Playing God?

Years ago when I was still in my 20’s, not long after I found out I carried the BRCA1 mutation, and after I enrolled in a research study through the NIH (National Institute of Health), a researcher involved with a physiological program through a University (I don’t remember which now), interviewed me over the phone.  She was gathering data from different BRCA+ women, discussing their psychological and emotional states after finding out they were mutation carriers, as well as asking other questions regarding future health decisions.  I specifically remember her asking me about genetic embryonic screening, if it would be something I would consider, eliminating the 50/50 chance of passing the mutation down to my children.  At the time, it was a relatively newer advancement and most likely not covered by insurance (though I did not look into it at that time), but the question itself has stayed with me for years.

When my husband and I were trying to conceive our first child (he’s a little over 2 now), it took us a lot longer than we anticipated.  I actually miscarried fairly early on, only about 2 months after initially trying, but then it took over a year to conceive again (I was 35).  Luckily that time, I carried a healthy baby boy to full term.  We were actually in the process of investigating IVF.  We already met with a fertility Dr multiple times and started the process with blood work and screenings to test for other possible genetic issues.   It was literally the month before we were going to start the IVF process that we finally conceived.  I remember calling the Dr’s office to inform them I was in fact pregnant and the receptionist said it actually happens more often than you think.  Perhaps women finally relax knowing they’re going to take steps towards IVF, which allows their bodies to simply create a more inviting atmosphere for conception?

Fast forward to today and we’re investigating IVF once again, but this time for very different reasons.  I mentioned in my previous blog post, that the best measure against ovarian cancer, is an oophorectomy.  As of late, some women have actually been pursuing these at fairly young ages, 20’s and early 30’s.  They are freezing their eggs beforehand, eliminating the need for ovaries when it comes to conception because you can actually carry a perfectly healthy baby to term through the IVF process without ovaries. They will still have their uterus and cervix. Amazing right?!

My Oncologist asked if I considered freezing my eggs prior to chemo, but that was more to help protect them against chemo.  Zoladex shots were proven to help, but it was not a guarantee.  There was so much going on at the time of my cancer diagnosis that the thought of freezing my eggs was way too overwhelming.  But luckily, the Zoladex shots did work and my egg quality is still great (refer to my last post “The Story of the Eggs”).

So now the decision of IVF for us, comes down to timing.  I turn 39 this August, which leaves about 7- 8 months of wiggle room, if that, since my ovaries will need to be removed by 40.  So why not take the IVF route?  Fertility Dr said IVF has 80% chance of conception, you can choose the healthiest embryo(s) to implant, you can possibly choose a boy or girl, and screen for the BRCA mutation (if insurance covers the cost since I am a cancer survivor), on top of other genetic abnormalities.  Hmmmm…. I thought to myself as I sat across my Dr at a circular marble table in front of a faux-fireplace (our Dr likes to have a relaxing, conversational atmosphere).

There were a lot of thoughts flowing through my mind in that “Hmmmm….”!  It’s a bit out of this world, futuristic to think one could possibly choose out of a lot of embryos.  IVF has been occurring for decades now, but being in the driver’s seat is a whole other story. You’re the one making these decisions that directly impacts your family’s future.  So I found myself asking if it’s normal to feel hesitation and ambivalence about this approach?  Is it normal to feel a bit guilty about “playing god”, so to speak?  I mean in a sense you are playing god on multiple levels; possibly choosing the sex of your baby, separating healthier embryos, and so forth.

In thinking it through since my last appointment (last week), I’ve found a bit of comfort on both sides of the fence.  Conceiving naturally is the easier approach, in that you don’t have to endure the IVF process, and provides a sense of contentment that nature did its job, our 2nd baby was “meant to be”.   IVF, however, also provides a sense of comfort, in that embryo viability is strong and you possibly know 100% it does not carry the BRCA mutation, which in its own can be extremely comforting for many BRCA carriers who have struggled with either prophylactic procedures and/or cancer treatment.

Of course there are no guarantees in life, even if you do implant a healthy, non-BRCA embryo.  And if you are a BRCA mutation carrier with family history of ovarian cancer, deciding to freeze your eggs and pursue an opphorectomy at a young age, IVF is your only choice to conceive, which is certainly not an easy path to take!

No matter what decision one makes in their BRCA journey, it will always have a mix of positives and negatives.  There is no crystal ball, no clear path in life.  We make decisions to the best of our abilities.  Sometimes those decisions work out and sometimes they don’t.  Life can be challenging enough, so let’s be kind BRCA sisters.  Let’s be kind to ourselves and allow the process to proceed with whatever our best intentions are.

I will keep you posted on our continued journey and welcome others to please share their own!!

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