The experiences of fertility preservation

Charlene Purdy shares the outcome of her master’s thesis: Exploring the subjective experiences of fertility preservation among cancer survivors in South Africa.

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Globally cancer is characterised as a complex and life-threatening disease, affecting one in every five women and one in every six men, and has been ranked as one of the top causes for morality worldwide. 

Due to advance cancer treatments developed over the past decade, cancer survivors are living longer, however, treatment side effects remain a concern. Impaired fertility is classified as one of the main side effects that affects both women and men. Many patients and their families referred to the combination of a cancer diagnosis and facing possible infertility as a “double jeopardy” or “dual trauma.” 

Oncofertility

Oncofertility refers to the nexus between infertility and oncology therapy. It entails oncologists referring patients who want to conceive in the future to a fertility specialist to preserve their biological material for future use. 

Although fertility preservation for cancer therapy is a relatively new subject, it has become increasingly crucial to enhance cancer survivors’ quality of life. 

Case studies

Ten women aged between 26 – 42 years old, residing in Cape Town and Johannesburg who had undergone fertility preservation prior to beginning cancer treatment, participated in one-on-one interviews to discuss their experiences with the procedure. Seven participants had breast cancer, one had lymphoma and the remaining two had ovarian cancer. 

Temporary psychological distress

These women reported that receiving a cancer diagnosis was unexpected and demoralising, and that it disrupted every aspect of their personal, social, and marital lives causing temporary psychological distress. “I went into depression, and I was angry, it (cancer) was an invasion.” (*Diane, 36). 

The decision to undergo fertility preservation before undergoing treatment was straightforward, despite the negative aspects of fertility preservation, such as lack of information, time constraints, financial implications and potential risks involved. 

The aspiration for biological motherhood with the aim of “completing the circle [of life]” is considered inevitable, unquestioned, and the driving force in the uptake of fertility preservation. (*Zandre, 26).

The overall experience compromised certainties, such as their inherent need for biological motherhood and uncertainties, such as the potential risks involved, fertility preservation process and lack of information. 

Hormone injections

It’s evident that although some women expressed feeling “nervous and anxious” undergoing hormone treatment (*Sam, 29), all the women remained committed to the procedure, since they felt that hormone therapy was their only option to “biological child or no child at all.” (*Diane). 

Many reported facing their fears of needles; the hormone injections for many were “flippen hard.” (*Jane, 34). However, women felt that the injections prepared them for their upcoming cancer treatment, which for many was “worse than the chemo.” (*Jodi, 30). 

Physical and emotional toll 

Undergoing roughly two weeks of hormone therapy as part of fertility preservation resulted in some of the participants experiencing temporary physical changes in their bodies. 

Hormone treatment in preparation for gamete harvesting left several women feeling uncomfortable, bloated, and tearful which for some resulted in some disruptions in their daily lives, such as inhibiting “physical” (*Nicole, 29) and “social” (*Rochelle, 28) activities. The physical and emotional toll resulted in social withdrawal for many participants. Other factors, such as having cancer also contributed to social withdrawal. Women reported that they were already emotionally volatile after receiving their diagnosis and that undergoing hormone treatment exacerbated their volatile emotional status and isolation. 

Stronger and empowered

For several women, fertility preservation was a happy experience and the process ended on a high note with them having harvested numerous eggs. However, their high spirits were brought down promptly with the harsh reality of having to undergo cancer treatment. Despite facing a life-threating disease the women reported that the process has produced a feeling of being stronger and empowered, while appreciating and living life to the fullest.

*Not their real names.

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