Proposed law would assure cancer patients insurance for fertility preservation
As a physician who practices in obstetrics and gynecology in Chicago and the suburbs, I frequently work with young patients whose lives are upended by a major diagnosis like cancer. Fortunately, modern advancements in cancer treatment protocols, coupled with widespread early detection programs have led to extended life expectancy and improved survival rates for cancer patients.
However, radical surgery, chemotherapy and/or radiation therapy can leave patients infertile or unable to have biological children.
Major medical organizations like the American Society of Clinical Oncology, the American Society of Reproductive Medicine and the National Comprehensive Cancer Network all state that the treating oncologist has a responsibility to inform patients about the risks that their cancer treatment will permanently impair fertility and discuss fertility preservation options at the earliest opportunity possible. After these conversations are initiated, patients are referred to fertility specialists who can offer options like sperm or egg banking.
Unfortunately, these fertility preservation options can be costly and many patients are shocked to find that even though it's a recommended treatment by their physicians and major medical organizations, insurance doesn't typically cover the associated costs.
Current Illinois insurance law does not include fertility preservation as a covered items in private insurance policies for these young adult cancer patients. It should be noted that Illinois insurance law does cover other treatments of side effects of cancer treatment - cranial prosthesis (wigs) for hair loss from chemotherapy, breast reconstruction after a mastectomy, medical management of premature ovarian failure (menopause) after loss of ovarian function, etc.
It seems unjust that we are choosing which condition resulting from cancer treatment will and won't be covered when family building for many young adults is a primary concern.
Low-income women who are unable to produce $10,000 to $15,000 in out-of-pocket expenses for egg preservation are forced to decide between lifesaving cancer treatment and their desire for a future family.
Additionally, current Illinois insurance law requires large insurance groups to cover the diagnosis and treatment of medical infertility, defined as the absence of pregnancy after one year of attempted conception. Patients who meet this definition then qualify for insurance coverage for procedures such as egg harvesting and in-vitro fertilization.
Sadly, many young oncology patients will only qualify for insurance coverage for infertility after their cancer treatment, when it is often too late to retrieve viable eggs or bank viable sperm.
Up-front coverage of these fertility preserving procedures gives young cancer patients a much better chance at having a family in the future.
I strongly urge Illinois legislators to support House Bill 2617, which provides insurance coverage for chemotherapy, radiation therapy, radical surgery or other medically necessary treatment that threatens their ability to have a biological family. Rep. Robyn Gabel, an Evanston Democrat, is the chief sponsor of the legislation and co-sponsors include Reps. Laura Fine, a Northbrook Democrat, Steve Andersson, a St. Charles Republican, and Anna Moeller, an Elgin Democrat. The bill has the support of the American College of Obstetricians and Gynecologists, the American Society for Reproductive Medicine and the Alliance for Fertility Preservation.
We urge you to support family building in Illinois by supporting HB 2617 and doing all you can to get fertility preservation passed in 2018.
Michelle Brown, M.D., of Chicago, is a resident physician in the Department of OB/Gyn at University of Chicago Medical Center.