Many of you have asked me whether I think all the infertility treatments I underwent over the past three years contributed to my getting breast cancer. My short answer is, no. My long explanation follows:
For those of you just tuning in, Paul and I (well, really ME — not so much Paul — physically (but he was on the emotional roller coaster with me every step of the way!)) did 10 IUI’s, 4 fresh IVF retrievals and 2 frozen embryo transfers. None of which resulted in a baby. It was an emotional three years filled with tears, anxiety, desperation, angst, fights followed by hugs, high’s & low’s, pins & needles and — as you might imagine — TONS of hormone injections to my stomach and ass!
A typical IVF round costs a ton of money (and isn’t covered at all by our insurance) and is a pretty lengthy process. First you go on birth control pills for about a month, then you layer in twice daily Lupron shots to your stomach for about 2 weeks. This part is so that the doctor can control your cycle and ensure that you aren’t ovulating (in short, Lupron suppresses ovulation). Eventually you will get what seems like your period, but it’s really just break through bleeding (I think this is accurate, I’m a bit rusty on the technicalities of IVF now that I’ve had to become a cancer expert). On the second day of your fake period, you go in for your baseline ultrasound and blood work. The doctor will check to see if there appear to be follicles, confirm there are no cysts and checks your blood hormone levels to ensure that if you are given stimulation drugs, the round will likely be fruitful. If and when you pass this stage (I’ve been stopped at this stage two or three times and it’s devastating because you feel like you are losing precious time and you just get really mad at your body for failing you), you then layer in the follicle stimulation drugs. Depending on what your protocol you are on (we tried them ALL) you may have to give yourself up to 8 shots daily for 10-12 days. Sounds fun, huh?
The doctor closely monitors your blood work and performs ultrasounds throughout stimulation to ensure all is well — that meant lots of early morning road trips down to Mountain View for Paul and I. Eventually the day comes when you get to “trigger”. Exactly 36 hours before your retrieval is to take place, you give yourself an HCG shot to the belly. The HCG shot tells your brain to tell your ovaries it’s time to ovulate. They time it so that on retrieval day, your body releases the follicles and eggs. At NOVA they put me under twilight anesthesia — which meant I was awake for the procedure but feeling no pain! — and they aspirated out any and all eggs from my stimulated follicles. Sexy, right?
After that, they put sperm and egg together and hopefully you get an embryo. After that, they let the embryo(s) grow in the lab for a few days. My doctor liked to get them back inside me as quickly as possible. He is of the mindset that the body is a better environment for them than the lab. But they do watch them initially to “grade” the quality of the embryo. grading helps the doctor determine which embies to transfer (which are good versus which are so-so). Then you have a certain number of embryos put back inside of you and you go through the dreaded 2-week wait — wondering if they took. Wondering if it worked. Wondering if you should have taken time off work and laid flat on your back the first few days. Wondering if that glass of wine you just had killed your chances of success. Wondering if that sushi you just ate killed your chances of success. Wondering if that ab workout at the gym caused them to fall out. etc
You are supposed to wait the full 2 weeks and then go to the doctor for a blood test to confirm if it worked or not. But you know me, I was peeing on home pregnancy test sticks daily. I single-handidly kept Walgreens in business by buying a zillion home pregnancy tests. So, it goes without saying, that I always knew our IVF’s were unsuccessful. We did this “fresh” retrieval process FOUR times.
We also did TWO FET’s or Frozen Embryo Transfers. Some of my retrievals yielded more embryos than we wanted to transfer (not lookin’ to be octomom over here!). So we put a few on ice. The prep on your body for a FET involves lots of hormones. It is less rigorous than a fresh stimulation, but you do have to pump yourself up with lots of estrogen to get your uterine lining thick and ready to receive the embryo. You also have to take a handful of progesterone shots to the rear with a long-ass (no pun intended) needle. This one Paul had to do for me — he would’ve made a good doctor! Even after you prep your body, there is no guarantee that your embryos will survive the thaw process. It’s a very stressful time. Thankfully, all of our embryos thawed like GD champs (must’ve been the Buffalo in us both!). Once you get your thaw report, you set your transfer date and then you go through the dreaded 2-week wait AGAIN. We had one FET round result in a positive pregnancy test, but my body quickly determined that the embryo was not “right” so that positive, turned to a negative within a day. It was so sad I can’t even describe to you in words. Quite honestly, ALL of it was sad. To turn up empty after each round was terrible. Indescribable and horrible. This sort of thing can make or break a marriage. Thankfully, it brought Paul and I closer and anchored us together — but we had our fair share of human moments and shouting matches. Especially me, since I was hopped up on lots of hormones 😉
Finally, we gave up on my eggs, and moved on to a donor. It was while I was prepping my body for my last FET with our one remaining biological embryo — and then again when I was prepping to receive the donor embryo (which would have been her egg and Paul’s sperm) that I noticed the persistent lump in my breast. The prep for a donor round is the same as the prep for a FET. Lots of estrogen to get your lining ready. So, at this point, we are talking about 3 years straight of countless hormones being pumped into my body. Did the thought cross my mind that those hormones may have caused my body to go berserk and start creating abnormal cells that then went on to give me breast cancer? Of course. After I really thought it through, do I still think that? No. And here’s why.
When they bioposed my tumor I still had 4 estrogen patches stuck to my belly feeding me hormones in anticipation of the donor transfer. The receptor results from that biopsy indicated that the cancer was Her2/Neu negative, progesterone negative and only weakly positive for estrogen. On the day of my surgery, which was approximately 4 weeks after diagnosis (read: four weeks after I removed the estrogen patches and discontinued them altogether), they removed my tumor. We later had an Oncotype test performed on the tumor tissue from surgery day, and my estrogen receptor was a strong negative. Which means my cancer is NOT fed by estrogen, or any hormones, for that matter. That means it came back only weakly positive for estrogen at a time when I was hopped up on a ton of estrogen for the donor round. I almost feel like an am an example that proves IVF doesn’t cause breast cancer*. If anything, I believe that all those hormones helped me catch the tumor. I believe that they some how accelerated their growth, and without the drugs, I might not have been able to catch it at Stage 1. I mean, think about it. I had a mammogram 11 months before I found this cancer — and that mammogram came back clean.
Additionally, I read somewhere that a tumor 1.5cm in size (which mine was) would’ve been present in the body for 8-10 years. Which means, when I had that mammo 11 months ago, I had cancer, in fact, I’ve had cancer for a very long time — I had it before I started infertility treatments — it was just hiding out in my body — I just didn’t know it. Yet, after all these drugs, I was able to feel it when I gave myself a self exam. Go figure…
Look, I also hate to say the cliched “everything happens for a reason” line. But I think it’s applicable here. I wasn’t really jazzed about moving to a donor round. Who wants to give up on having their own biological child? It took me a good 6 months to move forward with our initial donor round. Then I was diagnosed the week our donor started her follicle stimulating hormones. I was sad to have to postpone the whole thing on my end because we’d already been through so damn much in three years. THEN when the donor F’ing failed to produce any viable eggs, I thought I’d totally lose my shit. But, hindsight is a beautiful thing. I am now WAY more comfortable using a donor. It’s become patently clear to me that I just don’t have good genes to pass along. And now that I’ve gotten breast cancer at such a young age, I am happy to avail myself of a young woman who is willing to help out an infertile couple. So, that’s how I’m looking at all of this.
So, we are dealing with my cancer one day at a time. Trudging through chemo and all of it’s lovely side effects. But the bright side is (drum roll please) we are moving forward with another (proven) donor! I have a great feeling about this one. I honestly believe we will finally get our miracle baby! YAY for donor eggs!
* For those of you who are truly interested, I believe that there is one study out there — out of Australia — that examines IVF and BC relatedness. I didn’t bother to read more than the summary of the article — but I think it said there is a very weak correlation in young women (read: 20 year olds) who undergo IVF who then go on to get BC.
PS – this is all just my opinion and how I am choosing to view my situation. I’m not a doctor nor a scientist. So take this post as you will 🙂