Bill could preserve fertility in cancer patients

Op-ed: Insurance companies should cover the cost of fertility preservation for teen-age and young adult cancer

Almost seven years after my leukemia diagnosis at age 23, side effects from the chemotherapy that saved my life mean I likely won't bear children. I wasn't given an option to preserve my fertility, but even if I had been, the decision would have come with a huge price tag. Insurance companies are not required to cover the cost of fertility preservation for teen-age and young adult cancer patients.

There is now hope for the 3,100 young Marylanders who are diagnosed with cancer each year, however, thanks to two bills introduced by State Sen. James M. Mathis Jr. and Del. Cory V. McCray. With support from the Ulman Cancer Fund for Young Adults, the legislation would require health insurance companies to pay for the preservation of eggs or sperm for women and men who are exposed to cancer treatment or medicine that could destroy their fertility and ability to have children.

During my month in the hospital and seven months of outpatient chemo, my doctors never talked about preserving my fertility. At the beginning, I was way too sick. My leukemia was aggressive, and if I had waited any longer to come to the hospital, they told me, I probably would have died. Their mission was to keep me alive, and after a month in the hospital, a week in the ICU, bags of blood and chemotherapy, and lots and lots of pills, I was alive.

The chemo, however, had long-term side effects that I began to experience almost immediately. One drug I received is known to cause heart damage, and less than a year after my diagnosis, I had heart failure. My insurance covered the tests and medicine I needed to get my heart healthy, and it would have covered a heart transplant if I had needed it. It wasn't until I asked my doctors about fertility that they mentioned I might not be able to have children, but they really couldn't be sure. An expert from Shady Grove Fertility, a company also supporting the legislation, told a group of young survivors and me that freezing eggs or sperm before treatment was the only way to be sure that we would be able to have children. My insurance had no obligation to cover that treatment.

As I met other young adult cancer patients, I heard three types of stories. Some were like mine, where the stage and type of cancer made it impossible to take the time to extract and freeze eggs or sperm. Some were lucky: They had the time to go through the process of preserving their fertility. The third scenario was probably the worst: patients who had the time to do something, but couldn't afford to because their insurance companies wouldn't pay for the thousands of dollars worth of treatment.

Your ability to have a family shouldn't come down to a financial consideration when you've just been diagnosed with cancer, when co-pays and out-of-pocket expenses for life-saving treatment are the most important. Other side effects of cancer treatment are covered, says the American Society for Reproductive Medicine. Your insurance company will pay for a wig, breast reconstruction or specialty bras. They will not help you have a family when you are ready.

More and more pediatric and young adult cancer patients are surviving their disease and treatment, and we are ready to move on with our lives. We want to finish school, go to college, get a degree, get a job, get married and start a family, or do whichever combination of those makes us happy. We've been through a lot, and this bill would make one thing in our future easier. For all the young adult cancer survivors in Maryland, I urge the legislature to support this bill, and I urge readers write to your senator or delegate and tell them you support it too.

Kristina Gaddy is a young adult cancer survivor and advocate in Baltimore; she volunteers with the Ulman Cancer Fund for Young Adults, There Goes My Hero and First Descents. Her email is kristinagaddy@gmail.com.

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