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Egg freezing makes babies possible after breast cancer treatment


"Capital (Annapolis, MD)"

10-14-13

Oct. 11--A year had passed since Amber Blose's son Cameron died after being born four months premature. Then she received more heartbreaking news: She had an aggressive form of breast cancer.

In the months that followed, the 32-year-old Glen Burnie woman would undergo surgery, chemotherapy and radiation therapy to remove the tumor.

The treatments would greatly diminish Blose's fertility.

Blose wanted so much to try for another baby.

"I want to have a baby, so what do I have to do to do that?" she said.

A week later, she met with her oncologist at Anne Arundel Medical Center to discuss her treatment. That same day, she met with a fertility specialist and made a plan to freeze her eggs before treatment so that after her recovery the couple could try again.

More women diagnosed with cancer are turning to egg freezing to preserve their fertility since October 2012, when the American Society for Reproductive Medicine stopped labeling the technology as experimental, said Dr. Gilbert L. Mottla, a physician at Shady Grove Fertility Center who treated Blose.

"That changed everything," Mottla said.

Doctors used to utilize a slow-freeze process that could create ice crystals, damaging the eggs. Today, the eggs are preserved through a flash-freeze process called vitrification.

The newer system has a 90 percent success rate when it comes to protecting eggs from damage during freezing and thawing, Mottla said. This is compared to previous thawing success rates of 40 percent to 50 percent, he said.

Egg cells are extremely sensitive to chemotherapy, Mottla said. A 25-year-old woman who undergoes chemotherapy may find herself with the fertility of a 35- to 40-year-old woman. The treatments also can make a woman sterile.

Using vitrification, doctors remove and preserve a woman's egg cells before she undergoes treatment.

Women interested in egg freezing are urged to make an appointment with fertility specialists when they learn they've been diagnosed with cancer.

Shady Grove's doctors often see patients the same day they are diagnosed, since doctors don't want to delay cancer treatment.

"We want people to get an immediate consultation," Mottla said.

Blose, however, had her lumpectomy before the egg freezing.

Three weeks later, she began the two-week process of injecting fertility hormones daily to develop multiple eggs.

Blose was nervous about giving herself shots.

She sat down with the doctor and her husband, Chris, to learn about each medicine and how to administer it.

After the second day, Blose was a pro at using the needle. For two weeks doctors watched her to see if eggs were growing.

"I had eight of them, and Dr. Mottla was OK with that," she said.

During a 15-minute process, the eggs were retrieved vaginally through a needle guided by use of a sonogram, Mottla said. Blose was under light anesthesia throughout the egg retrieval.

In many cases, Mottla said, chemotherapy begins the next day. Blose started a week later.

Her last cancer treatment was March 25.

To her surprise, she got pregnant naturally the next month.

"That was a huge surprise," Blose said. "My oncologist was like, 'You didn't want to wait, did you?'"

The couple are expecting a boy in late January. Blose is under close watch by Dr. William J. Sweeney of Annapolis.

Blose will keep her eight eggs frozen at Shady Grove, which charges $360 a year. She says they might need them later.

But the couple has discussed donating the eggs to other women, once they have decided they are done having children.

The center has an egg bank where women donate eggs, and it freezes and thaws eggs daily, Mottla said.

Mottla says there are small risks to the procedure, like those associated with in vitro fertilization. These include problems associated with light anesthesia or overstimulation of eggs, which is possible but happens rarely.

Oncologists have studied whether increased estrogen levels during the two weeks of fertility treatments prior to a procedure could affect a woman who has breast cancer. But Mottla said a woman would need to have months or years of increased estrogen to have a problem.

It's too early to say how many more women are turning to egg freezing before treatments. But Mottla said he has seen an increase since last fall.

"It gives women a unique sense of hope at a time when they have a great challenge ahead," Mottla said.

___

(c)2013 The Capital (Annapolis, Md.)

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Copyright "Capital (Annapolis, MD)" 2013

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