Making Fertility Decisions Post-Diagnosis

Liz Moroney celebrated her 23rd birthday in an unusual place — at a fertility clinic. Liz, a recent college graduate, wanted to plan for having children before it was too late.

Diagnosed with Hodgkin’s lymphoma in June 2010, she spent 4 months in chemotherapy treatment in New York. Afterward, she and her reproductive endocrinologist watched her fertility numbers dwindle over a year of visits. Her endocrinologist was skeptical of the effectiveness of fertility treatment; So, too, was Liz.

But her connections to Dana-Farber gave her hope. After relocating from New York to Boston in November 2010, a DF/BWCC doctor referred her to Elizabeth Ginsburg, MD, reproductive endocrinologist of Brigham and Women’s Center for Infertility and Reproductive Surgery, who had a promising prognosis: fertility treatment would be feasible with high levels of hormones.

“It is optimal to freeze eggs or embryos before chemotherapy, as the ovaries will be more sensitive to fertility medications and typically more eggs will be obtained for freezing,” Ginsburg says,. “However, this is not always possible due to the timing of cancer therapies. Because egg quality is best when women are young, freezing eggs at younger ages, even after chemotherapy, may result in higher odds of pregnancy than waiting to become pregnant in the future, when egg quality and quantity will both be lower. Unfortunately, there are no accurate ways to predict which women will be fertile, and which infertile after cancer treatments.

Elizabeth Moroney
Elizabeth Moroney

Liz would need to make frequent early morning trips to the hospital for hormone injections twice daily for 10 days. The process would finish on the twelfth day, with the harvesting of her eggs. The logistics, and the potential side effects, would make the process difficult to sustain. Liz was also concerned about the impact on her romantic relationships down the road. She didn’t like the idea of undergoing a medical procedure when she was in good health, and had trouble committing to a treatment with no short-term benefits.

For 2 ½ years, she put off the decision. Finally, in March 2013, she walked into the clinic, ready to proceed.

After finishing her first cycle of fertility treatment in March, which resulted in successfully freezing eggs, Liz is now contemplating a second cycle to increase her chances of pregnancy. “Many people don’t see this as a possibility for young women, but it is an option,” she says.

If you are thinking about seeking fertility treatment, talk to your doctor. Liz also offers her own advice:

  • Save money to finance your treatment in case your insurance plan doesn’t cover it.
  • During treatment, try to cut back on responsibilities. For those fresh out of college, adjusting to new “real world” responsibilities is difficult enough and something like fertility treatment can only make that challenge harder.
  • Hormones can cause behavioral changes. Establish actions that you’ll take if your hormones get the best of you. “I wrote down that I would take a walk around the block if I got angry or upset about something,” says Liz.
  • Drink water. Lots of it. “I would fill up water bottles at the beginning of the day so they were easily accessible,” Liz explains.
  • Plan to do fun things after treatment is over as motivation through the process. “I focused on running and training for a 5K, as well as going out with my friends,” says Liz.

2 thoughts on “Making Fertility Decisions Post-Diagnosis”

Comments are closed.