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Survivorship Guide for Bone Marrow/Stem Cell Transplant
Coping with Late Effects

Parenthood Options Post Transplant

Both radiation and chemotherapy affect fertility, as does chronic GVHD. Although there have been documented cases of individuals conceiving and having children naturally post transplant, this is rare.[15] The vast majority of transplant recipients become infertile due to the effects of chemotherapy and radiation.

Your choices about having children will depend in part on the steps you took prior to your transplant. If you are male, you may have been offered the choice of freezing your sperm. Or if you are female, you may have chosen to freeze embryos or to undertake the more experimental procedure of freezing eggs or ovarian tissue. Even if you did not take these steps, there are still ways for you to have a family. New technologies, new ways to adopt, and changing societal norms have opened up a whole array of options for individuals who are infertile and wish to have their own children. Below are a few survivor experiences that you may find helpful:

We have had an older daughter via adoption and twins born via a gestational surrogate. (I was able to freeze embryos before treatment.)

My gestational carrier is currently 15 weeks pregnant with my twins. My husband and I froze embryos before I began my treatments. The thinking was that I’d be able to have them myself. However, although I have been stable for a really long time, I still have a small indicator for the cancer, and the fear is that if it gets out of control again, we won’t be able to get it back under control.

I used my sister’s eggs and husband’s sperm to create the embryos. Then we found a surrogate to carry the embryos to term. The process was long, expensive, and complicated. Although we found a great surrogate, the agency we used to find her was terrible, and we had to file a complaint against them.

The first fertility clinic we used was also problematic. We then switched to a fertility clinic at a large university hospital and now have two delightful children – a boy and a girl. My recommendation is to do as much research as you can about the agencies you plan to use.

We are trying to hire a surrogate to have our baby. Part of me wonders whether I should bring up a child if I am not healthy enough to carry one. I know that life is uncertain and healthy people can die, leaving young children behind. However, my life is REALLY uncertain.

We still are deciding. We may adopt or may consider egg donation.

If you are interested in having a child that is genetically your own, or if you’d like to carry a baby to term, the first step is to talk to a fertility specialist or a reproductive endocrinologist. Take time to do some research about the topic, since centers vary in quality and experience. Survivors who are trying to conceive on their own should discuss this with their BMT physicians in advance to make sure that they are not taking medications that can have harmful effects on fetal development.

Adoption

Adoption is an option that can be considered by most individuals. There are different types of adoption, including domestic and international. Some adoptions, known as open adoptions, allow the parents to know the identity of the birth mother and have contact with her both before and after the birth. A closed adoption refers to an adoption where the future parents and the biological mother have either very limited or no contact information about each other. Some individuals choose to try foster care and may adopt the child through this route.

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