I was diagnosed with cancer and couldn't afford fertility treatment. IVF should be free.

When I was 32 years old, I was diagnosed with cervical cancer and was forced to make some quick decisions about having children.

First, I had to decide whether to freeze my eggs before undergoing cancer treatment. But when I found out that egg freezing wasn’t covered by my insurance and would cost thousands of dollars, I had no choice but to take that option off the table. My nonprofit job just didn’t pay enough for me to afford such a large out-of-pocket expense.

After cancer treatment, my doctor said that my only chance of getting pregnant would be through in vitro fertilization (IVF). But when I found out the procedure wasn’t covered by my insurance and would also cost thousands of dollars, I had no choice but to take that option off the table, too.

My story is more common than you think. Between 2012 and 2016, nearly 100,000 American women a year were diagnosed with gynecological cancer, including cervical, uterine and ovarian. Recent studies show that cases of cervical cancer in low-income communities and cancer among young people are rising.

Chemotherapy, radiation and surgery can have damaging effects on a person’s reproductive system, so assisted reproductive technology like egg freezing and IVF are critical safety nets for cancer survivors who want to have children. Yet, year after year, thousands of women, including not just those who survive cancer, can’t pursue families simply because of the exorbitant cost of IVF.

I want to be a mom. Abortion policies and IVF choices limit my options – and my future.

Why is IVF still so expensive? The answer is simple.

A single cycle of IVF can cost anywhere between $15,000-$30,000. Most women and people who can get pregnant go through several cycles before conceiving, which could cost hundreds of thousands of dollars.

Women and in some cases their families are forced to make an impossible choice – to incur massive debt or forgo the dream of having children. It just doesn’t make sense. Fertility care is essential health care.

A recent survey showed 42% of Americans say they or people they know have used fertility treatments. In fact, about 1 of every 50 people you meet in the United States were conceived through IVF. So why does IVF still cost tens of thousands of dollars and remain out of reach for a majority of women and people who can get pregnant?

The answer is simple: sexism.

And its economic impact is real. Thousands of women are putting their career aspirations on hold taking lower-paying jobs at companies whose insurance plans will help them achieve their dream of having children. And while nearly 800 of the world's largest companies offer employer-paid fertility care, according to FertilityIQ, this only highlights how access to IVF is a matter of class.

For low-income women, Medicaid programs – even in states that have expanded coverage for reproductive health care like California – don’t cover IVF at all. In fact, access to health plans that cover IVF is limited nationwide.

My frozen embryo: An embryo that could be my second child is in Alabama. A court just put that in jeopardy.

IVF access is decided by states – and corporations

Only 21 states require health insurance companies to cover some fertility treatments and just 15 mandate that they include IVF.

In 2022, only 54% of the biggest U.S. employers with 20,000 workers or more offered insurance coverage for IVF to employees. For smaller companies, even fewer offer those health plans to workers. But even for people lucky enough to live in a state or work for a company where IVF coverage is an option, high insurance premiums still prevent many people from accessing care.

Starbucks, one of the few companies that offer IVF coverage for part-time employees, was exposed in 2022 for charging workers high insurance premiums that took most if not all of their paychecks and resulted in some workers going into debt with the company. That is beyond unacceptable.

But now, cost isn’t the only potential barrier to accessing IVF. In February, a Republican judge in Alabama issued a ruling that stopped IVF treatments across the state in a blatant attempt to advance a sexist anti-abortion agenda. Even extremist Republicans knew the judge went too far, but the damage was done, and heartbroken Alabama women and their families are paying the price.

A bill co-sponsored by Sen. Tammy Duckworth, D-Ill., offers one solution. If passed, it would expand access to IVF, override state restrictions and allow the Justice Department to prosecute any entity, state or individual from blocking care.

Congress should pass this bill, but it’s also important that we demand more. All of us should be able to access IVF no matter where we live, and we shouldn’t have to pay for it. IVF should be free for everybody.

In a country where women are the largest growing workforce in a majority of industries and represent more than half of the college-educated workforce, our options are still extremely limited when it comes to deciding whether and when to have children.

When most people think about “choice” and reproductive rights, they think about expanding access to abortion. But that’s too limiting. From birth control, abortion and egg freezing to intrauterine insemination, IVF and menopause care, our health care decisions should be in our hands alone and all options should be readily available.

I’m now 42, happy, healthy, settled and living a wonderful life with my husband, dog and many, many nieces and nephews. But sometimes I imagine living in a country where egg freezing and IVF were free. Would I have made the same decisions as I did in my 30s? I don’t know. But I want the next generation to truly have options.

Nicole Regalado is vice president of campaigns atUltraViolet, where she focuses on combating sexist and racist online disinformation, building a feminist internet that's safe for all and disrupting sexism in politics and culture.

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This article originally appeared on USA TODAY: Why is IVF so expensive? Fertility treatment should be free