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The Next Generation

Building a family after cancer

It's a frustrating fact: Preserving fertility for women who face cancer treatments that damage their reproductive organs is much more complicated than it is for men. But the options are slowly expanding for women who would like to build families after treatment.

For years, a myth about young people with cancer has circulated: If you're facing a life-threatening illness, who cares about infertility? But for the nearly 6 million adults of reproductive age who have survived adult or childhood cancer, fertility is a significant factor in preserving quality of life after treatment, says Senait Fisseha, M.D., medical director of the University of Michigan Center for Reproductive Medicine.

The key is to seek out fertility counseling before treatment begins to understand the options, even if the options for women aren't as straightforward as sperm banking, says Marcia Leonard, N.P., who leads the U-M Comprehensive Cancer Center's Fertility Counseling program.

"I firmly believe that a fertility consult is extremely valuable. As a woman becomes knowledgeable about what's going to happen, she gains some control, Leonard says. "She can learn about her options and then decide if theyre in her best interests. Having that knowledge and control makes it a whole different ball game than finding out in 10 years that she's infertile."

Deciding which path to pursue to build a family is a personal choice. We talked with three women to learn how they became mothers after cancer.

Embryo and Egg Preservation

Ewelina Saputo was 23 when she was diagnosed with leukemia. It was a shock, since she hadn't had any symptoms; the cancer was found during a routine blood test at a doctor's appointment. When she learned that the medications she would take in preparation for a bone marrow transplant would likely cause infertility, she asked about her options.

Saputo was a good candidate for embryo preservation because her cancer was caught early, she said. She was taking Gleevec to keep the disease at bay while she waited to find a match for her transplant -- a process that would take nearly seven months.

In the meantime, Saputo got engaged to her then-boyfriend, Dominic, and went through hormone therapy to stimulate her ovaries to produce eggs. The eggs were removed, fertilized with her soon-to-be husband's sperm and frozen. Saputo underwent the bone marrow transplant -- and a 75-day stay in the hospital -- and remains cancer-free today.

In 2009, two years after the Saputos married, two embryos were implanted in Saputo's uterus. Her two sons, Antonio and Julian, were born on June 1, 2010.

"It's amazing and hectic, but it's fun," Saputo says. "I think we were in shock. We couldn't believe we were having twins after everything we went through."

In vitro fertilization remains one of the most reliable means of preserving fertility after cancer treatment, Fisseha says, but many women don't have the option of delaying cancer treatment as long as Saputo did. Until recently, it took four to six weeks to complete the process that would allow a woman's eggs to be harvested; that has been trimmed to two to three weeks, regardless of where a woman is in her cycle. The shortened time frame has helped many women, but it remains an obstacle to those who can't afford to delay cancer treatment due to the aggressive nature or advanced stage of the disease.

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This article first appeared in the Winter, 2012 issue of Thrive.
Print Thrive Magazine; Winter, 2012