Assisted Reproduction, breast cancer, Brigham and Women's Hospital, Cancer Kitten, Cathy Kenney, chemo, chemotherapy, DCIS, Freezing Eggs, Freezing Oocytes, Gonal F, HCG Injection, LiveStrong, Reproductive and Infertility Specialists, retrieving eggs, Stage 1 invasive ductal carcinoma, Stimulated oocyte growth, Trans-vag ultrasound, young woman with breast cancer
One of my chemotherapy drugs may cause infertility by killing the eggs I still have. (For those of you who don’t understand why woman spend 30 + years on a hormonal roller coaster which ends with a real bender sometime in our fifties, well, it’s because we finally run out of eggs. We have a finite number of those puppies.) My oncologist advised me to look into fertility options, should I want to have my own children someday. This came as a bit of a shocker to me. At the time, I had no idea if I had the BRCA 1 or 2 gene mutation, and therefore whether I was going to have a lumpectomy or a bilateral mastectomy. There were already so many unknowns and decisions to make, and here was another.
Needless to say, I felt compelled to retrieve my eggs. I’ve never been one to constantly talk about having kids and a family somday, but I’ve wanted that without question since I met Bing. I didn’t want to undergo chemo and worry with every dose that I just killed my last mini-me. I’m totally excited to have a little person that I can mold into a crazy little fun mess, although I’m not so sure having a mini-me is a very good idea for society. I won’t know until I try it though. Which somehow leads me to Pam.
Pam is Dr. Ginsburg’s nurse. Dr. Ginsburg is the fertility doctor at Brigham and Women’s Hospital who handles the scared cancer patients who want to make sure they can have mini-me messes someday. My sister Kimmie is a teacher and had the summer off. She dutifully accompanied me to many of my doctor appointments, and she openly admits meeting Pam for the first time was a summer highlight.
Before we could access Pam, we had to meet with Dr. Ginsburg, to go over all of the pros and cons of freezing embryos versus eggs (oocytes). At the time, I planned to freeze embryos, but due to reasons in large part beyond my control, I ended up freezing eggs. The difference being, the success rate with frozen embryos is known, the success rates with frozen eggs is still considered to be in its trial stages and has only really been performed with women in their twenties. Dr. Ginsburg seemed to think that given my great AMH levels combined with my age (33), it was realistic for me to have both a successful retrieval and eventual successful use of my frozen eggs. Oh, the other difference between freezing eggs and embryos is that when the eggs are eventually used, the sperm has to be injected into them because they end up with a hardened shell. This process is often referred to as ICSI, or intracytoplasmic sperm injection, and is an additional cost. Sigh.
Once I paid for this retrieval to happen (at a discount thanks to a program through LiveStrong), I made an appointment to meet with Pam to learn how to inject myself with all sorts of follicle stimulating hormones.
Pam is like my friend Kristin after about 3 large, make that ginormous, cups of coffee. Kim and I LOVED her, of course. She is the Elf of the reproductive world. She talked a mile a minute, explaining how to inject the Gonal-F, where to go for my blood draws, and how to prep the final hCG injection. She was squirting stuff everywhere out of needles, demonstrating what not to do, drawing pictures and writing notes on fourteen different pieces of paper, and all the while I was fielding cold boxes of medications she tossed at me from her bag of reproductive goodies.
Since the final hCG injection is adminstered with a rather large needle and basically in the butt, she focused this training session on Kim. For the hCG injection spot, she drew a picture of a butt, and explained to find the butt crack, pausing to ponder whether there is a medical term for butt crack, then move up and over an inch or two to find the sweet spot. She sped through all of this information, and just as Kim and I thought it was time to make our escape, I made the mistake of mentioning that I horseback ride, to which Pam switched from coffee speed to sipping-a-bourbon speed. I think she literally sat down and put her feet up on the desk. Apparently her daughter loves horses. Honestly, if it weren’t for Kimmie needing to work, we could’ve hung out with Pam all day.
It took me about 20 minutes to inject myself the first time. I froze my skin with ice and prepped it with alcohol. Then I jumped around squealing and willing myself to stab myself with a needle the size of a thread. Kimmie witnessed this scene briefly, then decided I was too pathetic to watch and went home. I finally stabbed myself, pushed the plunger in…and realized that it didn’t work. So I re-numbed the area, changed out the needle and checked the hormone fluid level. I stuck myself again…and the needle didn’t click. At this time, I panicked, thinking all hope was lost and I’d have to wait another 4 weeks to start this process again. I once more stabbed myself and finally realized…the injection had worked the first time. This is what my poor tummy looked like after round one of fertility treatment:
The self-injections became easier as time went on. Kind of.