Editor’s note: RFG Fellow Madison Chapman recently earned her master’s degree in Development Economics, Humanitarian Studies and Gender from The Fletcher School of Law and Diplomacy at Tufts University, and received a Presidential Management Fellowship, which allows her to work as a civil servant. She also survived lymphoma while in graduate school, and now that she’s been in remission for more than a year, she wanted to get more involved in the cancer advocacy community. She recently published the following article on cancer treatment and fertility in Ms. Magazine.

This article is about health care access, infertility, President Biden, and the big business of fertility preservation and IVF in the United States.

But first, a disclaimer:

In December 2018, I was diagnosed with Hodgkin’s lymphoma. It took a month of testing, prodding and scanning to confirm, but a biopsy finally revealed that stealthy stalker—cancer. I was 24 and in my first semester of graduate school.

Days later, I met my oncologists. I nodded robotically as we discussed treatment, survival rates, chemotherapy, nausea, hair loss. Then my oncologists caught me off guard: Did I want to freeze my eggs?

Between 20-70 percent of those undergoing cancer treatment experience infertility, yet only a handful of states mandate that health insurance companies cover the exorbitant fees for in vitro fertilization (IVF). Many of these mandates do not apply to those with cancer or other chronic illnesses. The Affordable Care Act (ACA), despite expanding access to health care, also fails to mandate fertility coverage federally.

Those faced with the harrowing decision to pay out of pocket for fertility treatment—especially transgender folk, queer folk, the chronically ill and Black women, who are at greater risk of infertility—can experience severe physical, emotional and psychological harm as a result.

My oncologists told me that I could undergo precautionary egg preservation. Yet my health insurance company, unsurprisingly, did not insure egg freezing, so I would have to pay the $12,000 sticker price up front. I had nowhere near $12,000 to spend, but with the immense privilege of family and community financial support, I decided to go through with the procedure.

After one month of injecting myself with hormones and feet in stirrups, I was able to harvest 35 eggs before chemotherapy—my own insurance policy on motherhood. Unfortunately, even with a generous subsidy from the Livestrong Foundation, that “insurance policy” cost $5,000 plus a shocking $1,000 annual storage fee—in fine print, of course.

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