Maybe I’m being sensitive, but twice this week I’ve been asked: 1) are you married? 2) do you have kids (followed by: why not?). These are questions that many women (I don’t know about men) are asked all the time, especially after you are a ‘certain age’. The Holiday season is upon us and…well…these topics are bound to come up. I’ve been thinking about posting on this topic for a while but the recency of these inquiries just pushed me to finally write about it.

It’s hard to be a woman with a chronic illness for a myriad of reasons and planning for a family is no exception. As women, we are encouraged to have it all, but many times we don’t really focus on fertility. We focus on the career, the money, the relationships, and the idea that in the “distant” future, we’d be better poised to begin a family. We’ve had the plan of getting married in our 20’s or early 30’s and having kids by age 40. However, when we get to the ages where we would reach these self-imposed (or socially-imposed) milestones, we make a new plan until we need to make ‘adjustments’ to those milestones (again).

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I know I am not alone in this. It is also more complicated for those of us who have chronic illnesses because we need to consider:

  • physical limitations – in the case of lupus, due to the unpredictable nature of the disease and resulting medication changes, it’s hard to really plan for something that requires your attention on creating a new life. In the case of lupus, it is best to be flare-free for as long as possible in order to maximize the possibility of pregnancy, to avoid miscarriages and in consideration of your (and baby’s) health in general.
  • medications– many meds for lupus are not pregnancy -friendly. They are contraindicated so you need to work with your doc to slowly get off of ones you can’t take before and during pregnancy. You’ll need to discuss if there are pregnancy-friendly options and have a ‘trial-run’to see how you do with the pregnancy-friendly options. I wrote about this last year on how I began working with my doc to prepare my body.
  • money– we already have medical bills, medication costs and the like, so planning for a family (in whichever form you intend to do so) needs to be considered as well. For example: Can egg freezing be covered by insurance?

I wish I knew to ask about these things when I was in my 20’s, although it wouldn’t have changed much of anything in terms of my having a family at that time since I was newly diagnosed with lupus and having a lot of difficulty. That said, perhaps this is where we and our medical providers can be more proactive if this is something important to us:

Just a few questions to consider asking your medical provider:

  1. What options do I have for treatment of my illness and how do they affect my fertility?
  2. Should I undergo some tests now to check my fertility status?
  3. Are there any resources for me to check out  such as support groups, insurance coverage for fertility preservation?

I could go on and on, but here are some links with more information and you can go from there based on your own situation:

Chronic illness and fertility: http://www.babycenter.com/404_what-chronic-illnesses-can-affect-fertility-and-why_6147.bc

Preserving fertility: http://www.savemyfertility.org/fact-sheets/preserving-fertility

Lupus and pregnancy (Lupus Foundaiton of America): http://www.lupus.org/answers/entry/lupus-and-pregnancy

Lupus and pregnancy (WebMD): http://www.webmd.com/lupus/guide/pregnancy-lupus#1

There are many different types of families and ways to go about it:  http://www.path2parenthood.org/

Nothing is ever perfect or able to be planned but we can be aware of our options and feel empowered to take the necessary steps when we can. As for those questions from nosy family members at the Holiday dinner, well, I guess you can always hide in the bathroom.