00:00 - Good morning.

00:01 - I want to thank everyone for joining us today.

00:04 - I especially want to thank today's

00:05 - speakers for joining us for this very important announcement.

00:09 - Amanda Rice, the founder and CEO of the Chick Mission

00:13 - and also a survivor, Rachel Dan Check, a cancer survivor,

00:19 - doctor Lindsay Goldblatt, hematology

00:22 - oncology fellow at Fox Chase.

00:25 - Doctor Sally Vitez and doctor Nicole Marchetto,

00:29 - reproductive endocrinology and infertility specialist at Shady Grove Fertility.

00:35 - I also want to recognize my house members,

00:37 - Bridget and Kristen, who are here.

00:40 - Thank you.

00:41 - Thank you.

00:42 - For their efforts as well.

00:46 - There are few words more scary than you have cancer

00:50 - for a young person in their reproductive years.

00:54 - There's the added worry of what kind of cancer treatment am I going to have?

00:59 - And what's it going to do to my fertility?

01:02 - We know cancer treatment can save a patient's life,

01:05 - but it can also damage your reproductive function.

01:08 - We also know that any fertility preservation

01:11 - effort must begin before the cancer treatment starts.

01:15 - Time is truly of the essence.

01:18 - We also know that paying for fertility preservation can be cost prohibitive

01:23 - for most and are inconsistently covered by insurers, leaving many

01:27 - with a nearly impossible choice between future fertility

01:32 - and the ability to solve their cancer.

01:35 - Approximately 5300 adolescents

01:38 - and young adults are diagnosed with cancer each year.

01:42 - Many are not married, are newly married,

01:46 - actively trying to start a family, are not even aware of the fertility risks.

01:52 - And while fertility preservation is recommended by major medical societies,

01:55 - less than 50% of oncologists discuss fertility preservation with patients.

02:01 - That's why we've introduced Senate Bill 1315

02:05 - to require insurance coverage in Pennsylvania for standard fertility

02:09 - preservation for cancer patients who must undergo medical treatment

02:13 - that results in infertility.

02:16 - So this will

02:16 - include egg freezing, sperm freezing, ovarian

02:20 - tissue preservation, storage for up to three years

02:25 - and applies before the treatment begins when intervention is still possible,

02:31 - but it does not include IVF or other fertility treatments,

02:35 - and it includes any exemption for a religious employer

02:39 - due to any potential faith conflicts.

02:43 - To date, 21 states including Connecticut, Delaware, Florida,

02:46 - Georgia, Maryland, new Jersey, New York and Oklahoma have taken

02:50 - this important step to ensure access to fertility preservation

02:54 - for patients facing medical treatment that threatens their fertility.

02:59 - Cancer patients should never have to choose

03:01 - between starting life saving treatment and future family.

03:06 - Protecting parenthood after cancer should be the standard of

03:09 - care here in Pennsylvania.

03:11 - So now it is my great honor to introduce Amanda Rice,

03:15 - the founder and CEO of The Mission.

03:18 - I know it's kind of a crazy title, and I thought it was kind of,

03:22 - but it really catches you.

03:23 - Chick mission provides a needs space hope grants to patients facing cancer

03:29 - that helps to offset the fertility preservation costs,

03:32 - and has supported 850 patients nationwide.

03:37 - Amazing work, Amanda. Thank you.

03:44 - I don't mind my booster seat.

03:48 - My name is Amanda Rice.

03:49 - I'm the founder and CEO of the Chick Mission, which is a creative name.

03:54 - It definitely it gets you.

03:56 - But I'm also a three time cancer survivor.

03:59 - Generations of my family, including my mom

04:02 - and my grandparents, called Luzerne County home.

04:05 - And I spent a lot of my youth driving, listening to the top 40

04:10 - and visiting my grandparents at Harveys Lake.

04:15 - When I was diagnosed in my 30s, not once, not twice, but three times.

04:20 - I learned to speak the language of cancer pretty quickly.

04:24 - Things move incredibly fast.

04:27 - Appointments, decisions, language

04:30 - you never expected to understand suddenly becomes your daily vocabulary.

04:34 - You don't really have the luxury of processing how you feel.

04:38 - You just move through it.

04:40 - With my recurrence, I was facing

04:44 - chemotherapy, radiation, and long term drug therapy.

04:48 - I had already gone through a mastectomy and multiple surgeries that came with it.

04:52 - But I was one of the lucky ones.

04:54 - I had fertility coverage through my employer.

04:57 - But here's the thing.

04:59 - I wasn't infertile yet.

05:01 - I was being asked to make a decision about something

05:03 - that hadn't happened to me, but very likely would.

05:07 - Like so many patients, I found myself living into, reality is at once

05:11 - fighting for my life while quietly grieving the possibility

05:14 - of losing a family I hadn't even had the chance to build yet.

05:19 - Today we have extraordinary advancements in cancer care.

05:22 - Survival rates are improving.

05:24 - Patients live longer, fuller lives.

05:27 - But our system has not kept pace when it comes to protecting

05:30 - what comes after survival.

05:32 - Fertility preservation is not experimental.

05:35 - It is not elective.

05:37 - It is a well-established, time sensitive medical intervention

05:41 - that must happen before treatment begins.

05:44 - In Pennsylvania, access is still inconsistent and too often out of reach.

05:50 - Patients are given days, sometimes hours, to make these decisions.

05:55 - They are handed costs that can exceed 15 to $20,000.

05:59 - So many people are forced to walk away

06:02 - not because the care doesn't exist, but simply because they cannot afford it.

06:06 - That is not a medical gap.

06:09 - This is a policy gap.

06:11 - I founded the chick mission to step into that exact moment.

06:15 - We provide financial assistance to women facing cancer

06:18 - so they can preserve their fertility before treatment begins today.

06:22 - And today, we have supported over 850 patients,

06:25 - committed more than $5.5 million in funding, and built a network

06:30 - of over 100 partner clinics nationwide, including here in Pennsylvania.

06:35 - We've seen what happens when this barrier is removed.

06:38 - We've seen patients move forward with treatment

06:40 - without carrying the additional burden of losing their future family.

06:44 - We have seen what it means not just to survive, but to have options

06:47 - after survival.

06:49 - In Pennsylvania, as in many states, coverage

06:51 - is not guaranteed for patients facing intergenic infertility.

06:55 - Infertility caused by necessary medical treatment.

06:58 - A side effect, and that means access is uneven,

07:02 - it's unpredictable, and it is fundamentally inequitable.

07:06 - Legislation changes that.

07:08 - Passing comprehensive fertility

07:10 - preservation coverage ensures that patients across the state receive

07:13 - consistent, timely access to care regardless of income or circumstance.

07:19 - It integrates fertility preservation into standard oncology care and removes

07:23 - the financial barrier at the exact moments patients are least equipped to carry it.

07:28 - Pennsylvania has the opportunity to make that the standard, not the exception,

07:32 - because patients deserve more than survival.

07:36 - They deserve the chance to build a life after cancer,

07:39 - and they deserve a system that protects their future.

07:42 - Thank you.

07:49 - Rachel.

07:58 - My name

07:58 - is Rachel Dan, and I'm from Pittsburgh, Pennsylvania.

08:02 - Two years ago, I was diagnosed

08:04 - with stage three ovarian cancer.

08:08 - At the time, I was newly married

08:10 - and my husband and I were trying to start a family.

08:13 - After about six months, we were told it was still normal.

08:17 - But when it didn't happen, I kept pushing for answers.

08:21 - I had a routine appointment.

08:22 - I asked for additional screening.

08:25 - Eventually, we saw a fertility specialist where testing revealed

08:29 - what looked like a cyst that needed to be removed.

08:32 - But we were hopeful that it was something benign.

08:35 - I went into surgery expecting a routine procedure,

08:39 - but when I woke up, everything had changed.

08:43 - That first was cancer

08:47 - stage three ovarian cancer at age 30.

08:51 - Overnight I went from trying to get pregnant to being told

08:55 - this was my last chance to preserve my fertility before treatment began.

09:00 - I moved immediately into

09:02 - a fertility preservation cycle because there was no time to wait.

09:05 - That window is incredibly small, and if you miss it, it's gone.

09:09 - And then treatment started.

09:11 - Months of chemotherapy, a major surgery, and the loss of my remaining ovary.

09:16 - Even after that treatment continued.

09:20 - Of everything cancer took for me.

09:22 - The possibility of not being able to have my own family was the hardest part.

09:26 - Because you're not just fighting to stay alive.

09:29 - You're also trying to hold on

09:30 - to a version of your future that suddenly feels uncertain.

09:34 - Today I'm one year and eight months out from active treatment,

09:39 - and now I'm beginning to think about what building my family could look like

09:42 - with the options that fertility preservation gave me.

09:46 - I'm one of the lucky ones, but not everyone gets that chance.

09:51 - Many patients aren't referred in time.

09:53 - Many cannot access fertility specialist quickly enough,

09:57 - and many simply cannot afford it.

10:01 - I know firsthand how devastating this experiences,

10:05 - and I also know that access to fertility preservation

10:08 - is not guaranteed, especially here in Pennsylvania.

10:11 - We have to do better because no one should hear the word cancer

10:16 - and at the same time lose their chance at a future family

10:19 - simply because they did not have access to care in time.

10:23 - That is why this matters not just for me,

10:27 - but for every patient who will sit in that chair next.

10:37 - Move that bag. Is.

10:48 - Good morning, and thank you so much for the opportunity to speak today.

10:52 - My name is Lindsay Goldblatt, and I stand before you today in two roles

10:55 - as a physician and my second year of oncology fellowship training

10:59 - and as a patient

11:00 - whose life has been shaped by cancer long before I ever wore a white coat.

11:04 - Cancer has always been a part of my story.

11:06 - My grandmother died of ovarian cancer before I was born, and I watched my mom

11:11 - battle and survive breast cancer twice before I turned 18 at age 20.

11:15 - I learned that I carry the BRCA one mutation, the same mutation

11:19 - that was responsible for my parent, my grandmother, and my mother's diagnosis.

11:23 - That moment reframed my future almost instantly.

11:27 - I was faced with a series of deeply consequential decisions at a young age

11:31 - whether to undergo risk reducing mastectomy, when to remove my

11:35 - ovaries and accept premature menopause, and how to plan if

11:39 - and when I wanted to have children before making all of these decisions,

11:44 - all while pursuing a career in medicine.

11:47 - Among all of these decisions, fertility

11:49 - preservation was the most complex and the most difficult.

11:53 - It meant navigating insurance and ambiguity and prior authorizations,

11:58 - coordinating time sensitive care, undergoing daily hormone injections,

12:02 - managing a very physically demanding process with significant side effects.

12:07 - I also experienced complications from that

12:10 - that landed me in the hospital for a week.

12:13 - Now, as an oncologist, I see much.

12:16 - I see how much more urgent and constrained this becomes for patients

12:19 - newly diagnosed with cancer.

12:21 - We often need to start chemotherapy within two weeks,

12:24 - and many of these treatments carry significant risk of permanent infertility.

12:28 - So in this narrow window of time, we ask patients to complete fertility

12:32 - preservation before treatment begins.

12:34 - And yet, many patients never pursue it.

12:37 - Not because they don't want children, not because they don't value their future,

12:41 - and not even because they're intimidated

12:42 - by the physical demands and potential complications,

12:46 - but because of the financial barriers, which, ironically,

12:49 - is the one part of this process that we all have the power to change.

12:53 - Inconsistent insurance coverage, unclear approvals,

12:56 - out of pocket costs that can reach the tens of thousands of dollars,

13:00 - create obstacles at the exact moment patients are least able to navigate them.

13:05 - As a result,

13:06 - we see patients who survive cancer but later grieve the loss of a family.

13:10 - They were never given the fair chance to create.

13:13 - We celebrate survivorship, and rightly so,

13:16 - but survivorship must include the possibility of full life afterward.

13:20 - The ability to build a family should never depend on zip

13:23 - code, employer or financial privilege.

13:26 - I stand here today both as a physician advocating for my patients

13:30 - and as someone who understands personally the way of these decisions.

13:35 - I was fortunate, but many are not.

13:38 - They deserve better.

13:39 - And saving a patient's life should not cost them their chance to create one.

13:44 - I urge you to support this legislation that ensures comprehensive, timely

13:48 - and equitable insurance coverage for fertility

13:50 - preservations for patients facing treatments that threaten it.

13:54 - Thank you.

14:07 - Good morning.

14:08 - My name is doctor Sally Vitez and I am a double board

14:11 - certified Ob-Gyn and reproductive endocrinologist.

14:16 - I care for patients who are navigating fertility decisions.

14:20 - At the same time they are processing a cancer diagnosis.

14:25 - I meet patients at one of the most vulnerable moments of their lives,

14:30 - and what I see repeatedly is that the hardest part

14:34 - is not always the medicine, it's the gap around it.

14:38 - With modern medicine, we can save the patient's life in the cancer center.

14:43 - We can support fertility building in the fertility setting,

14:46 - but there is often a disconnect between those two points in care.

14:51 - Fertility preservation for patients facing cancer is time sensitive,

14:56 - and there is a narrow window between when treatment

14:59 - begins and intervention is still possible.

15:03 - Patients are trying to understand what is happening.

15:06 - What will treatment involve and what the next steps look like,

15:10 - often all at once.

15:12 - When fertility is introduced into that conversation, something changes.

15:18 - The discussion expands beyond diagnosis and treatment of cancer,

15:22 - and it includes the possibility, the possibility of life after cancer.

15:28 - And that moment. That moment matters.

15:32 - It allows patients to think about themselves

15:35 - not only as someone undergoing treatment,

15:38 - but as someone who will come through it.

15:41 - And that shift is often fragile, because very quickly

15:45 - the conversation turns to logistics, to coordination and financial limitations,

15:51 - rather than what that future could actually look like.

15:55 - When I sit with a young woman who has just been diagnosed with cancer

15:59 - and explained to her that we can freeze her eggs before treatment begins,

16:03 - I watch something shift in her eyes.

16:06 - She feels hope.

16:08 - Hope sometimes.

16:10 - For the first time since hearing her diagnosis for a life after cancer.

16:15 - And often I watch that hope collapse when she learns

16:19 - that her insurance will not cover it and she cannot afford it.

16:23 - From a clinical standpoint, fertility preservation is well established.

16:28 - It is part of how we counsel patients prior to treatment,

16:31 - and it is our standard of care.

16:34 - The challenge is not whether we can provide that care.

16:37 - It's whether patients can move from being informed and able to actually act.

16:42 - This is not a question of science.

16:45 - It's not a question of medicine.

16:46 - It is a question of access.

16:49 - We have the science.

16:51 - We have the protocols.

16:52 - But we have a system where too often dollars

16:56 - and cents determine whether a patient can access that care.

17:00 - And that is what needs to change. Thank you.

17:12 - Thank you for the opportunity to speak.

17:14 - My name is Doctor Nicole Marchetto and like Doctor Vitez,

17:18 - I am a double board certified gyn and reproductive endocrinology

17:23 - and infertility specialist at Shady Grove Fertility, a US fertility partner

17:28 - in Uncle Fertility.

17:29 - We operate on a timeline that most people cannot fathom.

17:33 - A patient is diagnosed with cancer and within 24 hours

17:36 - she is in my office, still processing the worst news of her life.

17:40 - And I must tell her that the very treatment designed to save her

17:43 - life may also take away the ability to have children.

17:46 - Within two weeks, we need to complete an egg retrieval before chemotherapy begins.

17:51 - There is no time to fundraise.

17:53 - There is no time to seek loan approval.

17:56 - There is no time to appeal.

17:58 - An insurance denial.

18:00 - Every day of delay is one day

18:02 - closer to treatment and a day further from parenthood.

18:06 - Cost should never be the reason a patient runs out of time.

18:10 - We tell our patients to be hopeful, to fight, to picture their future.

18:14 - But what kind of future are we offering when we save their life and strip away

18:18 - their chance to become a parent simply because their insurance says no?

18:23 - These patients are being asked to survive,

18:26 - and then they are told that the life waiting on the other side

18:29 - may not include the family they have always imagined.

18:32 - This is not a side effect of cancer.

18:34 - It is a side effect of policy.

18:37 - The science is ready.

18:38 - The protocols are ready.

18:40 - The patients are ready.

18:42 - It is the insurance companies that are holding us back.

18:45 - I've had the privilege of helping cancer survivors

18:47 - conceive and carry pregnancies after chemotherapy treatment,

18:51 - using the eggs that they have frozen before their world turns upside down.

18:55 - Those moments are why I went into medicine.

18:58 - But I have also sat with survivors

19:01 - who could not afford preservation prior to treatment, who completed treatment

19:05 - cancer free

19:06 - and are in remission, who then learned that they were permanently infertile

19:10 - and had not had the opportunity to freeze their eggs prior.

19:15 - Both outcomes happen in the same hospitals,

19:17 - in the same centers, with the same doctors using the same science.

19:21 - The only difference is money.

19:24 - This is not a medical failure.

19:25 - Rather a policy failure.

19:27 - We are looking for your help to change that.

19:30 - Thank you.

19:38 - So, as you can tell,

19:39 - there's a lot of passion behind Senate Bill 1315.

19:42 - And we are going to ask all of you to help us get it across the finish line.

19:46 - Because no person should ever have to decide

19:49 - between a future family and a cancer treatment.

19:53 - So I want to thank you all for coming today,

19:55 - and I want to thank these amazing women.

19:56 - So please, let's give them a round of applause.

20:01 - Thank you

20:02 - guys very.

20:05 - Thank you.