Tragedy and Triumph: Overcoming Cancer and Infertility

My name is Bryan Ettinger. I am a two time cancer survivor and active participant in the cancer community. I was 23 years old in 2009 when I was diagnosed with cancer for the first time. I felt something was not right with my left testicle, and was told by my primary doctor that I would need to see a urologist.

I went to see the urologist on a Friday, thinking that he would confirm that I had nothing to worry about. Unfortunately, the ultrasound showed that my testicle was 90% tumor and would need to be removed. I went from thinking I would be fine, to being informed I had cancer and that I would be in surgery in three days.

I went through with the surgery and did my subsequent follow up at a cancer treatment and research institution in New York. It was here that the issue of fertility became a serious thought for the first time. I was told I had three options in regards to post surgery care: I could undergo radiation, do a cycle of chemotherapy, or opt for surveillance to make sure the cancer hadn't come back.

I was also told that with the first two options there was a risk of losing my fertility and thus the chance to have biological children. Facing this reality as a 23 year old only a few months removed from college was daunting. Thus, my family and I decided to opt for surveillance in light of this fact and the doctors telling us that there was a very low probability of the cancer coming back. The issue of fertility in my mind had altered my choice around the course of care. This proved to be a fateful decision.

Surveillance consisted of a schedule of CAT scans, chest x–rays, and blood tests, which I underwent from 2009–2012. In 2012, I was told the gut wrenching news that the cancer had come back after one such test. I was diagnosed with a germ cell tumor behind my rib cage that was 7 cm in size.

I was devastated to say the least, and once again I had to seriously consider my fertility and my options around that particular issue. I was told by my oncologist that he strongly recommended me going to a sperm bank to store a healthy sample for the future after chemotherapy. He informed me that in all likelihood, chemotherapy would cause serious harm to my fertility and that there was a chance my ability to naturally reproduce may never come back. I decided to take my doctor's advice and I went to the sperm bank to preserve my chance of having a child in the future.

My experience at the sperm bank was not a positive one, but I cannot say it was the fault of the facility. The only term I can use to describe how I felt while at the fertility clinic is despair. I was very much living in self–pity, wondering why this had happened to me and why I had to be in this place. I felt it wasn't fair and that this couldn't be my life.

I went through the sperm analysis, stored a healthy sample, and started chemotherapy not long after. I went through four cycles of chemotherapy, which I finished up in January of 2013. I have been in remission since that time, but my issues with fertility have not ended since then. There is a yearly fee for storage of the healthy sperm sample, and insurance does not pay for this. At the time, insurance also didn't pay for the doctor visit or sperm analysis. The out of pocket costs for this—on top of all the cancer bills—is quite overwhelming for anyone. I count myself lucky and grateful that my parents helped me defray the costs.

I decided to undergo another sperm analysis since the one I had undergone in 2014 (one year post–chemotherapy) had shown that I had very low levels of sperm production due to the chemotherapy. This time around however...