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Fertility Preservation Before Chemotherapy: A Personal Account of Uncertainty and Hope

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Fertility Preservation Before Chemotherapy: A Personal Account of Uncertainty and Hope
Fertility PreservationChemotherapyBreast Cancer

After a breast cancer diagnosis at 31, Arathi Devandran faced a 30-minute decision to undergo fertility preservation before chemotherapy. The process led to 12 difficult days of treatment and the freezing of 12 embryos. Four years later, she still grapples with the uncertainty of motherhood but is learning to live with it.

Two weeks before chemotherapy, she had 30 minutes to decide whether to undergo fertility preservation. The choice led to 12 difficult days of treatment and 12 frozen embryos.

Four years on, she still has no clear answer about motherhood, but is learning to live with the uncertainty. After a breast cancer diagnosis at 31, Arathi Devandran underwent fertility preservation before starting chemotherapy, giving her future self the possibility of becoming a mother. Add CNA as a trusted source to help Google better understand and surface our content in search results. It was 9.30pm as the doctor walked my husband and me out of his office.

It was New Year’s Eve 2022 – he should have closed his clinic eight hours ago.

“In the next 30 minutes, you need to decide if you want to go ahead with fertility preservation so we can start the process today,” he said. A small laugh escaped me even though I was not amused about the situation. I was tired, it had been a long few weeks, and I was still recovering from two surgeries to remove the lump in my left breast.

Since I was married and didn’t have children, my medical team had recommended I speak with a fertility specialist to consider whether I wanted to do fertility preservation before chemotherapy started two weeks later. My hormones would need to be pushed to high levels, coaxing my body into a state where eggs could be harvested. It was going to be a lot for my body to take.

My husband went to get me a cup of hot chocolate as I stared at my hands. When he came back, I said: “Let’s do it. I want to give my future self a chance. ”This is one of the things about disease that no one tells you about.

It compresses time, collapsing decisions that should have taken years into windows of 30 minutes. But it also forcibly suspends you in the present, because the future becomes a place you cannot fully trust. , in essence, is almost entirely an act of imagining forward. Motherhood asks you to believe in a future self, a future child, a future that assumes that you will be there.

Motherhood is an act of imagining forward, says the writer, pictured with her husband – it asks you to believe in a future where you will be there. Ultimately, I was being asked to invest in that future at the exact moment that cancer was making any future feel like an abstraction. The honest to goodness truth is, I’ve never known if I wanted to be a mother.

I had a complicated relationship with my mother and the women in my family growing up, and for a long time, I didn’t want to perpetuate some of those behaviours in my own life. As I did more therapy, I began to realise that being a mother did not necessarily mean making the same choices the women before me had. I had agency to decide who I wanted to be and how I wanted to be me.

I had agency to give myself a chance to heal my own wounds around belonging, selfhood and self-worth. My husband is the complete opposite of my eternal sceptic. In one of our early conversations when we met in our late 20s, he was unequivocal about his desires: He wanted to be a father. After we got married, my hesitancies solidified.

I struggled with the idea that my life would be narrowed to a relational role, that of “mother”. I had spent most of my adulthood clawing back my identity and personhood. The idea of surrendering that again felt impossible. In the first week of the new year, we were neck deep in fertility appointments.

Every other day, I would go to the hospital for an intravaginal scan, the size of my ovaries and developing follicles measured with clinical precision. With just two weeks before starting chemotherapy, the writer had 30 minutes to decide whether to undergo fertility preservation. I injected myself with hormones up to three times a day, each injection with a longer needle than the last. I felt constantly bloated.

The heaviness around my hips, the sluggishness in my body, this feeling that my body was being stretched and ripened to do something, with no guarantee that it would amount to anything – those 12 days were some of the hardest days of my life. One afternoon, my husband saw me crying as I assembled yet another injection and took my hand.

He had tears in his eyes too, and he said: “If you want to stop this now, you just have to say the word. ” I cried harder, knowing how much it cost him to say this – my husband who probably wanted this even more than I did. I told him that we’d already crossed that bridge, the decision had been made, and I would see it through. I pushed the needle into the tummy fat and winced.

Just a few more days till it was time for the egg extraction. My egg extraction was the most painful procedure I have ever undergone. I remember waking up and screaming for medication, because I couldn’t bear the pain and it had to stop. My husband was frightened; even through my previous surgeries, he had not seen me so discombobulated with pain.

I remember very little of that day, only that they gave me extremely strong painkillers and I sank into a sweet, dark, deep sleep. The writer says her egg extraction procedure was more painful than her breast cancer surgeries. For a week after, we waited for updates from the lab. Again and again, I told him: “This was our moonshot.

If it doesn’t work out, it is okay, because we gave it our best shot. We tried. ”I am 35 years old now, an age where many of my friends are young mothers. In one friend group, I am the only one who is not.

When the last of us announced her pregnancy, I felt profound elation for her, but also a sadness I couldn’t quite name. Another friend messaged to say she was praying I would one day know the joy of motherhood. It was meant with love, though the message irked me for days. I sat with that irritation until I understood it.

The frustration, I realised, is that conversations about motherhood – the decision of whether to become a mother – are so often binary. And binary discussions are a privilege, available to those who do not have to reckon with complications like chronic disease. This was our moonshot. If it doesn’t work out, it is okay, because we gave it our best shot.

We tried. When you are ill, the question of whether you want to be a mother is not a lifestyle consideration. It is a question about your hedge towards a future, a question of trusting the possibility that things will not fall apart. It is a question that is already threaded with grief.

When I think of motherhood now, I see myself standing very still on a razor-thin line. On one side: Grief, the possibility that this choice has already been taken away from me by a disease I did not ask for. On the other: Hope, that modern medicine has made a door available, if I want to walk through it. What I have learned, standing on this line, is that there is no morality in either direction.

There is only the holding of contradictory things at once. In the four years since my breast cancer diagnosis, my husband and I have awkwardly shuffled around on our do-we-want-children spectrum. He has slowly crab-walked into a more moderate position, accepting that there could be a future where he may not be a father. And I have side shuffled towards him, into considering a future where being the mother seems less terrifying than being not-the-mother.

But the truth of parenting is that it is a continuous dance, a give and take of nurture and discipline, of one person’s instinct balancing the other’s hesitation. My husband has always been the clear nurturer of us two. But my disease has also changed things for him. He has told me, clearly, that his biggest fear is this: that we have a child, and something happens to me, and he is left to raise the child on his own.

The 35-year-old writer is now on long-term hormonal therapy and says she is “still swimming in this nebulous space of not knowing what the future holds”. So both our moves towards moderation – perhaps these are just different ways that we tend to each other and to what we have built in our partnership. The question underneath all of this is: what truly are we tending? The answer, I think, is the family we have already become.

I am now on long-term hormonal treatment for my breast cancer, still swimming in this nebulous space of not knowing what the future holds for me. Somewhere in a lab, there are 12 embryos waiting. The question of what comes next – whether my body will be ready, whether this is truly something my husband and I will pursue, what kind of mother I would even be – remains wide open.

But here is what I know: On the eve of a new year, in 30 minutes, I decided to give my future self a chance. That decision doesn’t resolve the muddy complications of what comes after. It doesn’t make the binary questions easier to bear, or the weight of them lighter.

It doesn’t tell me whether I am a woman who will be a mother, or a woman who will have chosen not to be, or a woman who simply never got to find out.is a section on CNA Lifestyle that seeks to inform, empower and inspire the modern woman. If you have women-related news, issues and ideas to share with us, email We know it's a hassle to switch browsers but we want your experience with CNA to be fast, secure and the best it can possibly be.

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