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Breast cancer is the most common cancer for women age
15 to 39 , and women ages 15 to 34 die more frequently from breast cancer than any other cancer .
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about the options in preserving their fertility .” Indeed , with her treatment options potentially jeopardizing her ability to have a family , Jessica met the next day with G . Wright Bates , M . D ., professor of reproductive endocrinology , and his team . “ Many available therapies , while very successful in treating cancer , can impact the egg quality and number or a woman ’ s ability for future fertility ,” Dr . Bates says . “ For this reason , the initial consult with the oncology team is absolutely crucial to the patient .”
As with her cancer treatment , Jessica had options on how to preserve her fertility . But just like other women in her situation , what she did not have was a lot of time . Treatment for breast cancer typically does not have to start immediately , but she did not have months to wait either . After consulting with Dr . Bates ’ team , she decided to have her eggs harvested and frozen . She had a three-week period to accomplish that before she started chemotherapy .
“ It takes at least two weeks to prep the ovary with hormonal stimulation and harvest the eggs ,” Dr . Bates says . “ It ’ s a fairly simple procedure ; there are no incisions . It ’ s an ultrasound-guided needle biopsy of the ovary with anesthesia , so the patients are very comfortable . We ’ re actually now freezing both eggs and embryos or fertilized eggs , very successfully , and Jessica ’ s case is a prime example .”
Cancer treatment
A woman who is diagnosed with breast cancer at UAB meets with an oncologist , surgeon and radiation oncologist as quickly as possible after diagnosis to discuss treatment options .
In Jessica ’ s case , she met with oncologist Andres Forero , M . D ., radiation oncologist Jennifer de los Santos , M . D ., and Dr . Krontiras . A breast cancer diagnosis in young women like Jessica is rare ; estimates from the Young Survival Coalition are that 13,110 cases of breast cancer are diagnosed in women under the age of 40 each year . However , breast cancer is the most common cancer for women age 15 to 39 , and women ages 15 to 34 die more frequently from breast cancer than any other cancer .
“ Patients as young as Jessica usually don ’ t have as good a prognosis as patients who develop cancer in older ages , because often those cancers in younger patients tend to be more aggressive ,” says Dr . Forero , a Cancer Center senior scientist . “ Unfortunately , we are seeing more and more younger patients being diagnosed with breast cancer .”
UAB ’ s team of physicians came up with a plan for Jessica that included three different types of therapy , including local therapy of the breast cancer with surgery and radiation therapy . They also treated Jessica systemically with chemotherapy .
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The physicians gave Jessica all of her treatment options on that visit . She ultimately chose to take part in a clinical trial , a research study that for her consisted of 12 chemotherapy treatments for 14 weeks . When that was completed , she had four treatments of Adriamycin and cytoxan every other week . She then had her lumpectomy on March 7 , 2012 , six months after her diagnosis .
“ I discussed in detail whether I should have a lumpectomy or a mastectomy , and if I had a mastectomy , should it be one side or two ,” Jessica recalls . “ Dr . Krontiras was pretty emphatic that the research has shown that there really wasn ’ t much difference — at least in my case — so we did the lumpectomy . It ’ s an easier procedure with a shorter recovery time , and if the outcome is going to be the same , then that made more sense to me .”
Freezing embryos of frozen eggs
Two years later , after Jessica and Will had married , and following successful cancer treatment , the happy couple decided to pursue a family .
Dr . Bates ’ team thawed Jessica ’ s eggs , fertilized them with Will ’ s sperm and planned to do an embryo transfer . But for whatever reason , Jessica ’ s endometrium did not respond to where Dr . Bates felt comfortable enough to transfer the embryos .
“ We have several markers that we use for receptivity with the goal of our giving the patients the optimum chance for pregnancy ,” Dr . Bates says . “ Occasionally , the endometrium is not ready , and that ’ s what happened with Jessica .”
Wes Edmonds , Ph . D ., scientific director of Assisted Reproductive Technologies who oversees the operation of UAB ’ s In Vitro Fertilization Laboratory , prepared Jessica ’ s eggs as though her body would be ready . When the egg cells were fertilized , they grew in the lab for a few days until they became embryos . It was at that point Dr . Bates decided it was not ideal to transfer them to Jessica ’ s uterus . So , the team opted to freeze the embryos and try again a few months later .
It is not uncommon to freeze embryos in this scenario , but it is extremely rare to freeze embryos that were frozen as oocytes , or egg cells . Dr . Edmonds says that research — and previous successes with this method at UAB — gave Jessica and Will a good chance to realize a pregnancy .
“ With recent advancements in cryopreservation technologies , we ’ re seeing more and more of these success stories ,” Dr . Edmonds says . “ Our per-transfer pregnancy rates for cryopreserved embryos are currently equal to , or even slightly better than , those we see with fresh , same-cycle embryo transfers . What this means is that our cryopreservation techniques are having minimal , if any , negative impact on the quality
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of the embryos . Fortunately , we were able to achieve this success for Jessica too , which really gives us great personal satisfaction . The elation we feel when this is successful is off the charts because we know we ’ re helping our patients achieve their goals of becoming parents . It ’ s exceptionally rewarding .”
With the embryos refrozen , the reproductive team gave Jessica ’ s uterus two more months to respond to treatment and hit those markers for receptivity before proceeding with the embryo transfer .
In November 2014 , two months after the first attempt to transfer the embryos was put on hold , two embryos were transferred to Jessica ’ s uterus , and one of them “ took .” Finally , it was official . Jessica was pregnant and due to give birth in July 2015 .
It was a long , hard-fought journey to get to pregnancy , but Jessica says she was never skeptical that the fertility preservation process was going to work .
“ I have the utmost faith in Dr . Bates and his entire team and their abilities ,” Jessica says . “ That said , Will and I still knew there was a chance it wouldn ’ t work . Nothing is ever 100 percent . And if it didn ’ t work — and we only had two embryos , so this was it ; this was our one shot — I would have been sad about it , but there are other ways to have a family . You can adopt embryos . You can adopt babies . I would have been disappointed , but it wouldn ’ t have been the end of the world . And I had to at least try .”
The pregnancy
Jessica ’ s pregnancy was about as smooth as she could have hoped . She never had any nausea . She started to get tired easily toward the end , which is normal in many pregnancies . And when you ’ re carrying a big baby in the Alabama summer heat , it makes it even easier to understand .
But the result on July 28 , 2015 , was everything Jessica and Will could have hoped after overcoming so many obstacles : William Cooper Sparks was born in UAB ’ s Women and Infants Center as a 10-pound , 4-ounce , healthy baby .
“ It was so surreal ,” Jessica says . “ If you had told me back when I was diagnosed that one day I ’ d be a mom , I don ’ t think I would ’ ve believed you . But the whole experience was just amazing . Being able to hold my little boy is the best feeling in the world .”
Jessica is quick to thank her physicians and caregivers for their expertise , help and guidance all the way through her treatment to Cooper ’ s birth and beyond . She continues to receive mammograms every six months , and she will be on a hormone receptor blocker for 10 years as a continuance of treatment for the breast cancer .
While she says she is forever grateful for how her physicians were able to treat the cancer , she ’ s also
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thankful that they encouraged her to look beyond her immediate diagnoses four years ago and consider what her life might look like down the road .
“ Obviously , they want to save your life , but you do have to think about what happens after you ’ re treated ,” Jessica says . “ It ’ s all well and good to live , but what about the 50 years of life or more you may have once your treatment is completed ? That ’ s something they didn ’ t ignore . I ’ m very glad that at that first appointment Dr . Forero said , ‘ If you want to have a baby , you need to talk to Dr . Bates .’”
For the physicians , they couldn ’ t be happier for Jessica ’ s successful cancer treatment and journey to motherhood . After she completed treatment , Dr . Forero got to know Jessica as a colleague , when she worked as a registered nurse in UAB ’ s Infusion Therapy clinics .
“ Helping her go through this difficult process and deal with all of these issues is very rewarding ,” Dr . Forero says . “ Finishing the therapy and knowing we gave her a chance , based on research , that she can be cured . And the most rewarding part , seeing her be a mother and helping her go through the process and get to that point , getting past the anxiety of stopping her medication and seeing her have a wonderful , lovely baby . It ’ s rewarding . It ’ s amazing . It would touch the heart of anybody .”
“ Jessica ’ s case is a prime example of a woman ’ s persistence and desire to be a mom ,” Dr . Bates adds . “ We were fortunate to provide her some hope in the wake of a breast cancer diagnosis . And it ’ s especially satisfying for my team and me to see the end results . It makes us even more committed to fertility preservation and even more thankful that we are a part of a great institution like UAB that is at the forefront of technology yet takes the time to care for the individual and treat the whole person .”
Jessica , who has been a student in UAB ’ s School of Nursing and a patient in many UAB specialties , and is now a nurse practitioner at UAB , hopes her story may inspire others to explore their options .
“ The one thing I hope this story gives others is hope ,” she says . “ It ’ s an amazing story , an incredible one , that a lot of people had a hand in writing . These are all amazing people , who helped give me hope in my most desperate time . I hope this story is able to do the same for others .”
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