Meet your match, get married, buy a house, have kids. The majority of my female friends will be having kids later this year or already have kids. A couple of years ago my facebook wall was plastered with wedding photos from various friends. Now the babies are all over the news feed.
Since we purchased our house last year, I have been getting questions like, ‘when are you guys going to have kids?’ or ‘have you guys discussed having children?’. This is now a fairly difficult question to answer. A simple, ‘oh we aren’t there yet’ is the easiest response that I usually give.
I have a 50/50 chance of passing this gene onto offspring. So there are a few options that we are considering.
1) Conceive naturally, then get amniocentesis to determine if the gene was passed onto the child. At this point, you must be sure that you will abort if the gene is passed or you have just taken child’s right away to chose to be tested or not when they are an adult. This is an ethical dilemma. This is also all covered by OHIP.
2) Conceive naturally, have the baby, try to not think about the 50/50 chance you passed the gene on. Hope that your kid wants to be tested when they are an adult. Accept that if they develop gastric/breast cancer, they had the choice to be tested or not and watch them die. It’s a tough thing to swallow!
3) In vitro fertilization. From what my genetic counsellor knows, no one has gone this route before with CDH1 gene but it is possible. You can extract the eggs that don’t have the gene so it won’t be passed. Once the egg has been fertilized and implanted, you can under go amniocentesis to be sure the right egg was chosen or just hope for the best. Amniocentesis carries a risk of causing an abortion so this is a little scary.
Also, from what I know about in vitro is that you have to inject artificial hormones to help stimulate the eggs. These artificial hormones carry a risk of developing breast cancer. But what if you already have a 40% chance of developing it on your own?
Another thing that my husband and I have been discussing when to have the kid(s) – before or after the prophylactic gastrectomy. There is one study that showed that you can have healthy children post prophylactic gastrectomy. It is just considered a higher risk pregnancy and you should be monitored closely. You also have a very high chance of becoming anemic and needing blood transfusions. This is fairly common.
Here are some pros and cons we’ve come up when having the kid talk.
Pros of having kids before:
– will have a closer to normal pregnancy
– there is a low risk that I will get full blown cancer over the next few years
– more energy to raise them
– if they remove my stomach and find cancer in it and in the lymph nods, I will may have to go through chemo which will affect the integrity of the eggs.
– I approach closer to the average age where people develop HDGC
– more mental stress that I may be a walking time bomb
– We will have small children to take care of when I go into surgery and through the recovery
So far we’ve concluded that we should take care of what we do know first and then think of all the secondary things.
We have a meeting with the fertility specialist Feb 26th, the meeting with the Gastroenterologist in Toronto (who did my mom’s surgery) and also a meeting with a dietitian to discuss how my life will change post total gastrectomy on March 12th. After those meetings are done there will be no more medical consults and just the decision of when to have the stomach removed.
Dun Dun Daaaaaa…..