Patient Stories

Margaret Cieprisz | Lisa Holderby | Iveta Gigova

Iveta Gigova

It was a heavy blow... but we didn't give up our dream to have children. Because of uterine cancer I had to have a hysterectomy in the summer of 2002. I was 35 and it was 3 months after my wedding. The surgery went fine, the tumor was determined to be still an "early stage", and so the prognosis was not bad. My ovaries seemed fine and my oncologist spared them, even taking extra care to move one so it's less likely to be harmed if I would need chemo later. He knew I really wanted biological children - I had chosen to try treatment for 4 years before accepting there was no hope for my uterus.

The hope I did have was more important and more far-reaching. There were people out there, and medical procedures, that could still allow me and my husband to have our own children. We didn't have to give up our dream.

Back when the nightmare all started, in the fall of 1998, I had just turned 32. A year before that, at 31, during a routine ob/gyn check-up my doctor did an ultrasound and saw something small which she said should be checked again next time. There was a small chance it was a polyp. Six months went by, and I had a new job, new health insurance, and with that, had to choose a new ob/gyn. By the time I did that and an appointment could be scheduled, it was another 3 months. The new doctor did not have ultrasound in her office and could not see anything on exam but decided to send me for more advanced imaging. That did turn up a polyp, and I was told it was best to have it removed, just to spare me any complications, however small their likelihood. I didn't think much of it and scheduled the D&C right away. I don't have much of a recollection of how that went - except a moment in the cab with my roommate who insisted on taking me to the hospital. I had a sudden flash then, that may be I was getting into something bigger than I realized. But the only specific concern I remember was about the anesthesia, of all things.

My next memory is of the day I had my follow-up appointment with the doctor. Things were hectic at work and I decided to call and reschedule. About 15 minutes later I got a call back. It was my doctor. She said, "I really think you should come today, there is something important we have to talk about". Then comes the memory of sitting in her office and hearing the words abnormal, atypical, tumor, cancer, carcinoma, chances of survival... over and over again. And a diagram she drew for me - which is still in my files - to show me what my chances might be. She had just managed to calm down my fear a little bit - it was, after all, an "early stage", perhaps even a "pre-" condition – and while she kept talking and I strained to concentrate on her explanation, I heard the words "family plans". It was like thunder in the distance, followed by a few empty seconds - and then it hit me for the first time that this meant I couldn't have children.

A whole month of agony went by before I could get an appointment with the oncologist I had been referred to, Dr. Del Priore. It was around Christmas time and the atmosphere in the waiting room was almost light-hearted - I felt bizarre. After a short wait I saw him coming out of his office and hurried to say hello. He greeted me with the words “you should have told them you are a cancer patient and they would have scheduled the appointment much sooner". My heart stopped for a second as panic rushed back through my every cell. Then I was indignant. He was an oncologist, all right, but how dare this insensitive guy say the word cancer in my face? I had tried so hard for the past month to deny it, this recognition. I had done diligent research and was nearly prepared, with trepidation, to propose a course of treatment, and to convince myself there was a way out, or around, "the cancer". Well, it was a name, a word. I had to hear the rest of what he had to say. I took a deep breath and followed the doctor into his office.

Dr. Del Priore knew his stuff. He was not going to be taken by surprise no matter what scientific facts and findings I brought up in the conversation. I was quickly getting to like him and, surprisingly, to feel more comfortable than I had been at any point in the past month. Yes, to him that was cancer without further discussion, but it was also just the beginning of the story, the start of exploring my options. Preserving fertility was the goal that came second only to preserving my life. A very close second, and he obviously understood. We were on the same page. Hormonal treatment was an option. He started explaining the risks. I had already read the article from the long-term study of hormonally treated young women with endometrial carcinoma. Some chilling outcomes, and some good ones too. I was willing to take a risk, but how big was it? He insisted on mentioning other options. Adoption was one. Surrogacy was another. Surrogacy? That I had not come across. Please explain. He explained. It sounded almost outlandish but wonderful too. Quite complicated, he said there were aspects he did not know enough to talk about – for instance the legality of it (what??? I'm astonished...what am I missing? what century am I in? what are we talking about?) Then we move on, and eventually back to the hormonal treatment. I did get a second and a third opinion. Similar but not exactly the same. Fewer options. I went with Dr. Del Priore's.

The next 4 years were spent on some form of hormones or another, with hopes and fears rising and subsiding, and anxiety about the need to get pregnant, which presupposed a need to have a partner for that - and for life. Frequent biopsies or D&C's, some good results, some ambiguous or borderline. But I got to the point of getting engaged to the man I wanted to have children with, on my 35th birthday in September. I was ready to use the precious window of opportunity... So we went ahead and tried - once, no luck, It was time for my regularly scheduled biopsy with Dr. Del Priore. We talked briefly about the the possibility of holding off on the next biopsy, to prevent disruption of our pregnancy work. Then, in a week or so, Dr. Del Priore called. The cancer was back. Sounded like back with a vengeance. I was afraid to ask, but did in the end - and he agreed to put me on another course of medication, although his hopes were not high and he was felt strongly it was time for a hysterectomy.

We waited to check the results after the wedding. They came back bad and he sent me for an MRI. That report came back and it was scary - the cancer may have broken through the uterine wall. Or something had. No, he was not willing to take any more chances on my life. He wanted to schedule a date for the hysterectomy –NOW. In the mean time, he gave me the numbers for two prominent fertility specialists to discuss surrogacy. I got appointments for second opinions. This time one of them was more lenient - but I didn't even wait for that call. I scheduled a date for the surgery, and appointments with the reproductive specialists. I was ready for the next stage. I had great hopes for life after the surgery. I was just praying for a good outcome and for the chance to act on those hopes.

I was lucky. The outcome was good and I could devote my every moment now to the surrogacy efforts. Getting accurate and complete information, learning the intricacies of the process, choosing a clinic, finding a surrogate, finding an agency, lawyer, medical coverage, the money... The next two years were filled with the stresses and joys of this process...then the roller-coaster of the IVF cycles... then the pregnancy and its complications... And then the babies arrived. It was a miracle like no other. It's been the revelation of true happiness. It was worth every battle, every risk and every price paid. I just had to be given the option.