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I'm 32 and Diagnosed with Breast Cancer: Can I Still Have Kids After Treatment?

Dr Nandita

Dr Nandita Palshetkar  |52 Answers  |Ask -

Gynaecologist, IVF expert - Answered on Jan 03, 2025

Dr Nandita Palshetkar is the medical director of Bloom IVF.
She is a pioneer in ICSI, laser hatching, spindle view, oocyte and embryo freezing, IMSI, in vivo vaginal culture, metabolomics, embryoscope and spindle check technologies.
With over 30 years of experience, Dr Nandita is managing 10 centres across India.
She has written over 100 papers, edited 25 books and given over 1,000 lectures and speeches.
She has also won several prestigious awards, including the Dronacharya Award (2021), the Bharat Gaurav Award at the House of Commons in London (2014) and the Inspiring Gynaecologists of India (2018) to name a few.
Dr Nandita completed her MBBS from Grant Medical College and Sir J J Hospital, Mumbai, and her MD in obstetrics and gynaecology from Mumbai University."... more
Asked by Anonymous - Dec 31, 2024Hindi
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Hi Doctor, I’m 32 years old and recently got diagnosed with breast cancer. I’ve been advised to start treatment soon, but I’ve always wanted to have kids, and I’m unsure if I’ll be able to have children after this treatment. My doctor mentioned the option of egg freezing, and I’m a little confused about the whole process. On top of that, my partner and I are also thinking about waiting a few more years before starting a family due to career and personal goals. I’m really torn about what to do. Could you help me understand the whole egg freezing process? What are the risks involved, how long does it take, and how much does it cost? Should I freeze my eggs now, or is it okay to wait until later?

Ans: Hello, sorry to hear about your breast cancer, but the best part is breast cancer is curable
Since you are 32 years of age, and you might undergo chemo, radiotherapy which might affect your fertility. So best option is to undergo egg freezing.
Before we start the procedure, we need to know your AMH level (to know your ovarian reserve) and basic blood work up to get your fitness fir the procedure
The procedure normally needs first 15 days of your cycle where you will need to undergo 3 to 4 scans to monitor the egg growth (follicle growth) and injections from day 2 of your periods till the eggs grow and mature
These injections are safe in form of LH OR FSH hormone. It can sometimes cause
Nausea vomit, constipation, mood swings, low abdominal heaviness, breast tenderness.
These are experienced by some.
Once you are ready then you will be admitted as day care procedure and egg retrieval done under short anesthesia. You will be able to go home in 6 to 7 hours.
During this period of stimulation, you can do regular routine work.
Zumba, jumping and heavy activities avoided during stim.
So, freezing your eggs now is a better. Option
If you delay further the quality and quantity of eggs gets hampered.
DISCLAIMER: The answer provided by rediffGURUS is for informational and general awareness purposes only. It is not a substitute for professional medical diagnosis or treatment.
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Dr Nandita

Dr Nandita Palshetkar  |52 Answers  |Ask -

Gynaecologist, IVF expert - Answered on Dec 09, 2024

Asked by Anonymous - Dec 05, 2024Hindi
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Hi Doctor, I am Neha, 34 years old, a marketing professional from Mumbai. My job can be pretty stressful at times. My husband and I have been trying to conceive for the past three years without success. Recently, my gynecologist suggested we consider IVF. While I’m open to the idea, I’m also anxious about what lies ahead. Could you please explain what tests and evaluations are required before starting the IVF process? I want to know if these tests can predict the chances of success. Also, considering my hectic work schedule, should I make any lifestyle changes to improve our odds?
Ans: Hello Neha considering you are 34 years, and trying to conceive since 3 years
First of all, you both need to undergo blood test
1) Neha:
CBC, Blood Sugars, Vit B12, Vit D, Liver and Kidney screening, hormonal (TSH AND PROLACTIN), viral markers test and most important AMH LEVEL to know ovarian reserve.
Usg pelvis tp rule out fibroids, ovarian cyst
2) Husband:
Blood Sugars
Semen analysis to know about sperm count, motility.
These tests can give an idea about both. Fertility level and any particular supplements needed and chances of successful pregnancy.
Considering hectic lifestyle certain measures to be taken
1) stress management: yoga, walks, exercise, meditation
2) adequate sleep at least 6 to 7 hours
3) Adequate exercise and walks which releases endorphins , dopamine and good hormones needed for hormone circulation.
4) Good nutrition:
Contains antioxidants
Vit B6, Vit B12, Omega 3 fatty acids, iron, zinc, magnesium, calcium, Vit D, green veggies, fruits, eggs, chicken for protein
5) your gynec will advise certain supplements to be taken for additional supplements.

..Read more

Dr Nandita

Dr Nandita Palshetkar  |52 Answers  |Ask -

Gynaecologist, IVF expert - Answered on Dec 16, 2024

Asked by Anonymous - Dec 06, 2024Hindi
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My name is Priya, and I’m 36 years old. I work at a school in Pune. My husband and I have recently decided to go ahead with IVF after struggling with unexplained infertility for four years. While I’m hopeful about becoming a mother, I’m also quite nervous about the ovarian stimulation process and the egg retrieval procedure. Could you please explain the potential risks and side effects of these steps? I have read about complications like ovarian hyperstimulation syndrome. I want to be as informed and prepared as possible before we start this journey. Thank you for your guidance.
Ans: Hello Priya, since you are 36 years, married since 4 years, primary infertility, yes, ivf is a better option.
Many patients have lots of myths regarding ivf treatment. But with modern injections and process of egg retrieval it's not that difficult as it seems to be.
The injections which have to be given for 10 to 12 days are either intramuscular in the muscle) or subcutaneous (just below the skin). Easy to be taken. We get injections in PEN form too like insulin injection which is easy to operate and can be self-injected. The effects of the injections are till the process. It doesn't have long lasting side effects.
The main side effects:
1) nausea vomit
2) breast tenderness
3) bloating
4) headache
5) mood swings and hot flushes
6) fatigue
7) pain after egg retrieval
8) cramping
9) constipation due to progesterone therapy
10) ovarian hyperstimulation
Ovarian hyperstimulation syndrome (OHSS) occurs when fertility drugs overstimulate the ovaries, causing them to swell and release chemicals into the bloodstream.
Symptoms:
Severe abdominal pain.
Severe, persistent nausea and vomiting.
Blood clots.
Decreased urination.
Shortness of breath.
Tight or enlarged abdomen.
To consult the doctor if above symptoms to decide if need of hospitalization
So, tat investigations and necessary treatment can be done
But with regular ultrasound and modern injections, ohss is become very rare and treatable

..Read more

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Janak

Janak Patel  |15 Answers  |Ask -

MF, PF Expert - Answered on Feb 10, 2025

Asked by Anonymous - Feb 10, 2025Hindi
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Advice Needed: Transitioning Back to India & Financial Planning Hello, I’m currently in the process of transitioning back to India after spending the last 15 years abroad. My family includes my wife (early 30s) and our 1-year-old baby. We are staying with my parents for now but are planning to move into a larger, more comfortable residence, either by buying or renting. I’d love to hear some perspectives on my financial situation, as I’m trying to figure out the best course of action in this new chapter. Here’s a quick summary of where I stand: 1. Cash Savings: We’re consolidating assets from both India and abroad, and will have about ₹4 crore in liquid funds. 2. Retirement Savings: I have a PPF-equivalent account of around ₹70 lakhs, which I can only access at age 65. I’m hoping the modest returns from this will be sufficient for my retirement. 3. Inherited Assets: I’ve inherited ancestral properties valued around ₹30 crore. I’m not planning to liquidate these assets or touch them for at least the next 10 years. 4. Career: I work in IT and expect a salary of about ₹1.3 lakh per month (after tax) in India. My wife is in the early stages of her career, so we’re still deciding whether she will work here or possibly start her own small business. Given all of this, here’s where I’m at: * Investment options: I’m considering investing the ₹4 crore in commercial real estate to generate passive income. I’ve seen a couple of properties with rental guarantees of ₹1.5 lakh per month, with a 5% annual increase. * Housing preference: My family prefers to live in a gated community, so I’m not really inclined to invest in residential property for passive income. * Housing decision: Should I buy an apartment or villa now, betting on my career certainty here, or focus on creating more financial freedom first before making career moves in India? In my heart, I feel that achieving financial independence should be my first priority before diving into career opportunities or starting a business here. What would you do in my situation? I'd love to hear your thoughts or any advice you can offer!
Ans: Hi,

Welcome back to India and Congratulations on taking this big decision to move back to India.

Before I start my response to your queries, just want you to know we share a couple of things in common. I was abroad for a considerable time and returned back to India and I was also in the IT field at that time, before I moved ship to Personal Finance and Financial Planning. So I can relate to some of your concerns, queries and thought process in that regard.

This may be a bit long but hopefully its helpful.
Your current Financial summary -
Cash/Liquid funds - INR 4 Crores
PPF equivalent - INR 70 Lakhs available at age 65
Inherited properties - valued at INR 30 crores no plan to liquidate as of now
Salary/Income - INR 1.3 lakhs per month in hand

As a few critical data points are not mentioned but with few indicators in queries, I will make some assumptions for the same - Age 37 years, Location for housing/work - Metro/2nd tier city.

Lets get a couple of things kept aside for this discussion -
PPF equivalent - INR 70 lakhs > for retirement can grow to an amount between INR 2 Crores (@4% returns) to INR 4.5 Crores (@7% returns), will cover this again when I mention Retirement below.
Inherited Properties - as there is no plan for liquidation, excluding this completely.

Decisions to be made -
1. Investment Options
2. Housing Buy/Rent
3. Financial freedom/independence

Lets go through each of these and I will add more for your consideration as they will have a weightage on all future decisions.

1. Investment Options
A> Commercial real estate with investment on INR 4 Crores and return of INR 1.5 lakhs per month
Pros -
Regular month income
Commercial Real Estate asset

Cons -
Return on Investment is 4.5% before reducing charges for maintenance, may be below 4% net in hand
Rental Income is taxable (added to other incomes and taxed as per slab rate) expect highest tax rate of 30% as total income will exceed INR 30 lakhs (Salary + rent)
All available funds will be deployed

Note - Commercial real estate appreciation is primarily based on location. Capital gains on Commercial real estate attract tax at 20% as of now.

B> Lets consider an alternative approach assuming investment is for a long term which is usually for real estate assets e.g. 20 years
Invest INR 4 Crores in Mutual funds.
A well diversified portfolio can generate 12% returns over the long term. The Corpus after 20 years will be over INR 38 Crores.

But considering your requirement for a monthly income from this investment, lets do another approach. Split your Investment.
Invest INR 2 Crores in a well diversified Mutual Funds portfolio expecting a 12% return - Corpus at the end of 20 years = INR 19+ crores
For regular income, Invest INR 2 Crores in Balanced Advantage mutual funds and considering a modest return of 10% (last 10 years data will show higher returns). Keep investment for 1 year before withdrawing to attract Long term Capital Gains tax (tax efficient approach). After 1 year you can receive INR 1.5 lakhs per month (increasing at 5% annually) for the next 20 years.

Pros -
Investment generates higher rate of return, Corpus growing/compounding at 12% return
Regular month income
Investment returns are more tax efficient
Flexibility to deploy all or partial funds towards building a corpus
Corpus can be liquidated in future much faster and easily than Real estate

Cons -
No real estate asset

Recommendation - Approach B is recommended as this will provide liquidity and appreciation towards wealth creation. This will also provide availability of funds for a new venture as and when required if that becomes a viable option in the future.

2. Housing Buy/Rent
If you plan to stay in India for long and settle down (not clearly indicated considering career options), you can consider buying a house property. But if the work location is not what you believe to be the place where you would like to settle down, then start with a Rental option and over time reconsider location for buying option.

Buying Property
Pros -
Asset is generated
Stability of residence if/when self occupied
Some amount of tax deductions/exemptions can be claimed if Loan is taken

Cons -
A large amount of funds required/blocked for full payment / partial payment (with loan)
EMI on Loan reduces income/funds in hand
EMI is much higher than rent
Locked to the property, change will be expensive

Renting Property
Pros -
Capital is not deployed immediately
Rent can be claimed for tax benefits
Provide opportunity to consider long term housing decision
Difference between EMI and Rent can be Invested to generate a good corpus
Flexibility to move jobs across locations

Cons
No Asset is generated
Rent is an expense
No sense of ownership in the house you stay

So in summary, the decision is more individual and how you perceive the house property as an asset. For flexibility to settle down in your career in India I can recommend to start with a Rental option and I am sure in a few years you will know where and what to buy (if at all) towards your house property. Also Location is again critical towards budget and type of housing to consider.

3. Financial freedom/independence
This is probably more important than we realize. With time if we accumulate debt through loans, and expenses, this is one goal which takes a back seat.
Assuming you have worked on the above 2 goals and finalized your options/approach for them, I would strongly recommend you plan your monthly expenses and cash in/outflows to understand what amount you have in hand that can be considered towards savings for the future.
With a long road ahead in your work life (another 20+ years), Asset allocation needs to be considered when planning to deploy your savings. Equity based investment can provide health returns for investments that are for more than 7 years and a well diversified Mutual Fund portfolio can achieve this. For requirements within 5-7 years do consider debt products to park your money and earn modest returns giving priority to liquidity and safety.

Few very important points are not mentioned but I would like to highlight and you should start considering them immediately.

1. Life Insurance - Buy a Term Life plan for yourself and once your wife starts earning, for her too. The amount needs to be calculated and my final recommendation (last para below) will cover this. Start with INR 50 lakhs and keep adding based on the Financial plan.

2. Health Insurance - Buy a good coverage for Family (even though you may have some with your employer). Recommend to go upto 1 Crore (and there are multiple options Base cover + Top-up covers for this).

3. Emergency Funds - Keep aside at least 6-9 months of expenses as emergency funds in a safe and liquid investment e.g. Fixed Deposits.

4. Your child's education - Within another 1.5 years schooling (pre-primary) will start and the education expenses are not as easily managed now. They will require a plan as they escalate very quickly as the child moves towards higher levels of education. Education inflation is in the range of 12% ~ 15% on average. So depending on what your decide for the school/education institute, this becomes a considerable amount and if unplanned may erode your corpus very quickly.

5. Though you have mentioned Retirement briefly, the PPF-equivalent amount will not be sufficient for retirement. Retirement typically at 60 years of age demands a corpus to cover the next 20-25 years of lifespan. Considering inflation may be just getting covered by the modest returns on your INR 70 lakhs fund, you are definitely short on the retirement side.

As you can see we have not considered the inherited property in this discussion, it can have a considerable impact towards your over financial plan.

Though I have provided some responses to your individual queries, this will still need a more comprehensive Financial Planning.
Hence I strongly recommend you approach a Certified Financial Planner and go through the process to arrive at a Financial plan which will be in sync with your Life plan. A CFP will take into account all aspects of your personal preferences and guide you towards various options and alternatives you can consider. The comprehensive Financial plan will include/cover all aspects of Investment management, Risk management (life and health Insurance), Retirement planning and Tax management - a tax efficient approach towards your requirements. Please remember just as Life is ever changing and evolving for each of us, so will your Financial plan require the changes and evolution to stay relevant for you, and this is where a CFP will add the most value when you have a long association. A CFP will plan and re-plan your goals and its requirements over the years and provide options and recommend the amounts and product categories to consider for each of them.

Best wishes for you to settle down and hope the above has provided a start towards it.

Thanks & Regards
Janak Patel
Certified Financial Planner.

...Read more

DISCLAIMER: The content of this post by the expert is the personal view of the rediffGURU. Investment in securities market are subject to market risks. Read all the related document carefully before investing. The securities quoted are for illustration only and are not recommendatory. Users are advised to pursue the information provided by the rediffGURU only as a source of information and as a point of reference and to rely on their own judgement when making a decision. RediffGURUS is an intermediary as per India's Information Technology Act.

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