'Cancer and heart failure made me infertile - surrogacy helped saved my life'
Being told that you have breast cancer is an extreme life-altering moment and is enough to leave anyone feeling like everything is crumbling around them. But finding out at the same time that you might also become infertile when you've always dreamed of becoming a mum is unimaginable pain.
This is the situation one mum found herself in after being diagnosed with breast cancer aged 33 and discovering that she would have to have chemotherapy to treat the disease. Doctors told Kreena Dhiman that it was likely she would lose her fertility as a result of the chemo and she soon found herself embarking on a journey to firstly survive, and then to become a parent in a way that she'd never expected.
Speaking on the latest episode of the podcast Open with Emma Campbell, Kreena, from West Sussex, candidly shared her story, which began with her diagnosis in 2013 and has amazingly resulted in her becoming a mother of four against all odds. She told how she had initially been dismissed by doctors after experiencing breast cancer symptoms, including inverted nipples. She was told she was too young to have the disease and her risk factors were low, but she pushed on and fought for a referral to an expert.
Kreena was just 33 when she was diagnosed with breast cancer (Kreena Dhiman)After attending numerous appointments and having ultrasounds, biopsies and blood tests, the doctors finally confirmed what she had known all along - that she had breast cancer. Initially, Kreena was told the cancer was contained to her breast and she would only need surgery and radiotherapy to treat it. However, after getting her pathology results back, she was devastated to discover that it had spread to her lymph nodes and she would have to have chemotherapy after all.
As well as losing her hair and not being able to hide her sickness from other people, Kreena now had to come to terms with the possibility that she would lose her fertility. She always knew she wanted to be a mum and asked for fertility preservation before having further treatment. At this point, she was recovering from a single mastectomy and just mere weeks away from starting chemo, so was harshly reminded by the specialist: "My job is to save your life not to create a new life."
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This didn't deter her though, as she knew she had to think ahead. "It was so heavy, everything was so heavy but I thought if I survive what does the future look like for me because children were so important to me. So we had long discussions about putting my ovaries to sleep and seeing if further down the line we could manage to retain my fertility, but I was 33 going on 34 and he was talking about in five years' time. By then I'd be approaching 40 and with potential damage to my ovaries and age not on my side, the risks felt too big."
With the support of her oncology team, Kreena began the process of egg harvesting to preserve her fertility and her protocol was carefully managed and reviewed by both her fertility and oncology doctors. "So we went into IVF and it was really tricky because it's like these two massive life events, cancer, and infertility were just hurtling alongside each other and we just had to get through it," she said.
The couple were originally denied funding for the IVF, despite living in a funded postcode and having cancer. Kreena had to fight with her CCG and her MP, paying for the treatment herself before the decision was overturned and they were refunded. And just three days after freezing her 12 embryos, she found herself in the chemo chair ready to begin the next phase of her treatment.
"I even now get really emotional talking about it," she said. "How did I, poor little Kreena, somehow go from healthy happy, you know, the top of my game to within four weeks about to start chemo and you're going through fertility treatment and you've put some embryos in the freezer but you don't know if you're actually going to live to see those come to life. It's all just so uncertain."
She made it through Chemo - only for her health to take a turn for the worse (Kreena Dhiman)Kreena made it successfully through her chemo by early 2015 and she and her husband Satty then embarked on a dream holiday to Vancouver to celebrate her being in remission. However, while on the trip, her health took a turn for the worse as she found herself struggling to breathe. She was rushed to hospital where experts could tell she was incredibly sick and told her family to prepare for the worst - but they couldn't work out what was wrong with her.
After many examinations and tests, she was finally seen by a cardiology expert who asked if her chemotherapy drug had been red, she confirmed that it had and before anyone knew what was going on, she was being taken to the cardiac intensive care unit. Kreena had acute heart failure. "My heart function was awful," she recalls. "I had a heart function of 6 per cent at that time, my lungs were covered in fluid my body was covered in fluid holding fluid because my heart just simply wasn't pumping and none of my organs were sort of working properly because my heart was failing."
She continued: "Me and Satty just looked at each other and we would just cry. Like, how could life be so cruel that we had come to celebrate the end of cancer and rolled straight into heart failure? Nothing was guaranteed. If they took the fluid off me, my blood pressure would just fall through the floor and I would have had a heart attack. So everything was in the balance. But I made it through 24 hours then I made it through 48 hours, made it through 72 hours and everyone was like we can't believe it, we just can't believe it."
Kreena pulled through and had to remain in the hospital as her heart function slowly rose from 6 per cent up to 10pc, however at this point it plateaued and while she no longer qualified for a hospital stay, she wasn't well enough to fly back to England. She and her husband had to remain in Canada for a further six weeks before they were able to make the trip back and she could recover at home - although Kreena still believed she would die. "I was in a wheelchair Satty was wheeling me around all the sites we promised we would see and we just created memories because we thought this might be the last memories we ever get to create," she said.
She then suffered acute heart failure (Kreena Dhiman)After making it back to the UK and recovering for several months, Kreena realised the imminent threat to her life had passed, and she once again began thinking about her future and what it might look like. She still desperately wanted to be a mother, but was told she would never be able to carry a pregnancy with the medication she was now on with her heart being so weak. So surrogacy looked to be the couple's only option.
After a lengthy search, considering looking for surrogates in India, America, and with private agencies, Kreena and Satty finally found the perfect independent surrogate in a woman named Ina in 2017. "We met up and we got on really well, then her partner and my partner met up and we thought it sounded like it could work," she says. "We would talk nearly every day about what we liked, what we didn't like, and our relationship was super strong. And then eventually we just said shall we do it and we matched which means you're official. It's very much like dating, you're exclusive or you're engaged.
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"Then we decided to try and get pregnant. So we transferred one of our embryos that was created in 2013 into Ina, and we were then waiting to see if we were pregnant. And during that time, we had the devastating news that the clinic didn't refreeze our remaining embryos, some kind of clinical error had occurred so now we just had this one embryo that was in Ina as our only chance of getting pregnant from that batch and that pressure was immense."
A few weeks later, Kreena checked her phone to find a video from Ina, revealing a positive pregnancy test. They were going to have a baby. Understandably, she immediately burst into tears. "I cried like I've never cried before," she admitted as she realised "this is the good that's come from this incredibly traumatic situation."
Kreena claims Ina's pregnancy was "beautiful" and when they welcomed their baby girl, Amaala, into the world, her first breath was "magic" because "she saved my life". The family settled in to enjoy their new life together, but they quickly began to wonder if they could add a sibling for their daughter. Only this time, they'd have to do things very differently without any embryos of their own.
The mum says her daughter "saved her" (Kreena Dhiman)"We decided to get an egg donor and long story short it wasn't going to happen in the UK for two reasons. One, donors of colour are very hard to find in the UK, especially South Asian donors. So that was going against us and then I think I wanted something more than an anonymous donor because I kind of thought, well, I'm not carrying this child, they're not gonna have my genetics, I need something and I didn't know what it was until a friend in the surrogacy community talked to me about known egg donation where you can meet the donor and see her as an adult.
"We selected a donor who looks exactly like me. So black hair, brown skin, brown eyes, Indian ethnicity, and created embryos with my husband's sperm, so the baby would have two Indian parents. We had to find another surrogate because Ina was unable to carry again for us, so we went on that whole journey."
With the help of friends in the surrogate community, in early 2020, after spending a few months getting to know each other, Kreena and Satty matched with Laura. They had chosen a fertility clinic in Cyprus for their treatment and Kreena and Laura flew out together in February 2020 to attempt a successful embryo transfer with embryos that had been created with their donor.
"Putting one in will give you a 60 per cent chance of a single pregnancy and a 40 per cent chance of no pregnancy, but two will give you an 80 per cent chance of single pregnancy and a 20 per cent chance of a twin pregnancy," their doctor explained. Together they decided to take the risk of having twins and opted to put two in - but they soon discovered they wouldn't be having two babies, they'd be having three.
After doing egg donation and surrogacy once more, the family has grown by three (Kreena Dhiman)Laura became pregnant with triplets, which was a shock to them all. Kreena was gobsmacked and had thought at first they wouldn't be able to manage, but she knew that they had to continue on after being "blessed" in this way. Their second surrogacy pregnancy continued to prove more complicated than the first, as this took place during lockdown, meaning Kreena was unable to attend scans and other appointments with Laura - she also wasn't able to be present for the birth and had to wait 14 hours to see her three baby boys after they arrived in the world.
But thankfully everything worked out for the best and Kreena is now a mother to four beautiful, happy children, though the mum acknowledges she still has a lot to process after all that's happened - and often fears the sickness will return. "I think I've become very confident and courageous in my story and I use it for good as I want to use it to invoke change for others, but I think there's still a lot of work to be done for myself," she adds. "Fear of recurrence is still very real. I end my endocrine therapy soon and I'm really afraid of coming off the drugs even though statistically the risk of recurrence is very low. My biggest fear is with the heart disease, am I constantly on borrowed time? I have to take drugs every day and I pick up the packet of drugs and think that it's keeping me alive. There's a lot of fear, of death and leaving my babies."
Despite all this, Kreena is working hard to help others who might be facing similar situations and make a difference. She's currently an Estee Lauder Companies UK&Ireland Breast Cancer Awareness Ambassador. She's in the midst of writing her first book and co-hosts The Intended Parent podcast sharing her surrogacy journey, providing a step-by-step guide to Independent surrogacy in the UK, and amplifying the positivity and reality of this path to parenthood. Alongside her friend and business partner their first online course titled 'Preparing For Surrogacy' will go live in September 2023 and will be the only place in the UK where intended parents are given impartial guidance on all their UK based surrogacy options, comparing agencies and independent surrogacy.
You can find Kreena on Instagram @kreenadhiman @theintendedparent or online at www.kreenadhiman.com or www.theintendedparent.co.uk
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