McGuinness' campaign, The Vicious Cycle, aims to raise awareness of the potential impact that cancer treatment can have on young women's fertility. Cancer Research UK, a leading charity that funds research, says on its website: "Chemotherapy can stop your ovaries from working for a while, or possibly permanently. Whether your infertility is temporary or permanent depends partly on the drugs and doses that you have."In the UK, guidelines currently issued by the National Institute for Health and Care Excellence (NICE) recommend that "people preparing to have treatment for cancer that is likely to result in fertility problems are offered cryopreservation."The extent of the impact, she adds, will depend on the type of cancer, how aggressive your treatment is, and your age when you start treatment. "For a 25 or 35-year-old, it would be much less likely to cause infertility than in a 45-year-old, because they'll have younger ovaries which will be less damaged by chemo," Dr. Rigg says. "Not all chemotherapy drugs do affect fertility, but the cocktail of drugs used for cancers like lymphoma and sarcoma is particularly aggressive."
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In Turner's case, her boyfriend Keith—who is now her husband—was totally supportive of creating and freezing embryos, despite being just nine months into the relationship at that point. But Turner was determined not to put all her eggs in one basket (so to speak), and also opted to have some of her eggs frozen unfertilized."I was actually reassured, in that same meeting, that we had time for a treatment which would hopefully secure my ability to have children," Turner says. "My mom and I went and sought a lot of information ourselves, and in the following meeting I was sent to the fertility department for a consultation, to fill me in on the options."
It dawned on me that I was infertile when I was 13 and started on hormone replacement therapy.
Unless cancer treatment is extremely urgent, it is possible for most post-pubescent, pre-menopausal women to access IVF before being treated, in order to freeze eggs, embryos, or a combination of the two. "We can stimulate her ovaries, get the eggs out, and freeze them for future use—or fertilize them with her partner's sperm, and keep those embryos in storage," explains Yacoub Khalaf, a consultant gynecologist and medical director of the assisted conception unit at Guy's and St Thomas' Hospital Trust in London.
In her 30s, though, Dobb began attending a late effects clinic for cancer survivors and met a fertility expert who, for the first time in her life, gave her the hope that she could become a mother. "Straight away he started talking about egg donation and surrogacy as a really positive way of having a family," she says.After Dobb's sister offered to donate her eggs, Dobb and partner Nisar were connected with the Donor Conception Network and Surrogacy UK, and met their surrogate Mikki, who went on to carry the embryo Dobb had always dreamed of. Dobb and Nisar now have three-year-old twins, and remain close to the woman who brought them into the world. But after decades of struggling to be taken seriously, she believes it's crucial that all the options are discussed with cancer patients, both before and after their treatment. "Hopefully nowadays most people will have the options of preserving their fertility—but, if that isn't the case, doctors need to be able to give patients all the options, including donor conception and surrogacy, so women aren't afraid of the unknown," she says.At Guy's and St Thomas', Dr Rigg believes things are improving. "There's a very big survivorship agenda driven by patients, so we're now thinking more and more about the quality of people's survivorship. It's no longer acceptable to say, 'Too bad, but at least you were cured,'" she says. "People who've been through cancer should be able to have a normal life afterwards."It's no longer acceptable to say, 'Too bad, but at least you were cured.'