Fertility Preservation Before Cancer Treatment

Health Insurance May Not Cover the Cost

When young people have cancer, their family’s primary focus is to get the treatment they need to save their lives.  That’s the first priority for any cancer patient.  But for people who have not had children, there’s another urgent concern—preserving their fertility, so they can have a family in the future.  And most states do not require health insurance to cover the cost of fertility preservation.  Only about 5 percent of new cancer diagnoses happen in young people ages 15 to 39, so fertility preservation has not been addressed until recently.

Fertility Preservation, the Whys and Hows

Cancer treatment can harm your fertility or in some cases cause sterility.  In women, surgery to remove ovaries or the uterus can cause infertility.  The effects of chemotherapy and radiation vary depending on the type and stage of cancer.  Chemotherapy drugs called alkylating agents and radiation applied to the ovaries do the most damage in women.  In men, surgical removal of the testicles and chemotherapy or radiation that damage sperm production, quality or quantity can lead to infertility.  Yet studies show that most oncologists don’t routinely discuss fertility with their patients.Fertility preservation involves freezing the eggs, sperm or embryos before cancer treatment for later use, usually in IVF.  Some experimental treatments freeze ovarian tissue with immature eggs, to be transplanted back into the patient when cancer treatment is over and they are ready to try to get pregnant.  This is the only option for pre-pubescent girls to preserve fertility, but it is still experimental. Sperm freezing has been practiced for decades, and semen frozen for 20 years has successfully been used in IVF.

Costs of Fertility Preservation

On average, the fee to perform sperm analysis and freeze the specimen runs about $300-$500.  Annual storage fees vary, but generally run about $400 per year.  Some sperm storage facilities give a lower rate if you pay up front for multiple years of storage.Egg freezing or oocyte cryopreservation is like the early part of an IVF cycle, only the eggs are frozen instead of being fertilized and transferred to your uterus.  Fertility drugs are used to stimulate your ovaries to produce multiple eggs, which are extracted and frozen for future use.  Egg freezing costs about $10,000 to $12,000 per cycle, plus the cost of fertility medications, which can run $5,000 to $10,000 per cycle.  Storage costs average $300 to $500 per year. Stimulating your ovaries and extracting the eggs may delay cancer treatment by two to three weeks, depending on where you are in your cycle.

Insurance Coverage and Other Options

In the past, fertility preservation was not covered for cancer treatment.  During the last two years, five states have mandated coverage of fertility preservation for young cancer patients:  Connecticut, Rhode Island, Delaware, Illinois and Maryland.  Eleven other states are considering coverage. But the majority of states do not require coverage.  These laws also do not cover self-funded employer health insurance plans or state and federal coverage like Medicaid and Tricare (for the military).Livestrong Fertility is a nonprofit that provides family-building options and fertility preservation discounts to people with financial need, before and after cancer treatment.  They offer access to discounted services and free medications.