Taking steps to preserve fertility: Lauren Higgins
Lauren Higgins’ thoughts in September 2017 weren’t on having kids. She was 33, single, and working full-time as a commercial real estate appraiser in Houston. “I was focused on so many other things,” she recalls. “I had taken up modeling, I was working out 7 days a week and I was busy with work.” Becoming a parent “really hadn’t crossed my mind.”
Then she received a diagnosis of stage IIb breast cancer. Lauren talked with LBBC contributing writer Robin Warshaw about how that news meant she had to immediately consider her future ability to get pregnant.
Robin: When did you learn that the breast cancer treatment you needed could affect your fertility?
Lauren: I was fortunate because both the doctor that completed my tests and the surgical oncologist were women under 40. During my initial meeting with the surgical oncologist, she advised me in detail about my treatment, which would include surgery, chemotherapy, and radiation. She asked, “Do you have any children?” I told her that I didn’t. She then asked, “Do you want to be able to have children in the future?”
I was stuttering and stammering because I hadn’t really given the topic any serious thought. She told me that a possible side effect of chemotherapy is losing the ability to have children.
As the weight of that set in, I broke down crying in her office. It just felt hopeless. It was one blow after the next. I’m thinking, “I’m 33 years old, I’m in the best shape of my life, I’ve never had any health issues and BOOM! Out of the clear blue sky I’m faced with breast cancer! How is this even happening?” Now I’m being told – in order to possibly save my life – I have to have surgery as soon as possible, undergo chemotherapy as soon as possible, endure radiation, and then be on hormone therapy for 10 years. And I’m being told that, before any of this starts, if I want to have children, they’re recommending I go through a whole process to preserve my fertility.
It was just overwhelming. I had to walk out of the room, get out, get some fresh air. I could feel myself working up to a panic attack. Just a few weeks before, when I had my core biopsy, I worked myself up into such a worry about whether I had cancer or not that I had to be rushed to the hospital.
Robin: Were you alone when she gave you this information?
Lauren: Thankfully, my mother was with me. She was, and continues to be, very supportive. She’s been to every appointment I’ve had. She’s been my primary caretaker. I couldn’t have made it without her.
When we found out about the possible fertility issues, my mom continued questioning and taking notes. She knew that I couldn’t do it at that point. She was my advocate. Looking back, she was probably heartbroken not only for me, but for herself. On the ride home, we discussed it. But I had pretty quickly made up my mind to go through with the fertility treatment because I wanted to have the option in the future.
Robin: Did you have any cancer treatment between hearing your diagnosis and seeing the fertility specialist?
Lauren: No. My gynecologist, medical oncologist, surgical oncologist, radiation oncologist, and reproductive endocrinologist all worked together, so the reproductive endocrinologist was familiar with my diagnosis and treatment timeline. He explained what fertility preservation options I had.
Robin: You decided to have eggs removed and frozen, but not fertilized with donor sperm to become embryos?
Lauren: Right. I had egg freezing, which allowed my eggs to be stored for in vitro fertilization at a later time. As a single, never-been-married woman, I did not have someone to be a sperm donor.
I have a newfound respect for women who go through fertility treatment. The process was very time-sensitive and stressful. Within a 2-week span, I had five ultrasounds. Every night I had to take three different medicines. Two were shots that I had to administer to my abdomen. I had a fourth medicine that I had to inject for the egg retrieval surgical procedure. I ended up getting six viable eggs. I was very lucky that my cancer treatment was only delayed by a month.
Robin: Did your health insurance cover the bills?
Lauren: Office visit co-pays and ultrasounds were covered, but the egg retrieval procedure and medicines were not. I didn’t know that fertility treatments were so expensive.
Two programs helped me: LiveStrong and Heart Beat. LiveStrong has a fertility preservation program which partners with doctors to discount procedure expenses. In addition, my mother paid about $5,500 in out-of-pocket expenses for the egg retrieval procedure. Heart Beat covered about $3,000 in medicines. This was a true blessing considering the unknown future costs of cancer treatment. I also pay a $500 yearly fee to keep my eggs stored.
Robin: Have you thought about when you might fertilize those eggs and try for a pregnancy?
Lauren: I haven’t because I’m still single with no serious prospects. Recently, I’ve had thoughts of not becoming a mother. Although I had no known genetic markers that have been linked to breast cancer, my cancer history makes me think twice about bringing a child into the world. I would never want my child to have to go through having to deal with cancer.
The other thing is that cancer forces you to spend the majority of your time getting treated. From September 2017 to September 2018, I spent most of my time socially sidelined. I worked, got treatments and rested at home. I did not spend any time dating.
Robin: Emotionally, how did you feel about having to decide about fertility preservation?
Lauren: Initially I cried, but once I was able to step away and take in my situation, there were some bright spots. I was thankful that my oncology team had been very clear and upfront about fertility implications. When I was diagnosed, I joined several social media support groups for breast cancer. I learned that not all women are informed about the fertility effects. Many women shared that they were informed only after having problems trying to conceive.
When I decided to go through with fertility preservation, I experienced a brief moment of relief before moving forward with tackling the cancer. I remember being very detached from my emotions. I just had to focus on getting through and staying alive.
After my last active treatment, my oncologist asked how I felt. I ended up crying because the whole time I had gone through treatment, I hadn’t considered how I felt. It was a reality moment and I thought, “You made it through. You’re still here. Now you can focus on your emotional health.”
Robin: Do you have advice for other women who receive a similar diagnosis and are considering fertility preservation?
Lauren: I didn’t know everything I’d have to go through. Looking back on it, cancer and cancer treatments take a lot away from you, but they don’t have to take everything. The fertility piece is something you can have some control on.
This article was supported by the Grant or Cooperative Agreement Number 1 U58 DP005403, funded by the Centers for Disease Control and Prevention. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention or the Department of Health and Human Services.