Sarah and Rich stood in front of a field with lots of yellow flowers

The COVID crisis has affected my access to fertility services

After being diagnosed with primary breast cancer, 37-year-old Sarah was warned her fertility may be affected by treatment. Now, she has also had to deal with coronavirus interrupting access to fertility services.

I wasn’t taken seriously at first

I was diagnosed with breast cancer in May 2017. I had actually been to see the doctor in January of that year, but the doctor told me I was too young to have breast cancer.

I told her that I had a family history of breast cancer – my mum had DCIS when she was 64, and my maternal grandmother died of breast cancer.

I'd had a short-lived period of anxiety about two years before that, and – when I was later diagnosed with breast cancer and put in a complaint – the doctor admitted she had not taken me seriously because of those past issues.

I had to choose between fertility options and cancer treatment

I don’t think breast cancer is easy for anyone, but I think I would have been in a much stronger situation to deal with it if I had been diagnosed earlier. I was told I was very lucky to still have early-stage breast cancer because - due to having two tumours and it being HER2+ - it was quite aggressive.

The delay also affected my fertility options. I got offered IVF, but I was told I had to make the decision whether to have it before I had the results of my CT scans, which I wasn’t prepared to do. Also, it would mean taking oestrogen and delaying chemotherapy, which could have allowed my cancer to progress.

So, I had the chemo, then a double mastectomy and reconstruction. Thankfully I didn’t need radiotherapy, but I have been on hormone treatment for nearly three years – which has actually been really hard to deal with. The side effects have a big impact on my life.

Now that I have been declared NED (no evidence of disease), I wanted to pursue fertility options.

Coronavirus has added further complications

When the coronavirus outbreak reached the UK, I got a letter saying I was extremely vulnerable. I phoned my GP and I was quite concerned, because I was being told that I might have a vulnerability – and that was quite upsetting when recently I have finally started to identify as being ‘well’.

My GP said it was a mistake, as it had never been logged that I’d finished chemo. I was quite concerned that, if I ended up in hospital, I might not be prioritised for treatment. I was also worried there might be implications for me being able to work.

The other major impact of COVID-19 has been on my fertility treatment.

All fertility services were cancelled

I got a referral to a fertility clinic in November last year, but due to delays I didn’t get to see anyone until February. When I was called back in March, I was told my fertility had been impacted by chemotherapy, but I could try to harvest my eggs in the summer.

I was meant to be able to call three weeks later to discuss these options further, but by then I was told that all fertility services, including our telephone appointment to discuss options, had been cancelled.

I am worried about delays to my treatment going forward, as well as delays for anyone else who is in a similar situation

The fertility clinic has just reopened and we finally had our phone conversation with a doctor. Coronavirus has helped us reach some decisions, but if we had wanted to follow certain treatment paths, it would have made this much more difficult. I feel worried for anyone who has just been diagnosed who may have had to start chemotherapy without access to fertility treatment.

I’m concerned about the knock-on effect of all this: if it was busy before coronavirus, how long will it take to get the process started again? The clinic has been helpful and appear to be able to take my treatment forward, but there is so much uncertainty at the moment. I am worried that treatment might be halted again if there is a second peak of the virus. If I am going to have treatment, I’ll need to come off my medication and I want to do that for as little time as possible. I want to move on with my life as I’m getting older and feel like I have spent the last few years in limbo.

Coronavirus reminds me of having cancer

I’ve been finding this whole thing quite hard. There are some parallels from when I was diagnosed with cancer.

It’s almost like having been diagnosed with cancer has slightly inoculated me against what is happening at the moment. We're all having to think about mortality and illness, and that’s not something you normally have to consider. But now it’s kind of a collective thing, whereas, with cancer, it’s much more personal.

Cancer is something that drops a bomb and causes a ripple through your life, and I think coronavirus is very much like that. The uncertainty can be very hard to deal with.

When I had cancer, it was very lonely and difficult. At least with this, we’re in it together.

I feel sorry for others with cancer

Compared to other people, I think I’m not that bad off. I feel so sorry for people who have just been diagnosed, or who have had their treatment plans or fertility treatment changed, or haven’t been able to access trials. I do feel quite strongly that cancer patients have been deprioritised, and I feel quite upset and angry on their behalf.

It’s difficult at the best of times, but with everything that’s going on, it’s just so much harder.

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