fertility emotions

Cancer is a challenging journey that often necessitates numerous life-altering decisions. For women of reproductive age, one of these critical decisions is understanding how cancer treatments might impact fertility and what can be done to preserve it. In this article we’ll explore this delicate intersection of oncology and reproductive health, and talk about the option of egg freezing.

The impact of cancer treatments on fertility

Cancer treatments, while lifesaving, can significantly affect fertility. These impacts can vary depending on the specific treatment, the dose, your age, and the area being treated.

• Chemotherapy medications, designed to target rapidly dividing cells, may inadvertently impact the eggs in the ovaries. This decrease can result in infertility, primary ovarian insufficiency, or a narrowed window of fertility, much like natural aging. Women over 35, having fewer eggs to start with, are more susceptible to this effect.
• Radiation therapy targeted at the pelvis or the entire abdomen can harm eggs and the uterus. The radiation can lead to scarring, or fibrosis, in the uterus, making it challenging for the uterus to accommodate a growing fetus. Consequently, women may face difficulties in conceiving or carrying a pregnancy to term, increasing the risk of miscarriage or premature labor.
• Treatments involving the brain, such as surgery or radiation, can affect the pituitary gland responsible for releasing hormones that stimulate egg maturation and ovulation. While the eggs in the ovaries are not directly damaged, the disruption in hormone regulation can affect fertility. However, hormone replacement medications may help restore fertility in these cases.
• Surgery involving one or both ovaries or the uterus can directly impact fertility. The degree of this impact would depend on the extent of surgical intervention.

If you are considering cancer treatment and are concerned about its potential impact on your fertility, it is important to discuss your concerns with your oncologist and/or a fertility doctor. They can provide you with information about the potential effects of cancer treatment on fertility and help you understand your options for preserving your fertility before treatment begins.

Egg freezing options

For those about to embark on cancer treatment, a few fertility preservation options can increase the chances of having biological children in the future. 

Egg freezing (oocyte cryopreservation) is a process involving stimulating the ovaries with hormones to produce multiple eggs, which are then retrieved and frozen for future use. The entire process takes about two weeks from start to finish, but the start date depends on your menstrual cycle. 

If you have a partner or choose to use donor sperm, the eggs can be fertilized before freezing, creating embryos for future implantation. The benefit of fertilizing the eggs immediately is that you will know how many embryos you have for future use.

Ovarian tissue freezing is a relatively new and experimental technique that involves surgically removing and freezing ovarian tissue, which contains thousands of immature eggs. This tissue can later be re-implanted to restore fertility or used to mature eggs in the laboratory. This may be an option for those who are not able to undergo egg freezing due the urgent need to begin cancer treatment.

To freeze or not to freeze

Making a choice on which fertility preservation option to pursue, if any, can be a difficult decision. A myriad of factors play into this decision, including your current health, age, cancer type, the proposed treatment regimen, personal circumstances, and future family plans.

Navigating a cancer diagnosis while also thinking about future fertility can be emotionally overwhelming. There are not only physical implications to consider, but also emotional, psychological, and social dimensions to this journey.

The chosen method must be compatible with your treatment plan and timing, as some methods require hormonal stimulation and time to mature and retrieve the eggs. A fertility doctor, alongside your oncology team, can provide the most accurate advice based on your unique situation.

It's important to seek emotional and mental health support during this challenging time. Reach out to your health care team, a mental health professional, supportive loved ones, or a support group of others going through a similar experience. It can be helpful to share your feelings, fears, and hopes, and to hear others' experiences and insights.

Financial considerations - how to pay for egg freezing 

Another important aspect to consider is the cost of fertility preservation treatments. These procedures can be expensive, and not all are covered by insurance. Average egg freezing costs range from $10,000 - $20,000 for consultations, testing, ultrasounds, medications, and the egg retrieval, plus the ongoing cost of annual storage. But ultimately depends on the clinic you’re going to, where you are located, the medications you are prescribed (it differs based on your age and body), and where/how long you store the eggs.

There may be ways to lessen the financial burden, including:

Insurance coverage 

Begin by thoroughly understanding your insurance coverage. Some health insurance plans provide partial or complete coverage for fertility preservation, especially in cases of medically necessary treatments such as cancer. Legislation in certain states mandates insurance coverage for fertility preservation for cancer patients. 

As of the writing of this article, these states require health insurance plans to cover medically necessary fertility preservation:

• California
• Colorado
• Connecticut
• Delaware
• Illinois
• Kentucky
• Louisiana
• Maryland
• New Hampshire
• New Jersey
• New York
• Rhode Island
• Texas
• Utah

Reach out to your insurance provider to understand what is covered and what out-of-pocket costs you can anticipate.

Flexible Spending Account (FSA) or Health Savings Account (HSA)

If you have an FSA or HSA through your insurance plan, these funds can often be used to cover fertility preservation expenses. Check with your plan administrator to confirm what expenses qualify.

Tax deductions

The IRS has traditionally considered fertility preservation treatments, like egg freezing, to be tax-deductible when they are deemed medically necessary. This typically refers to situations where a medical condition or treatment (such as chemotherapy for cancer) could cause infertility. You’ll want to talk to a tax professional about which egg freezing expenses you can deduct from your taxes.

Negotiating prices and shop around 

Don't hesitate to discuss the costs with your fertility clinic. Some clinics may offer discounted rates or payment plans for individuals facing financial constraints. Get pricing from a few clinics to see your options. 

Financing options

There are a growing number of financing options, such as loans or payment plans, to help patients pay for egg freezing. These options allow you to spread the cost of the procedure over several months, making it more manageable. For example, Sunfish makes egg freezing (and fertility treatment in general) attainable for all types of families with low-interest loans or lines of credit.

Financial assistance programs and grants for cancer patients

Numerous organizations offer grants or financial aid to cancer patients seeking fertility preservation. Examples include the Livestrong Fertility Program, Team Maggie, Chick Mission, the SAMFund, The Ferring Heartbeat program, and Fertile Action. These organizations aim to alleviate the financial burden of fertility preservation and increase access to these vital services.

Crowdfunding

With the rising popularity of crowdfunding platforms, many people turn to their community, near and far, for financial support. Websites like GoFundMe can be used to raise funds for medical treatments.

Employer benefits 

Increasingly, employers are recognizing the importance of supporting their employees' reproductive health and are incorporating fertility benefits into their packages. Explore whether your employer offers any such benefits or whether they would consider adding them.

Options if you choose not to freeze your eggs

If you don’t freeze your eggs before cancer treatment, it's important to remember that does not mean the end of the road for parenthood. There are multiple paths available to build a family. 

It may be possible to regain fertility naturally after cancer treatments, particularly if you are under 30 at the time of treatment. You’ll want to talk with your oncologist and a fertility doctor about when it would be safe to try for a pregnancy and the potential risks involved.

For women whose ovarian reserve has been significantly impacted, the use of donor eggs can be a great option. In this process, eggs from a donor are fertilized with your partner's sperm (or donor sperm), and the resulting embryos are implanted in your uterus. This path allows you to experience pregnancy and childbirth.

If the uterus has been damaged by radiation or surgery, or if pregnancy poses a health risk, gestational surrogacy might be an option. In this case, an embryo (created with your egg or a donor egg and your partner's or a donor's sperm) is carried by a gestational carrier.

Finally, adoption remains a heartfelt path to parenthood for many individuals and couples. Adopting a child can be a fulfilling choice that meets the deep desire to raise and nurture a child.

Living with the aftermath of a cancer diagnosis can be challenging, particularly when it affects your family planning. However, remember that numerous avenues to parenthood remain open, and while they may not be the paths you initially envisioned, they can be equally rewarding and enriching. Your dream of becoming a parent can still be a reality; it might just involve a different route than you originally planned.

Summing it up

Navigating the landscape of cancer and fertility can be laden with emotional and medical complexities. However, armed with knowledge about potential impacts and available options, you can make an informed decision that aligns with your future family-building aspirations. Your oncology and fertility teams can provide guidance and support, helping you weave your way through this intricate journey and minimizing future regrets. In the end, the goal is to optimize not just survival, but also quality of life and future dreams.

Even if you’re years off from wanting children, discussing your fertility with your primary care physician or OBGYN is a good idea. Being proactive and addressing your fertility concerns can help you make informed decisions and confidently navigate this phase of your life.

In this article, we’ll share some tools and knowledge necessary to empower yourself when discussing fertility-related matters with your doctor. By asking the right questions and advocating for yourself, you can ensure that your concerns are taken seriously and receive the support and guidance you deserve.

Educate yourself

Before your doctor's appointment, take the time to educate yourself about fertility and reproductive health. Familiarize yourself with the basics of female reproductive anatomy, menstrual cycles, and fertility potential. You can start by checking out our Learn section, which offers comprehensive information on fertility-related topics, including egg freezing, hormones, and more. 

Get some family history

You might also want to ask females in your family (your biological mother, older sisters, etc.) about their fertility experience. This will help you gain insight into any potential hereditary factors that could impact your own fertility. Their health history may be helpful for your provider to assess any genetic predispositions or conditions that may affect your fertility journey now or down the line.

Prepare ahead of time

Preparation is key to effective communication with your doctor. Make a list of questions or concerns you want to address during the appointment. This will help you stay focused and ensure that all important points are covered. Include specific questions about your fertility, potential testing or treatments, and the possibility of egg freezing. Think through your desired family-building timeline (if you have one) as this will play a role in determining the best next steps. 

Here are some questions you can consider asking:

• Given my family-building timeline, what steps should I take now to give me the best chance of success down the line?
• Are there any potential factors that could be affecting my fertility?
• Are there any tests or evaluations that can help determine my fertility potential?
• Based on my medical history, are there any specific concerns or conditions that may impact my fertility?
• What lifestyle changes can I make to optimize my fertility?
• Are there any specific dietary recommendations or supplements that can support fertility?
• Can you provide me with a referral to a fertility specialist or clinic if needed?
• Are there any long-term contraceptive options that provide reliable protection while allowing flexibility for future plans?
• Are there any factors in my medical history that might affect the choice of contraception or impact fertility in the future?
• Can you provide guidance on resources or support groups for people who are planning to delay parenthood for a few years?

Seek a fertility specialist

If you feel like your OBGYN doesn’t have the necessary expertise in fertility, or you have a gut feeling you may have a fertility issue, consider seeking a referral to a fertility specialist. These specialists, often reproductive endocrinologists (REIs), have specialized knowledge and experience in diagnosing and treating fertility issues. They can provide you with a more thorough evaluation and personalized advice.

Establish open communication

When speaking to your doctor, establish a comfortable and open line of communication. Explain your concerns clearly and concisely, emphasizing the importance of the topic to you. Use "I" statements to express your feelings and personal motivations for seeking fertility guidance. This approach helps create a more collaborative relationship with your doctor.

Some examples of these statements might include:

• “I think I might want to have children someday, and I want to understand more about my fertility to make informed decisions about when to start trying to conceive.”
• “I have a medical condition that could affect my fertility, and I would like to discuss the potential impact and/or treatment.”
• “I am at an age where I feel a sense of urgency to explore my fertility options, because I don't want to experience challenges building my family down the line.” 
• “I have a family history of reproductive issues, and I want to be proactive in understanding my own fertility health to prevent any potential complications in the future.”
• “I'm considering delaying pregnancy for a few years due to personal or career reasons, but I'm concerned about how that might affect my fertility. Can you provide information on fertility preservation options?”
• “I have irregular periods, and it's been challenging for me to track my ovulation. Can you help me understand my cycle better and provide advice on optimizing my fertility?”
• “I've always had a strong desire to become a parent, and understanding my fertility is essential to fulfilling that dream. Can we discuss tests or assessments that can give me a clearer picture of my reproductive health?”

Remember, these are just examples, you should personalize your questions and comments based on your specific situation and concerns. Your OBGYN will appreciate your openness and willingness to discuss your fertility goals and worries. If your OBGYN is dismissive of these questions or concerns, it may be time to consider talking to another doctor. 

Share your medical history

Come prepared. Be ready to provide your doctor with a comprehensive medical history, including any previous or current reproductive health issues. What kind of birth control are you on? Have you had any STIs, miscarriages, or abortions? Knowing your cycle – if it’s regular or not – is vital information too. . The more information you provide the doctor, the better they will be able to understand your unique circumstances and tailor recommendations to suit your needs.

Discuss fertility testing

If you have concerns about your fertility, or are just curious about your ovarian reserve, ask about appropriate tests to assess your reproductive health. Understanding your fertility potential can help guide discussions about future family planning or the need for egg freezing.

Possible tests include:

• Hormone level assessments: These are blood tests that measure hormone levels related to fertility. They can include assessments of anti-mullerian hormone (AMH), follicle-stimulating hormone (FSH), luteinizing hormone (LH), estrogen, progesterone, and thyroid hormones. These tests help evaluate ovarian function, the menstrual cycle, and potential hormonal imbalances that may affect fertility.
• Pelvic ultrasounds: A pelvic ultrasound is a non-invasive imaging procedure that uses sound waves to create images of the reproductive organs. It can help evaluate the health and condition of the uterus, ovaries, and fallopian tubes. This assessment can identify any structural abnormalities, such as fibroids, cysts, or polyps, that may impact fertility.
• Semen analysis: A semen analysis is a test performed on a male partner to assess the quantity, quality, and movement of sperm. The analysis involves collecting a semen sample, which is then examined under a microscope. It evaluates sperm count, motility (movement), morphology (shape), and other factors that can affect male fertility.

Ask your doctor which tests make sense now, and which ones can wait until you’re ready to start trying.

Inquire about egg freezing

If you are considering egg freezing, approach the topic directly with your doctor. Ask about the process, success rates, potential risks, and the ideal age to consider this option. If you’re already chatting with an REI, seek information on the specific protocols followed at the clinic, including the number of eggs typically recommended for optimal chances of future conception. 

Read more in Questions to Ask Your Doctor at an Egg Freezing Consultation

If you’re curious to see if you qualify for Freeze by Co’s Split program — where you can freeze your eggs for free if you give half of the eggs retrieved to another family who can’t conceive — you can take our quiz here. Additionally, our self-pay Keep program allows women to freeze their eggs and keep them all for their future use, with partnerships and discounts to lighten the financial load of egg freezing and as access to our member community.

Request second opinions

If you feel your concerns are not adequately addressed or your doctor dismisses your fertility-related questions, do not hesitate to seek a second opinion. A different perspective may offer fresh insights and alternative treatment options that can better meet your needs.

Trust your gut

Lastly, trust your instincts. If you feel unheard, rushed, or dismissed during your appointment, it is crucial to advocate for yourself. Remember, you are an active participant in your own fertility journey, and your concerns and desires deserve attention and respect.

Summing it up

Remember, every individual's journey is unique, and there is no one-size-fits-all approach to family planning. Your doctor is a valuable resource who can provide personalized guidance tailored to your specific needs. By opening up the lines of communication and actively participating in discussions about your fertility, you can embark on this phase of your life with confidence and peace of mind.

Taking control of your reproductive health and discussing fertility concerns or options like egg freezing with your doctor can be an empowering and transformative experience. With the right tools and a proactive mindset, you can ensure that your fertility journey is supported and guided by a healthcare professional who values your concerns and helps you make informed decisions about your reproductive future.

Read more:

• Questions to Ask Your Doctor at an Egg Freezing Consultation
• Can I Freeze My Eggs If… 
• What Can I Expect From the FSH Blood Test?

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Egg freezing, also known as oocyte cryopreservation, has grown in popularity, with a 46% increase in egg freezing cycles from 2020 to 2021 alone! This transformative medical procedure has garnered significant attention and interest. 

Amidst all the buzz and excitement, it's important to navigate your egg freezing journey with the facts. To ensure a successful and fulfilling experience, we've curated a guide to help you avoid seven common mistakes people make when freezing their eggs. 

Working with the wrong doctor

The importance of selecting the right doctor for your egg freezing journey cannot be overstated. Entrusting your reproductive health to a skilled and compassionate fertility specialist is paramount. Choosing a doctor who understands your unique needs, communicates effectively, and provides personalized care is essential for a successful egg freezing experience. 

Take the time to research and seek recommendations, ensuring you find a doctor who aligns with your values, instills confidence, and supports you every step of the way. Remember, the right doctor can make all the difference in your pursuit of fertility preservation.

Read more in What To Look For in An Egg Freezing Clinic

Not freezing their eggs sooner

We are born with all the eggs we will ever have, and lose them each month until we hit menopause and no eggs remain. Not only that, but our quality of eggs decline along with quantity. This is because eggs are more likely to contain chromosomal abnormalities (mistakes in their DNA) as we get older. 

One of the biggest mistakes individuals make is underestimating the impact of age on egg freezing. Fertility specialists often emphasize the significance of freezing eggs at a younger age, ideally before 40. Time is a precious resource when it comes to preserving fertility, and being proactive ensures a higher chance of success.

One survey study of 98 patients found that the vast majority of egg freezers showed no regret, stating that it was a good decision. But some stated that their only regret was not doing it sooner.

Overlooking lifestyle factors

Creating an optimal environment for egg freezing involves mindful attention to various lifestyle factors. Mistakes are made when individuals underestimate the significance of a balanced diet, regular exercise, and healthy habits. Embrace a nutrient-rich diet, prioritize stress management techniques, and maintain a consistent sleep routine. By incorporating these lifestyle choices, you not only enhance your overall well-being but also create an environment conducive to successful egg freezing.

Skipping the pre-freezing fertility assessment

Embarking on the egg freezing journey without a comprehensive fertility assessment is akin to navigating uncharted waters without a map. To avoid this mistake, consult a knowledgeable fertility specialist who can evaluate your ovarian reserve, hormonal levels, and overall reproductive health. This pre-freezing evaluation allows for a tailored approach and provides valuable insights into your ovarian reserve, which can help predict how well your body would respond to egg freezing medications. Knowledge is power, and a thorough assessment is the first step towards a graceful and informed decision.

Ignoring emotional support

The egg freezing journey can be emotionally charged, as it involves contemplation of one's fertility and future family-building aspirations. Neglecting emotional support during this transformative process is a common yet avoidable mistake. Seek a support system composed of loved ones, therapists, or support groups who can provide guidance, empathy, and understanding. Emotional well-being is the cornerstone of this journey, and by tending to it, you pave the way for a more harmonious experience.

If you freeze your eggs with Cofertility, our inclusive online spaces allow you to connect with others going through the process at the same time.

Thinking it’s an insurance policy

One misunderstanding people make when freezing their eggs is viewing it as an insurance policy against future infertility. While egg freezing does offer a chance to preserve fertility potential, it's important to understand its limitations and set realistic expectations.

Egg freezing is not a guarantee of future pregnancy. It is a proactive step to preserve eggs at a younger age when they are more viable, increasing the chances of successful conception later on. However, there are various factors that can influence the outcome, such as the quality of the eggs, overall health, age at the time of egg freezing, quality of the egg freezing clinic, sperm health, and the chosen fertility treatment in the future.

It's essential to have a clear understanding of the success rates associated with egg freezing and the potential limitations. The chances of achieving a successful pregnancy with frozen eggs can vary depending on individual factors and the quality of the eggs at the time of freezing. Consulting with a fertility doctor can provide valuable insights into your specific situation.

Failing to plan for the future

Freezing eggs is a remarkable step towards reproductive empowerment, but it should not be seen as a standalone solution. A mistake often made is neglecting to plan for the future beyond egg freezing. Engage in discussions with your fertility doctor about next steps, including potential pathways to parenthood, such as in vitro fertilization (IVF). By mapping out your future plans, you embrace a sense of preparedness and ensure a seamless transition when the time comes to utilize your frozen eggs.

Paying too much

One of the common mistakes people make when freezing their eggs is not fully understanding the costs involved and potentially paying more than necessary. The pricing structure for egg freezing can be complex and opaque, leading to confusion and unexpected financial burdens. Average egg freezing cycle costs range from $10,000 - $20,000 for consultations, testing, ultrasounds, medications, and the egg retrieval, plus the ongoing cost of annual storage.

If you work with Cofertility, you can rest assured that you’re getting the best price when working with one of our partner clinics. Through our Keep program, we offer our members partnerships and discounts to lighten the financial load of egg freezing, as well as access to our member community.

Or, in our Split program, which offers women a chance to freeze your eggs *for free* when donating half the eggs to a family who cannot otherwise conceive. If you qualify for the program, every expense associated with the egg freezing procedure —  medications, supplements, travel if necessary, insurance, and 10 years of storage — are completely free of charge. We don’t even need a payment or credit card up front, as the family you match with covers all the expenses.

Let us help you freeze those eggs!

If you are interested in freezing your eggs, we can connect you with a fertility specialist for a consultation to discuss your specific situation. Our Freeze by Co platform is making egg freezing more empowering, positive, and accessible — even free — when you give half of the eggs retrieved to a family who can’t otherwise conceive.