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and Honorary Lecturer in Reproductive Medicine and Surgery at Guy’s and St Thomas’ Hospital NHS Foundation Trust. If that’s the case, she may have the option of freezing her eggs, though this is less established and, until a few years ago, fewer eggs than embryos survived the freezing and thawing process. A new freezing technique called vitrification has boosted the thaw rate of eggs; recently, the first two British babies were born from eggs frozen using this technique, at the Midland Fertility Services clinic.

      If the cancer has a hormonal element, as some kinds of breast and ovarian cancer do, or the cancer needs immediate treatment, IVF beforehand might not be possible. ‘In some cancers, it’s not safe to have ovarian stimulation,’ says Mr El-Toukhy. ‘There are other options we can offer, including preserving ovarian tissue by freezing it. But at this stage it is experimental, and very few babies have been born from it worldwide.’ The idea of this treatment is that the ovarian tissue can be put back inside the woman’s body to grow eggs when she’s well, or in future, the immature eggs inside the tissue might even be matured in a test tube and used in IVF.

      Of course, there is no guarantee that any assisted reproduction technique will work. ‘The clinician has to talk to the patient openly about what treatments they can offer, and the realistic chance of achieving a pregnancy,’ says Mr El-Toukhy. ‘But you could argue that a chance is better than no chance.’

      Some women do still have functioning ovaries after treatment for cancer, which means they can have IVF if needed, or even get pregnant naturally. ‘There are a lot of factors that affect whether the patient retains her ovarian function — the type of cancer, the age of the patient and her ovarian reserve, whether she had surgery, radiotherapy and chemo-therapy, the type of chemotherapy, the number of courses of chemotherapy and, of course, how badly the cancer has affected her general health,’ says Mr El-Toukhy. If cancer does affect fertility, there may be the option of egg donation or surrogacy.

      Sadly, although IVF and embryo freezing are routinely provided on the NHS, the rest of these treatments often need to be paid for.

      • • • • • • • • •

      Lucy, 32, a hospital manager from Hampshire, thought she might never have her own child after cancer.

      My husband John and I came out of the hospital, got straight into a cab and went to have a slap-up celebration lunch in Gordon Ramsay’s restaurant in Chelsea. We had good reason to celebrate: we’d just been told that we could go ahead with IVF and surrogacy. Just 10 months earlier, I’d been diagnosed with a rare form of cancer in my womb. I hadn’t even been sure if I’d still be around, and hadn’t dreamed I’d be fertile.

      It had all started two years before, when John and I had been delighted to find out that I was pregnant. But I had the worst morning sickness, constant vomiting and no energy. I couldn’t eat or drink anything without throwing it up. I felt hungover, but multiplied by a million.

      When I went for a scan at 10 weeks, the sonographer could see immediately that there was something wrong. In place of the expected embryo, there were a lot of fluid-filled cysts, like a little bunch of grapes. The doctor came in and said, ‘I’m sorry, but there’s no baby.’ He told me I had a molar pregnancy, where the fertilisation of an egg goes wrong, and it turns into a mass of cells that grow very rapidly, but don’t form the foetus and placenta of a normal pregnancy. It would need to be surgically removed. He added that there was a 10 per cent chance that the cells would continue to grow after surgery — a rare form of pregnancy-related cancer.

      We were so hung up on there being no baby that we couldn’t take in the cancer part at first. Later on, a more senior doctor explained it to us again, and two days later, I had an operation to remove the molar pregnancy. Though I was upset about losing the pregnancy, I was relieved when the surgery was over.

      But, two weeks later, I started getting really strong abdominal pains, and I was admitted to hospital and prescribed morphine. The next day, I was transferred to Charing Cross Hospital, the national screening centre for molar pregnancy, where I had every kind of chest X-ray and chest and abdominal CT scan.

      The first thing the consultant there said to me was that I had cancer. Molar pregnancies produce incredibly high levels of beta hCG, the pregnancy hormone (that explained my awful morning sickness). After having the molar pregnancy removed, my level should have gone down to zero, but lab tests showed it was still close to a million (in a healthy pregnancy, it wouldn’t normally go above 280,000). I was one of the unlucky 10 per cent whose molar pregnancy had turned into a form of cancer.

      On the ward, away from home, I felt lonely and scared. And I was still in pain. But the doctors were upbeat about my chances: they told me that chemotherapy had a 99 per cent success rate.

      I started having chemotherapy every two weeks — injections of a drug called methotrexate that would kill the remaining abnormal placental tissue. It took five months for the chemotherapy to work, for my hCG levels to get back to normal. The side effects weren’t too bad: my eyes were sore and I felt a bit tired and run down, but it was bearable.

      I was told not to get pregnant for a year, as the hCG produced by the pregnancy would interfere with my monitoring. That was hugely frustrating, as John and I wanted to get on with life. I went back to work as a hospital manager and we decided to make the most of the year: I went on a spending spree: I bought a brand new Mazda MX5, spent a fortune on manicures, pedicures, fake tans, massages, handbags, designer shades, ate out at some swanky London restaurants and went to the theatre, the British Grand Prix and to see Chelsea, John’s favourite team. We also booked a holiday to the Maldives — something else to look forward to.

      But we never got to go. My abdominal pain came back and I ended up having three operations to treat it that year. First, the surgeon performed a laparoscopy and found that the inside of my abdomen was filled with adhesions (pelvic adhesions are bands of tissue that stick tissue and organs together — a kind of internal scar tissue that can be caused by an operation, among other things). The second time, he had to open me up completely to get rid of the adhesions. That’s when he saw that my left Fallopian tube had come away from my uterus and had got caught up in my bowel. The left ovary had also died because its blood supply had been cut off, so he had to remove it.

      I was terrified that with only one ovary, my chances of conceiving would be halved, but the doctors explained that it wouldn’t alter my chances, as the Fallopian tube next to my remaining ovary was clear.

      I tried to move on, but just a few months later, the pain came back. In my next operation, the surgeon removed a blood clot from under my right Fallopian tube.

      Just a week after the operation, on my 30th birthday, we had an amazing weekend, cocktails and dinner at Claridges. We stayed over in a beautiful room, with a massive marble bathroom and one of those showers where you feel as though you’re standing in the heaviest rain. It was really special. Both John and I thought that I was finally better.

      Then, a month later, in the run-up to Christmas, I suspected I might be pregnant. I did a home test and it was positive. It was great news, but I was also freaked out and kept saying, ‘I don’t want to get sick again’. I didn’t feel nearly as nauseous as when I’d had the molar pregnancy, which was a good sign, I thought. But, driving on the motorway in the New Year, I felt the most unbearable sharp pain in my abdomen, and thought I was going to pass out.

      I turned back and drove straight to my GP who suspected it might be an ectopic pregnancy (where the foetus develops in a Fallopian tube), so I was admitted to our local hospital. They monitored my hCG level, to see if it was going up or down. If it was going down, it was likely to be a miscarriage; if it was going up, it was likely to be an ectopic pregnancy. But it stayed exactly the same — a sign that the pregnancy wasn’t viable, but also, possibly, that I might be ill again.

      I was sent back up to Charing Cross. After lots more scans and tests, doctors told me they suspected I had a much more serious form of cancer. I had yet another operation — keyhole surgery to get a biopsy of the mass they had seen in my uterus on the MRI and CT scans. But what the surgeon saw with the camera didn’t tally with the scans, so he decided to open me up completely, cutting up my womb to remove the mass. And