My fertility uncertainties after Hodgkin lymphoma and a stem cell transplant

Over the years, my opinion on the biggest challenge I’ve faced as a result of my Hodgkin lymphoma diagnosis has changed a few times.

During treatment, I thought the hardest part was recovering from my autologous stem cell transplant, when I had to stay in the hospital for four weeks and couldn’t go outside. After that, the biggest challenge became coping with my fear of recurrence. I had a period of intense anxiety and depression, though medication and daily meditation eventually helped me get to a better place.

Now that I’m three-and-a-half years into remission, I’m coping with the possibility that the stem cell transplant made me infertile.

Fertility preservation before my stem cell transplant

I first became aware that this was a possibility when I was diagnosed with stage IIB Hodgkin lymphoma in October 2013. I was just 21 years old. When I had a recurrence after 12 rounds of chemotherapy, my oncologist in Nacogdoches, TX, referred me to MD Anderson for a stem cell transplant.

My MD Anderson care team explained that the high-dose chemotherapy I’d need to prepare my body for the stem cell transplant would be aggressive, and it would almost definitely harm my fertility. I got a referral to see MD Anderson oncofertility specialist Dr. Terri Woodard to discuss my fertility preservation options.

Dr. Woodard explained that I could freeze either my eggs or whole embryos, though the latter option would give me the best chance of having biological children.

I decided to speak to my boyfriend, Daniel, about freezing embryos. We’d been dating for a year and a half and were seriously committed to each other. But broaching that conversation was difficult because starting a family wasn’t quite yet on our minds. Thankfully, Dr. Woodard and advanced practice nurse Deborah Holman gave me talking points to make the conversation less awkward.

A reason to hope

Daniel was very much on board with my decision, so I went through in-vitro fertilization, or IVF. In the end, only one egg successfully fertilized, but that one embryo helped me through my stem cell transplant in November 2014.

During treatment, everything was so scary and uncertain. Focusing on things that were certain gave me comfort. I was sure that I wanted to marry Daniel, and I was sure that I wanted to have children with him. This one frozen embryo gave us that chance. And it gave me the strength to push through treatment because it allowed me to envision my life after cancer.

Coping with fertility uncertainties

Six months after my stem cell transplant, Daniel proposed during a trip to Grand Teton National Park in Wyoming. We got married on Nov. 19, 2016, one day shy of the two-year anniversary of my stem cell transplant.

Daniel and I haven’t tried to start a family yet. But I face the uncertainty surrounding my fertility every day. Because I’m active, healthy and don't have any external scars that are noticeable, a lot of friends and family are asking when we plan to have children.

We’re trying not to get discouraged by the odds. We’ve spoken with couples who conceived naturally after a stem cell transplant, so we’re hopeful we’ll become another success story. And we still have that one frozen embryo. We know that it’s not a guaranteed pregnancy, but it still brings us hope. If neither option pans out, Daniel and I plan to adopt.

While it's very difficult to accept that I might not get to have a child that looks like me and Daniel, we know parenthood will be great, regardless of how it happens for us. After all, Both of us want children, and we'll do whatever it takes to get there.

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