in acceptance. Acceptance for what will come, what may change and that which we cannot control.

While I was hesitant to share this side of our journey, I decided to do so because I know I am not alone. I know there are thousands of other women like me facing the prospect of starting a family after cancer, dealing with infertility or coming to terms with the fact that they may not be able to have children. We share our experience in hopes of educating others, and finding comfort for myself. I need to know I am not alone and by sharing our experience with all of you I open myself for your love and support as we continue on this ever change path towards creating a family.

20 Comments

    KANIKA NOU

    May 16, 2018Reply

    Hi Anna!!!

    I am blessed that my kids were 8and 10 when I was diagnosed back on Sept 2016.

    I understand your fears and wants, and it stinks that cancer gives us another thing to worry about. I will be saying a prayer for you and your husband during this next chapter. I am a big believer that things will happen as God has great plans for you. The disappointment is a test of our faith and we must hold on tight to that Faith.

    God bless and your a beautiful and a strong woman.

      Anna

      May 17, 2018Reply

      Thank you so much for reading and for your kindness. I am so happy you have two beautiful children.

    Stacy L

    May 17, 2018Reply

    Just want to send a big hug!
    Thank you for this post 💗
    Thinking of you and hoping for the best!
    You are not alone and this helps more than you know 😇

      Anna

      May 17, 2018Reply

      Thank you friend. Your support means so much!!!

    Danielle Livingstone

    May 17, 2018Reply

    Thank you for your honesty. I am praying for you and your husband xxx

      Anna

      May 17, 2018Reply

      Danielle thank you for reading and for your kindness.

    Patricia W Leary

    May 17, 2018Reply

    Uncle Bud and I love you both so very much and join you in hoping and praying for the baby you both want so very much. Thank you, once again, for sharing your story, your hopes and fears, and your strength. You are helping so many others and, I hope, it is helping you. Love you lots, Anna.

      Anna

      May 17, 2018Reply

      Love you all tons. Having your unconditional support and love means the world.

    Megan

    May 17, 2018Reply

    Anna, your post brought tears to my eyes. I know your struggle, as I am currently in a similar situation. I was diagnosed with Hodgkin Lymphoma at the age of 28. You post is so inspiring and heat warming. I am praying for you and all the things to come! Xo, Megan

      Anna

      May 17, 2018Reply

      I will be sending you baby vibes as well. We’re in this together. Having others to turn to makes it less scary and more comforting.

    Irma

    May 18, 2018Reply

    I had my last Lupron shot in February and I’m praying my ovaries wake up soon. My husband and I had planned to wait 1 yr after we got married to start family planning and instead we got a cancer diagnosis. Reading your blogs helps me feel nobody is alone in this and your advise and tips have been so helpful in my own journey. God bless you !
    Irma

      Anna

      May 18, 2018Reply

      I am so happy to hear my experience helped you in some way. I am sending you hormone vibes in hopes that your ovaries wake up like mine did!

    Manzoor (Femara)

    May 21, 2018Reply

    Thanks for sharing such amazing info.Keep up the great work and check our posts about medicine used for breast cancer such femara here Femara (Letrozole):Uses, Side Effects, Mechanism, Dosage

      Anna

      May 21, 2018Reply

      Thank you for sharing.

    Mac

    May 25, 2018Reply

    I’m so proud of you hunny. I love you and appreciate everything you do for our little family and I know we will add a new member soon enough.

    Love always,
    The hubby

      Anna

      May 27, 2018Reply

      Love you honey!

    chemobaby

    May 26, 2018Reply

    Hi Anna, have commented before, also on your instagram. Will be sending you positive baby vibes, it must be so hard to be waiting and have yet another thing to do with your body be out of your control. Is it some solace to know that the average “normal” couple takes 5 months to conceive? Probably not, but I just wanted to let you know – no need to despair, and you are not alone, and you DO still have many options. Don’t give up hope. Sending you hugs!

      Anna

      May 27, 2018Reply

      Thank you so much. It does bring me some comfort and I am trying to work on my patience. Thanks for your continual support!

    katie C widdicombe

    May 27, 2018Reply

    Thank you for sharing your story. I found a lump the day my husband proposed, turned out to be triple positive breast cancer, and the whirl wind began. We planned a wedding in a week, froze 10 eggs, and I began treatment. I have done 7 chemo treatments, over half way done with that part but still radiation and anti estrogen to go… not sure what the future holds. I am a preschool teacher so have always wanted kiddos, hoping this is still a possibility. It definitely helps knowing I’m not alone but also so sad know so many others are going through this. Good luck on your journey, sending you strength and positivity, xo

      Anna

      May 27, 2018Reply

      You are definitely not alone. I’ll be sending you so much love!!!!

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