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The New Pro-Choice Movement: Fertility Preservation

Fertile Action founder and fertility preservation patient advocate, Alice Crisci, shares her thoughts on the challenges patients face when navigating insurance coverage or lack there of for oncofertility procedures.


By Alice Crisci

Every day, I struggle with the notion that most Americans diagnosed with cancer have to pay out of pocket for fertility preservation. For women, this cost can run as high as $20,000 in some markets. As an advocate, I engage insurance companies on a daily basis trying to get them to evaluate fertility preservation through a different lens other than infertility. I ask this question: “Would a 17-year-old with leukemia really be seeking infertility treatment?”

Breast reconstruction is coded and approved under a cancer diagnosis, and so too should fertility preservation be coded and approved the same way.  We shouldn’t need legislation to force insurance companies to make this change. As a patient advocate, I think the out these insurers are taking by evaluating coverage based on whether or not their plan covers infertility benefits is unethical.

Surely, no insurance plan in America covers cosmetic procedures, and yet we cover breast reconstruction. Remember analogies from your SAT’s:  Cosmetic Procedures: Infertility as Breast Reconstruction: Fertility Preservation. Unfortunately, insurance companies don’t see it that way. They look at it like this: Breast Reconstruction: Cancer as Fertility Preservation: Infertility.  How does that make any logical sense, if we know emphatically, that the cancer will cause infertility?

I recently had a young woman who pursued fertility preservation with a physician she was uncomfortable with because that physician’s fee was significantly lower than the physician this patient really wanted to see. As a recent college graduate with student loans and a part-time job, she felt she had no choice. Isn’t that what the reproductive rights movement has always been about? Choice?

  • Choice to use the birth control pill.
  • Choice to abort.
  • Choice to find an adoptive family.
  • Choice to be a single mother.
  • Choice to freeze your eggs or ovarian tissue when diagnosed with an illness that could cause infertility.

I don’t yet know if legislation is the answer or if placing public pressure on insurance companies to view fertility preservation under the cancer column, rather than the infertility column, will create lasting change. I do know until I figure out what the answer is, I’ll continue to write my advocacy letters requesting coverage for our patients, and I’ll continue expanding the Fertile Action network of fertility specialists who donate their fertility preservation services to help those touched by cancer preserve their reproductive right to have a baby in the future.

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