'I had to fight for my babies'

By Jane Elliott
BBC News health reporter

Hilary Blackburn had to fight to have her two children

When Hilary Blackburn was diagnosed with breast cancer, she feared she would never have the children she longed for.

She learnt of her illness aged 32, just months before her wedding, and was determined not to save just her own life but to preserve her fertility and keep her hopes alive.

Hilary now has two children - but says she had to fight hard to become a mother.

Medical experts say doctors must consider the future fertility of young women being treated for cancer, and warn there is a lack of communication between the oncology departments and fertility units.

Protecting fertility

Mr Richard Kennedy, director of the Centre for Reproductive Medicine at University Hospital Coventry and Warwick Medical School, called for better collaboration between the two medical disciplines.

He said that although it was done in some areas it was not universal.

Mr Kennedy, an advisor to the Human Fertilisation and Embryology Authority, said: "Clearly there is still work to be done to ensure that those who are looking after women with cancer - and especially breast cancer - consider that woman's fertility, if she is within child-bearing years.

I was aware that the clock was ticking Hilary Blackburn

"The problem is that cancer centres are not always working closely with infertility centres that can provide information and treatment to harvest the eggs.

"It requires greater collaboration in order to put together that package and I don't believe that is being done nationwide."

Mr Kennedy said couples should all be provided with easily understood information that would set out all their options, helping them to make fertility decisions at a time when they were facing many other difficult issues.

Hilary had two children naturally, despite having stored some embryos

Hilary, now 38, from West Sussex, agrees that women like her need more practical help.

"I was very well aware that the chemotherapy could have an implication on my fertility," she said.

"I was aware that the clock was ticking.

"My GP talked through the options.

"The consultant was pessimistic, but supportive, and it was clear that she thought I should focus on the treatment rather than worrying about my future fertility, which from a young woman's perspective is quite a hard thing to follow."

Research

So Hilary and partner Jason dedicated their energies into researching fertility issues.

They searched out the information they needed online and then presented them to the doctors.

"I only got the information because I actively pursued every avenue I could find, trying to achieve it," she said.

"I had to ask for every single piece of information which related to my fertility issues.

"I felt completely isolated and rather bewildered by the enormity of the decisions and implications of those decisions.

"There was also a very large time pressure which did not help," she said.

Treatment regime

Fortunately, Hilary's consultant was helpful and receptive and within days of having her cancer removed Hilary was starting on treatment to harvest her eggs. About 20 eggs were harvested and 13 embryos fertilised and stored.

"It was a bit of a whirlwind situation, I can hardly remember it," she said.

"I began my chemotherapy pretty much straight after that."

During the chemotherapy Hilary was prescribed the drug Zoladex - a hormonal therapy - which temporarily halted her periods during treatment.

"My feelings is the Zoladex helped preserve my fertility, but it made my chemo doubly horrible because I had the hot flushes as well," she said.

Within six weeks of the chemotherapy ending her periods had returned and within a year and a half of her diagnosis, much to the astonishment of everyone, she was naturally pregnant with Emily, now three and a half.

"My medical team were amazed and were even more amazed when I had the next baby, Austen, now 15 months.

"It was a real rollercoaster, but now we are delighted we have two naturally conceived healthy children."

Last year she and Jason had to take the difficult decision to have their embryos destroyed.

Others lose out

Kath McLachlan, Breast Cancer Care's clinical nurse specialist for younger women, agrees that clear concise information for women like Hilary is vital.

"Breast cancer is uncommon in pre-menopausal women so a diagnosis in itself can be an extremely isolating experience.

"Overwhelming anxiety and fear about treatment and the future can be even more acute for those hoping to start a family.

"Many women, and partners if they are in a relationship, may be very frightened that their treatment may lead to the loss of their fertility.

"We know from the women we support how important clear information about potential options can be at such a difficult time. "