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How fertility preservation gives young people with breast cancer ‘peace of mind’

Breast cancer treatment for women of reproductive age can hurt their likelihood of conceiving. Having the option to freeze eggs or embryos can make all the difference.

Betsy O’Brien Phillips had long dreamed of becoming a mother. But after finding a lump in her breast and being diagnosed with breast cancer at age 35 in late 2012, her future appeared unclear.

“I was definitely in shock. You are focused on the surviving aspect, and you don’t know what the rest of life looks like,” O’Brien Phillips, now 44, told NBC’s Kristen Dahlgren. “As some point ... somebody said, ‘Are you going to freeze your eggs?' I hadn’t thought about it.”

O’Brien Phillips’ treatment regimen included chemotherapy, surgery and radiation followed by five to 10 years of hormone suppressing treatment. According to the American Cancer Society, 3 in 4 breast cancers are “hormone receptor-positive,” meaning hormones can stimulate the cancer to grow. Most hormone receptor-positive breast cancers grow in response to estrogen, including O'Brien Phillips' — hence the treatment to shut down her ovaries and effectively stop the flow of estrogen.

The treatment, while saving her life, was also jeopardizing her chance at motherhood. She wouldn't be able to start trying to get pregnant until her mid-40s because of the treatment, and the natural decline of her fertility during those years could have an impact, too. But just a few weeks before she started chemo, she was able to meet with Dr. Mitchell Rosen at University of California San Francisco's Fertility Preservation Program.

O'Brien Phillips during chemo.
O'Brien Phillips during chemo.Courtesy Betsy O’Brien Phillips

“Having options available to you is really important,” Rosen told Dahlgren. “(If) you don’t have that option (to freeze your eggs) and then it’s 10 years down the road, you can’t turn back the clock.”

In Rosen's experience, the No. 1 reason breast cancer patients don't decide to freeze eggs or embryos is health insurance stress, he said. Only 11 states require insurers to cover fertility preservation in cancer patients, according to the Alliance for Fertility Preservation, but having time to research what your insurance will and won’t cover might not be feasible when you have start cancer treatment as soon as possible.

Every year, about 13,000 U.S. women under 40 are diagnosed with breast cancer. A recent study of breast cancer survivors trying to conceive after chemotherapy co-authored by Rosen found that 76% percent had ovarian function return. Of those, half gave birth without fertility treatments. Of the rest, 70% were able to conceive using eggs or embryos frozen before cancer treatment.

After meeting with Rosen, O’Brien Phillips froze her eggs, hoping that would give her a better chance of having a baby. Rosen said he recommends his patients who want to conceive after cancer treatment try intercourse first, but ideally they'll have eggs or embryos frozen before treatment as a backup.

O'Brien Phillips after her breast reconstruction.
O'Brien Phillips after her breast reconstruction.Courtesy Betsy O’Brien Phillips

“Having the eggs was a huge peace of mind in terms of getting on with my life,” O’Brien Phillips said. “That gave me the gift of time to find the right person that I was going to end up with and use (my eggs).”

She married her husband, John, in 2019, and underwent in vitro fertilization about eight years after freezing her eggs. To do so, she paused her hormone suppression treatment and is now pregnant with a baby girl due in June. She may restart her hormone suppression treatment after giving birth, but for now, she's taking it one doctor's appointment at a time.

After years of breast cancer treatment, Betsy O'Brien Phillips, 44, is expecting her first child with husband John in June.
After years of breast cancer treatment, Betsy O'Brien Phillips, 44, is expecting her first child with husband John in June.Courtesy Betsy O’Brien Phillips

“I wouldn’t have obviously expected when I was diagnosed with cancer that it would end up this way,” O’Brien Phillips said.

She feels grateful for the new addition to her family.

“She’s just going to be such a gift. Being able to experience those moments that we weren’t sure that they were going to happen will make it that much better,” O’Brien Phillips said.