This is what I wrote in an on-line discussion today about “loss of fertility” among young(er) women with BOT. Am I wrong to want to celebrate my health rather than mourn my “loss of fertility”?
….. it’s a really personal decision and one that – due to our own personal feelings, beliefs, circumstances and thoughts – is not always one that aligns with normative expectations around “family” and “motherhood”. And this can be very difficult to navigate in conversations – whether with family, friends, medical providers or strangers. I am 35 and have no children. I had diagnosis and surgery in July this year. I have always been conflicted about norms surrounding family/expectations of what a family is or should be – including if/how one should/n’t have children – and have always considered adoption as part of my family (my Dad is adopted). However, as you say, the choice being “made for you” through surgery/treatment is very different and this is, to some extent, what I experienced in July. But, that said, we should remember to celebrate our own physical health, excellent prognosis and longevity, and celebrate our strengths in dealing with a BOT diagnosis regardless of decisions we make (or are unable to make) relating to our fertility. Whilst fertility is of course a concern for some women – and more of a concern for some than for others – I do find it challenging at times that the focus on much of the discussions around gynae conditions/cancers centre on fertility. This is something that I feel really strongly about. I want to find spaces to talk through a whole range of issues relating to being a young (relatively!) woman who has had a radical hysterectomy and has been so fortunate that what was thought to be stage 2 OC was stage 2 BOT. I want to talk about hormones, oestrogen patches, sex after a radical hysterectomy, how to talk to/tell a new partner about this in the future, how to get around the angst of moments when I think about a 15 year follow-up period etc. But that is not something I have found easy to do. In particular, it has been hard to celebrate my successful treatment in some spaces due to others’ assumptions around my feelings linked to my “loss of fertility”. I had surgery the day following diagnosis and had little time to process but the CT indicated some spread so I knew what I had agreed to (TAH) prior to surgery. We did discuss fertility-sparing surgery but I was (again, it’s personal) eager to ensure that my health was maximised. I didn’t want to take the chance of maybe deciding to try to get pregnant in the coming years and, at the same time, risk spread/recurrence/cancer and then either discover I didn’t want to have a biological child, that I couldn’t get pregnant, or that I did have a child but also ended up seriously ill as a result (thus putting my child at risk of being without a mother). With the CT results in hand, my surgeon was in agreement. After surgery, it was clear that this was absolutely the correct decision and from a treatment/surgical perspective was the only option anyway: the tumour had spread (stage 2) and what was thought to be a simple cyst in the right ovary was found (during pathology) to be a second BOT. xx
jozi-ovari 
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