Non-traditional Family Building Planning

Abstract

Fertility patients frequently report living in a binary world, one divided between the fertile and the infertile. However, adolescent and young adult (AYA) cancer survivors who later learn they will have difficulty conceiving or bearing children have similar reactions to their diagnosis, but with some marked differences, as the injustices of their reality are much more complex. They frequently feel betrayed because the very treatments used to save their lives may be the ones that have caused them to be unable to have biogenetic children of their own, unable to fulfill their need for generativity and their longing for a return to normalcy [1]. In 1999, it was predicted that by the time this book is published [2012] one in every 250 young adults would be a survivor of cancer [2]. Although the ability to have biogenetically related offspring has been the topic of countless articles and books published in the area of reproductive health and medicine, less than half of adolescent and young adult cancer survivors can recall their oncologist or other members of their medical team discussing fertility related issues, including fertility preservation, prior to commencement of treatment [3–10]. Of those who did remember their physicians providing facts, advice, details, or statistics about fertility, many believed the information they received was inadequate and presented in an untimely manor [8–13].

Having cancer has been quite scary and physically exhausting. I felt sick and was worried that I would die. After the treatment put me into remission, I was nervous that I might never have a child. At the same time, I was also concerned I would pass my bad genes to my children and they eventually would get cancer too.

Since finding out that as a result of my cancer treatment I am sterile, many of my friends walk on eggshells when they are around me. I can see by their sideway glances that they are trying to be sensitive and considerate when speaking about their pregnancies and their children. I feel it is my job to reassure them that these are not forbidden topics.

I am quite fortunate. As soon as my oncologist informed me that my cancer treatment would cause infertility, my middle sister told me that when I wanted to become pregnant and have a child, she would like to donate her eggs to me. The reproductive endocrinologist with whom we consulted told us that quite often sisters donate eggs to sisters. Luckily, my middle sister Rita is 23 years old, and is eligible to help me out.

Not to be outdone by Rita, my youngest sister Melody offered to act as our gestational carrier, should I be unable to carry a baby to term. My husband and I will have to wait until Melody first has her own child to see whether she still wishes to be pregnant with our child. However, two of my closest friends who already have children have also volunteered to carry our child.

I am choosing not to disclose to my friends that Rita will act as my egg donor because I believe that the information about my child’s conception should belong to my child and that Jake and I have the obligation to be the first ones to explain the facts about his or her conception. Only after I disclose to my child, do I intend to tell others. Of course, everyone will already know that Melody acted as our gestational surrogate because I won’t ever be pregnant. My doctor told me that if one of my friends acts as our gestational carrier, I will have to tell her that we used Rita’s eggs to conceive.

However, this experience also has been very humbling. I do not think I would have been the type of sister or friend who would have gone through controlled ovarian hyperstimulation or pregnancy for anyone other than me. This has caused me to take a good, hard look at myself and my life. I hope I become a better person as a result of having gone through cancer treatment.

Joanna, Adult Cancer Patient