Episode 74: Fertility After Cancer - Navigating Parenthood & Building Hope

The Patient From Hell Podcast (00:01.437)
Hi everyone, this is Samira Daswani, the host of the podcast, The Patient From Hell. I think this is the first time I have a husband -wife duel on our podcast, so welcome, Megan and Mike.

Mike Scherer (00:15.233)
Thank you.

Megan Scherer (00:15.83)
We're happy to be here.

The Patient From Hell Podcast (00:17.783)
Can one of you guys tell me what you guys do maybe not full time with Worth the Wait and how that came to be?

Mike Scherer (00:27.009)
Yeah, so with Worth the Wait, we help.

adolescent and young adult cancer survivors either preserve fertility before cancer treatment on an emergency basis or help them build families through financial assistance grants. So that's how Worth the Weight really started. And at this point, we've, you know, we continue to do that. But at the same time now, we're also much larger in education and advocacy around why the conversation about fertility

and how cancer treatment can affect fertility is so important for adolescents and young adults.

The Patient From Hell Podcast (01:10.163)
And how did you guys end up working in this space?

Mike Scherer (01:15.718)
So Megan and I, we got married at 23. So married pretty young. We were high school sweethearts. We actually started dating at 15. And just a few years into our marriage, so three years into our marriage, I was diagnosed with testicular cancer.

So, you know, went from being hard charging, career oriented young professionals to all of a sudden cancer patient and caregiver. And it was about a two year.

know, time frame where I was being treated for testicular cancer and Megan was taking care of me. And so following that whole experience, when we were ready to start a family, we were thrown back into, you know, an uncertain time period because there, it was very difficult for us to start a family due to what my, you know, life saving cancer treatment did to my fertility.

The Patient From Hell Podcast (02:17.875)
I am one sorry to hear that. Before we go into the cancer story, I go back to when you guys were 15? Where did you guys go to school? How did y 'all meet?

Mike Scherer (02:25.507)
Sure.

Megan Scherer (02:31.314)
We went to separate elementary and middle schools, but we were in Spanish together freshman year of high school. I frankly just thought it was so annoying. Then we ended up in a giant auditorium study hall sophomore year. For some reason, they didn't see us alphabetically because my maiden name C.

Mike Scherer (02:46.626)
You

Megan Scherer (02:59.968)
his name S, somehow we ended up sitting, he sat behind me and he like started throwing little notes at me and he won me over.

The Patient From Hell Podcast (03:13.201)
Megan, which North one you are?

Megan Scherer (03:15.362)
my gosh, he's, Mike is so funny. So it was probably, probably a joke.

The Patient From Hell Podcast (03:23.891)
That is incredible you guys. So you guys met at 15, you got married at 23. Mike, when was diagnosis?

Mike Scherer (03:32.323)
I was 26.

The Patient From Hell Podcast (03:35.583)
And when do you guys end up talking about building a family?

Mike Scherer (03:40.63)
Yeah, so actually I remember I finished treatment in 2012. Right after treatment, one of the first questions we asked the doctor was like, when should we start thinking about this? How long do we have to wait? He said, give it at least one year. We waited two years. was 2014 is when we really got serious about starting a family.

The Patient From Hell Podcast (04:05.617)
Mike, can you talk to us about what kind of treatment you went through, if you don't mind?

Mike Scherer (04:09.037)
Sure.

Yeah, I had, so I had what's called non -seminoma testicular cancer. So it's an aggressive cancer. It has a very high cure rate, especially when you receive chemotherapy. The chemotherapy can be pretty brutal for it. So I had surgery first to remove my tumor. And then I went on a surveillance protocol. So just regular chest x -rays, CT scans and blood work.

And then after a few months of that, it had spread to lymph nodes. So that's when I had to go through three rounds of chemotherapy.

The Patient From Hell Podcast (04:52.755)
Are you suing the surveillance protocol today?

Mike Scherer (04:55.797)
Nope, nope, cancer free. Thanks, yeah, yep.

The Patient From Hell Podcast (04:58.496)
Yay! That's awesome. One of the other survivors on the Manta team talks about how she's been dating Ned. So now I just have to ask you, I'm assuming you've been dating Ned for a long time.

Mike Scherer (05:08.236)
Yep.

Mike Scherer (05:14.063)
Yeah, after, so after chemotherapy, it was a surveillance protocol for about five years after. And then once I was through that surveillance protocol with no evidence of disease, they actually with testicular cancer declared you cured. Right.

The Patient From Hell Podcast (05:31.335)
Wow, that's incredible. Yay.

Mike Scherer (05:33.579)
Yeah, so yeah, so I have a cured status and you know, it feels great to have that status, but like I tell a lot of people, cancer never really leaves your life. You think about it every single day. It's a part of who I am and who we are now. you know, yeah, you deal with something every single day due to having cancer.

The Patient From Hell Podcast (05:59.219)
I definitely relate. Megan, what was that like for you? 26, your husband gets diagnosed.

Megan Scherer (06:10.634)
Yeah, I mean, it was certainly unexpected and I'm a pretty type A person, so I'm like, I'm just gonna control everything I can control in this situation. Mike actually had to work through a lot of his treatment.

We were both working for small businesses at the time, so we didn't have FMLA. So I got a little sign up genius and I got all of our friends and family to take them to chemo. All of our family is local, so that was really helpful. I don't think I would have gotten through it without my mom's support. When you're 26, you're not thinking about...

becoming a caregiver, you're not thinking about someone you love being diagnosed with cancer. So it was crazy, but you know, we look at where we are now and what we've achieved with Worth the Wait. And I don't think Mike would ever say he's glad he got cancer, but I think a lot of good things came out of the experience.

The Patient From Hell Podcast (07:20.212)
I can relate to that as well. I'm not that far out. I'm your four? Four. Your four, I guess. So, getting there, hopefully.

Mike Scherer (07:28.439)
They're good. Yeah, get in there. Yep, that's awesome.

Megan Scherer (07:31.018)
Yeah, you're on the right path.

The Patient From Hell Podcast (07:35.091)
So what, before we go into worth the wait, could you talk a bit more about what you guys went through? So you're 26, 28 -ish when treatment starts to kind of close out. You start having a family, what happens next?

Mike Scherer (07:47.948)
Yeah.

Mike Scherer (07:51.533)
Yeah.

We so we had spoken to my doctors and kind of said hey when when we're trying to start a family, you know, what what do we need to know next and the recommendation was just try for a year and if you're not having any success then come back and see us. We we tried for about six months and we were like this is we're just going to you know talk to a doctor again. So at that point we actually went to Megan's OBGYN and

They started to really introduce us to the world of fertility treatments and different things we could be doing. So we had a lot of discussions and Megan and I decided that IUIs were our best path just for our lives at the time.

So we started doing IUIs. It ended up being about a two -year process with no insurance coverage. You know, on top of just doing procedures, you're also doing plenty of tests and, you know, blood draws and different things just to try and give you the best chance. But we had done six IUIs and we were close to giving up at that time and saying, okay,

you know, let's look into adoption.

Mike Scherer (09:18.207)
So we started to really go down that path and explore adoption, talked to some adoption agencies as well as folks who had adopted and just decided, let's just give it one more shot. we, Megan went on some pretty hardcore injectable drugs and we did one final IUI and that gave us our miracle son, Elliot.

The Patient From Hell Podcast (09:46.941)
Thank you for sharing that. How old is Elliot?

Mike Scherer (09:50.62)
He is seven.

Megan Scherer (09:50.678)
He's seven now.

The Patient From Hell Podcast (09:53.843)
That's a wonderful age.

Mike Scherer (09:56.545)
Yeah, it's a lot of

Megan Scherer (09:57.406)
It is so fun and and you know looking back on that experience knowing what we know now I would have done some things you know very differently. So an IUI is interseminin insemination so.

You can take like hormonal medication to increase your egg count. And then they basically take a sperm sample, spin it, and then put it back in. So the conception actually like happens inside your body rather than with IVF, which is, know, in a Petri dish. But we used all of the sperm that Mike banked for our IUIs that were failing one after another, one after another. So we had used everything he had frozen in advance.

And so that was definitely an interesting experience. It like, have nothing left. We're going off of fresh samples. So it really was a miracle that we were able to have our son. when he was about a year old, we were like, okay, like we want to do this again. So we ended up having a few more IUIs. And then Mike at the time had kind of met with a new doctor and he was like, no one ever should have done that. Like there's no way that was going to work.

you guys really need to go to IVF, which is in vitro fertilization where you know embryos are created outside of the body and We were like, my gosh, we've been through so much like we don't want to do this But we just felt like if we didn't we would have regrets later You know when we had a chance and we were young enough that you know We're gonna have a good shot at it. So we ended up doing just one round because it's it's so expensive and like

Mike said there's no insurance. We personally didn't have insurance coverage for it. So we said, that's our limit. We're going to do one. We were able to create one embryo and then we transferred it and it didn't work. So at that point we were like, we gave it our best shot and we're so happy to, you know, be parents to our son. And then COVID hit and we were like, my gosh, there's so much wrong with the world right now. Like, what can we do to do our part?

Megan Scherer (12:08.748)
to do something to improve humanity. And we thought, what are the causes that are important to us? we're like, young people with cancer and fertility. And so we came up with the idea to start a charity that would provide grants to people who were freezing eggs, sperm, embryos, and then building families in survivorship through adoption, surrogacy, IVF. And we got it started, and it caught on pretty quick.

The Patient From Hell Podcast (12:38.74)
I can totally see that. Especially when did you guys start this?

Megan Scherer (12:42.722)
2021.

The Patient From Hell Podcast (12:43.763)
look at that. I don't think we can have a conversation about fertility without talking about the macro landscape that we live in. And it sounds like when you guys were going through it, when you started this in 2021, things kept shifting, if I remember right. Can you guys talk a bit about how you have managed to pull this together in the environment we live in?

Mike Scherer (13:15.041)
Yeah, it's, you know, any more with the environment we live in, it's kind of a new thing every single day. And I don't think we really sat down and kind of discussed the impact that the environment we live in could have on Worth the Wait until, you know, probably last year at some point. So we're in Ohio and, you know, there's we actually did we had a vote.

The Patient From Hell Podcast (13:15.271)
Thank you.

Mike Scherer (13:43.783)
last year where they did enshrine abortion rights into Ohio's constitution, we were actually at an onco -fertility conference the night of that vote. And I can tell you it was an international conference and the entire conference had eyes on that vote, Ohio specifically. There were so many conversations about, know, okay, let's use this as kind of a litmus test as to what could potentially

happened here. So, know, Ohio had that vote and that was encouraging for us, but at the same time, you know, then we see the news coming out of Alabama.

with embryo personhood laws. you know, it's such a volatile time and it changes every day. Unfortunately, the people who really get caught up in these changes are young adult survivors who, you know, they need to preserve fertility and they might not be able to, or they might not be able to have a family without, you know, assisted reproductive technologies. And

Not only that, but young adult cancer survivors, it's a fact that they have a net worth of about $100 ,000 at least less than people who are not cancer survivors. So, not only are these procedures really expensive, but add to that, hey, you might not even be able to do it in your own state, so then you have to travel.

It's such a struggle and you know, not to get political, but I think the laws around these things can't be black and white because when you take that hardline black and white stance, a lot of things fall through the cracks. you know, it was so devastating to finish cancer treatment and, you know, be on cloud nine understanding like, my gosh,

Mike Scherer (15:50.127)
got through this, we survived as a couple. We can go back to our normal lives and then all of a sudden when we start trying to have a family, you're thrown right back into the despair and the uncertainty. you know, we had the opportunity. We could get procedures done, even though we paid for it out of pocket. But I can't imagine being told like, nope, you can't get help here. You have to go somewhere else.

So, you know, luckily at this point it hasn't impacted us all that much as a charity, but who knows what the future holds.

The Patient From Hell Podcast (16:35.953)
Mike, can I go back to early diagnosis? Did you know back then the impact it would have on fertility for you?

Mike Scherer (16:47.049)
So one of the first things my surgical oncologist said is, hey, you need to go bank sperm.

And, you know, they actually, with testicular cancer, looking at a lot of the statistics, even when you receive chemo, a lot of the statistics say your fertility should go back to a pretty normal level after you're treated. But the, like my oncologists were great, so they still said, hey, don't follow the statistics. If this is something that's important to you, we encourage you to bank sperm. So both my medical oncologist and my surgical oncologist get

those recommendations. don't know if Megan really thought about the fertility aspect all that much beyond banking. I personally did not.

Interestingly enough, had, Megan had to convince me to even go bank because I was immediately in that, okay, I need to get through these treatments and see what's next mindset. And so I didn't want any distractions. Luckily I had, you know, a partner who said like, this isn't a distraction. This is necessary planning for us and for something we might want in the future. But yeah, you know, we were,

I was fortunate to be counseled and it's something like 50 % of oncologists are even counseling patients on the potential impacts for fertility. But I think the other important thing there too is I have heard that people will look at statistics and say, if this treatment's not, if it doesn't look like it's gonna be gonadal toxic, we don't need to have that conversation or we don't need to counsel you. And interestingly,

Mike Scherer (18:39.155)
enough, my fertility was significantly impacted and it was continuing to decline as I was getting semen analysis done, you know, after the fact. So if I had, you know, relied on statistics, we likely wouldn't be where we are today. So, you know, I think it's still something that we always say as cancer survivors, we're not a statistic.

And I think that's an important message for people that are going through this is don't focus on that. If you want to potentially have all the options on the table in survivorship, consider the precautions and the procedures that you might need to go through.

The Patient From Hell Podcast (19:24.179)
have so many questions for you guys. Can we talk a bit more about the finances? Because there is the finances of going through treatment, cancer treatment, and then you're grappling with the finances of fertility. I'm an AYA survivor myself. I'm assuming some sort of commercial insurance for at least the cancer side. I'd love to unpack.

your point on net worth in the AYA population, because I think that's critical here. So can you maybe talk a bit about that general theme?

Megan Scherer (20:04.042)
Yeah, so there's a nonprofit called the SAM Fund.

and they provide financial assistance, help with rent bills. They also do some family building grants for survivors, not patients, but survivors. And they did a study, I think it was back in 2018. And so we love sharing their data of that net worth $100 ,000 less. So you asked us to be vulnerable. We spent about $100 ,000 to try to have two children.

and

That's something that's not accessible to a lot of people. And, you know, we were, we were nervous when Mike was going through treatment about like, how is this going to affect our jobs? We, we were kind of in unique situations. I was working at a family business. So I was like, well, I know I'm not going to lose my job over this. Right. But Mike wasn't. And so we thought about like, my gosh, what if one of us can't work? And, even in survivorship, like it took until 10 years of survivorship for Mike to be able to buy.

additional life insurance. And so things like that, that if you're not a survivor, if you're not in this cancer world, you don't realize what an impact is, you know what it is. And so when you think about, you know, patients, survivors are a hundred thousand less because they've taken off time work, they have medical debt, they've gone through probably the most difficult point in their life.

Megan Scherer (21:34.69)
And now they find out that they can't have a child in your traditional way. And you need to afford IVF, which can cost $30 ,000 at least. It's just when you think about having access to this type of care and having the financial resources, there's so much improvement that needs to be done. And so when we started Worth the Weight, we were like, you know what?

let's just try to help a few people and see how it goes. And then we realized like, there's a few other nonprofits that are in this space and they're all wonderful. We know them all, we work with all of them, but there's not enough of us. We don't have enough money to raise and give out to help all the young adult cancer patients and survivors with this really unmet need.

The Patient From Hell Podcast (22:26.183)
Megan, there are a couple of things you mentioned that I'd love to double click on. The first is life insurance. I think that's a, I had this, I grew up in India and I remember going, I live in the US now, I went back home. You're called an NRI, a non -resident Indian.

And you can't actually invest in the Indian market if you had an R .I. status. So I go back. The only form of investing in the market, at least at the time of this conversation, was life insurance. So I'm sitting across the table from a life insurance agent trying to tell me that I should buy life insurance. And I look at him, I'm like, I'm almost certain I won't qualify. And he goes, why? said, well, I'm cancer survivor. He goes, so am I. And I just remember this

moment and he was like yeah I don't qualify either. I'm like this is just we have a life insurance agent trying to tell me I should get life insurance neither of us actually qualify for the rules and it's just this moment of time I was just like huh it's an interesting world we live in. I love your take on it.

Mike Scherer (23:41.185)
Yeah, you know, I think...

Life insurance was actually one of the things that we didn't really think about until, it's funny because I'm a financial planner. So I do that for people all day long plan for their life insurance. do not sell life insurance. But, you know, when we had Elliot, that's when we kind of sat down and said, my gosh, I need more life insurance because, you know, now we have this little person here and we need to have funds available should something happen to either of

of us. And again, you know, it takes an awful lot of work, especially with the cancer history. And yeah, you know, luckily enough, I had enough time since treatment that I was able to qualify, but it was and still remains to be, you know, more expensive than it would have otherwise been. So, you know, I think the other thing that young adult cancer survivors grapple with, like with our insurance, we had insurance.

and our insurance worked out. was decent insurance, but we just knew even five years out when I was doing surveillance, we were going to hit our out -of -pocket maximum every single year. It was guaranteed. I would basically schedule my first surveillance follow -ups for January. My insurance would renew and boom, I'm in my out -of -pocket max already. Insurance certainly helps, but it was still a burden on us.

even beyond, you know, trying to start a family.

The Patient From Hell Podcast (25:19.955)
Mike, think you're the first. I think you might be the first survivor I've met who just shared that story with you. I did the same thing. I in fact denied the first biopsy because it was the second last week of December. And I was like, we're going to wait for the yurt rollover. We're going to wait for January 1 because otherwise the bill you end up getting is these numbers get big very quickly.

Mike Scherer (25:36.664)
Right.

The Patient From Hell Podcast (25:47.059)
And very recently someone had asked me to write an op -ed that hopefully will come out at some point. And I ran the numbers and even if you look across plans and I'm talking commercial insurance, look at the cross plans, HMO plans, PPO plans, high deductible plans, your average out of pocket max. And if you include premiums, you're looking at 19 ,000 to $22 ,000 on average.

And I'm with you, I hit my out of pocket max every January because that's when I schedule my surveillance. And those numbers, I don't know how you afford that in the US. It's really difficult to afford that effectively into perpetuity because at least in my case, I'm gonna have screening and imaging done at least for the next six years, if not longer. And I don't know how you can even afford.

basic surveillance in oncology anymore.

Mike Scherer (26:46.465)
Yeah, it is a challenge. That is one of the reasons.

When I was getting treated for cancer, the last thing I wanted to worry about was my work. But, you know, the harsh reality of it is, is man, I feel like I need to still be an asset to my company in some way, because I don't want them to say, sorry, but we're going to cut you loose. Now, luckily, you know, I worked for a smaller business that I now own a piece of. And, you know, I was extremely fortunate to have

at that time bosses that said don't worry about it like even if you're not working we're going to take care of you but it was still a fear of mine so I still tried to make myself as valuable and indispensable as I could but you know I think the other thing that creeps in there and also changes things for cancer survivors compared to other you know people not dealing with that is even networks right so you're

Networks can change which can impact the care that you get and the quality of care you get based on what you can afford and what your plan offers So, you know, I what if my like it was a memory that really It gives me, you know a lot of anxiety or it gives people call it out I got a phone call one time from my insurance company and they called me and they said hey you've been

getting your imaging done at this hospital center. But there's a center that's not very far from you that will do the same imaging and then ship it to your oncologist and it's a fraction of the cost.

Mike Scherer (28:36.127)
And I just kind of laughed and I said, well, are you telling me that you're going to cover the place that I go to? And they said, yeah, we're covering it, but we just want you to be aware that there's a place not too far from you that is a fraction of the cost. And I laughed and I said, I'm going to hang up now and I'm not going to change anything because I have insurance for a reason. the system is broken. If you have to come to me to tell me I need to manage my costs, this sounds like a you problem.

That's the harsh reality of the system that we live in.

The Patient From Hell Podcast (29:09.479)
right here.

Here, here, here, my guy. Yep, I get it. Yep, definitely been there.

those insurance calls. How did you navigate fertility on top of this?

Mike Scherer (29:29.46)
You know, it's, I don't really think we ever sat down and kind of calculated out what we were spending because it would have been overwhelming. We, again, I mean, Megan and I are very open. We were very fortunate that we could do that. We worked very hard.

But we still were able to afford it. And yeah, we certainly had to change other aspects of our lifestyle. But we had that gift to be able to do it. once we were finished and we looked at the numbers, that's when we really came to the realization that this is crazy. we're shocked that we were able to do it.

it hit us really afterwards. And it is kind of funny because I think a lot of people, a lot of parents, you'll hear them talk about how expensive their children are. And we laugh because we're like, man, we spent a majority of it before our kid was even here. But, you know, I think that's the other thing that we wanted to do with Worth the Weight because we look into the eyes of our child now and we don't think, man, you were an expensive little guy. We just think,

we're so fortunate to have you here and be able to raise you and When we sat down to start worth the wait, we said, okay, do we believe that a Let's say a young adult survivor said hey I'm not going to try to have a family simply because I Can't afford it. So there's a financial barrier and that's the only reason If we were able to come along and say hey we'll remove that

financial barrier. So are you willing to go through what is also a difficult process, let's say you're doing IVF. Would you be willing to do that if we were able to remove that financial burden? And the answer was yes. So we said, okay, that's what we need to do. And even with IUIs and IVF, the statistics aren't all that favorable that it's going to work. It takes multiple times in many cases.

Mike Scherer (31:58.19)
But we said, would you be willing to deal with these statistics if the financial burden was lessened or removed? And again, the overwhelming response was yes. That's why we set out. said, okay, that's what we're going to try our hardest to do.

The Patient From Hell Podcast (32:13.627)
incredible you guys that really is incredible I can't tell you how many times we have someone who comes to our community and asks us for this so now we know what is in them

Mike Scherer (32:26.071)
Definitely. And you know, mean, the shame of it is, is we're doing what we can right now, and it's still a fraction of the cost that we're able to alleviate. So, you know, it needs to get better in so many different aspects.

Megan Scherer (32:46.402)
And there's so many stories of, you know, I'm hearing from tons of AYA patients every week who are reaching out for assistance and there are people who are maxing out their credit cards to pay for it. There's people I know that are selling t -shirts, that are selling popcorn, that are

doing these things because this is the one thing in their life that they want to have a chance at. And, you know, if we can come alongside them and relieve some of that burden and, you know, our grants are, they average $2 ,500, which is a lot of money, but it's not always enough depending on, you know, what treatment you're seeking and where you live and how expensive it is.

We can pay for lot of sperm bankings with that size of a grant. And there are some really amazing partners that we work with that, you know, hospital foundations, that comprehensive cancer centers are really helping to reduce some of the costs of, you know, egg freezing. But these patients need us so much. And, you know, even some of the higher income earners, because we have criteria for, you know, who qualifies and it depends on how much money we raise and all of that.

to limit.

There's this one patient that keeps reaching out to me and they make $150 ,000 a year. And like that seems like a lot for most people, right? And they're trying to do surrogacy, which costs $200 ,000 to do surrogacy. And I have to keep saying like, I'm so sorry, you know, we're getting all these applications from people who are making way less than you and, know, keep reaching out if you want. But, you know, there's people that are in far worse, you know, financial

Megan Scherer (34:35.593)
and that's just hard. So we wish we had all the money in the world to be able to help people keep the hope of ParentHUD alive.

The Patient From Hell Podcast (34:49.705)
Those numbers are staggering!

I'm kind of stuck on the 200 ,000 for sorry you see.

Megan Scherer (34:57.108)
Mm -hmm. I mean, it's it's an industry and You know, there's certainly people who are trying to do it themselves if they have a family member or friend who can be You know the gestational carrier, but there's still a lot of legal fees all the money has to go in an escrow account before hands if the Gestational surrogates insurance isn't surrogate friendly. You have to pay for that whole

extra insurance plan. They're buying them on the marketplace that are surrogate friendly. So there's just so many like costs that you don't even think about that are it's not like it's going in the pocket of the surrogate.

The Patient From Hell Podcast (35:41.715)
Guys, I can ask you questions, I think for hours. I think I'm going to have to transition us to rapid fire. That's a series of questions that I can ask you. Mostly what and how questions. Short answers usually so that we can clip it and give the community the sort short version of the podcast. I took a couple of notes and I may ask you.

Mike Scherer (35:52.579)
Sure.

The Patient From Hell Podcast (36:07.483)
for clarification on a couple of things that you've mentioned as well. I think this is the first time we're doing a rapid fire with two people. we, you guys decide who wants to take the question. How about that? Does that work? Okay. All right. First one. What is IUI?

Megan Scherer (36:19.948)
Okay.

Mike Scherer (36:20.279)
Okay.

Mike Scherer (36:26.443)
I'll take it actually, Megan. IUI is intrauterine insemination. So it is an assisted reproductive technique where conception actually still occurs not in a petri dish, but it's really in layman's terms, it's a way to deliver the sperm more effectively into the uterus.

The Patient From Hell Podcast (36:55.409)
What is IVF?

Megan Scherer (36:58.72)
That is in vitro fertilization. So eggs are harvested from the female and then they are fertilized with sperm and embryos created and then they use a catheter and put it back in for transfer.

The Patient From Hell Podcast (37:16.113)
What is FMLA?

Megan Scherer (37:19.802)
that's Family Medical Leave Act. So that is basically like protection for your job for a certain amount of time if you're a patient or a caregiver.

The Patient From Hell Podcast (37:31.761)
What is gonadotoxin?

Mike Scherer (37:34.871)
So gonadal toxicity is essentially the measurement of the impact that your treatment will have on your ability to conceive.

The Patient From Hell Podcast (37:51.591)
Read my own handwriting, guys. Give me a second. All right, we're gonna skip that one. When should patients and partners ask about fertility options after a diagnosis?

Megan Scherer (38:02.912)
right away. You don't have time to waste and you know depending on the diagnosis you may have a very short window. You know banking sperm takes a day but preserving eggs can take weeks and so you want to know upfront.

The Patient From Hell Podcast (38:23.325)
What are the primary fertility preservation options for families dealing with cancer?

Megan Scherer (38:30.914)
So for males, it's sperm banking. There is also something that's very experimental right now that they're doing some really unique research at the University of Pittsburgh, and it's called testicular tissue cryopreservation. So for young boys who have not gone through puberty yet, they're taking the tissue out.

The Patient From Hell Podcast (38:31.399)
No.

Megan Scherer (38:54.806)
doing some interesting things and there's some monkey babies from it. And then for females, there's egg preservation, which can be turned into embryos when fertilized. And then this is no longer experimental. There's ovarian tissue cryopreservation. And so that is great for young adolescents. They can even do it in babies. And then...

they later like put the tissue back in. So it's really a great option for people that don't have time for an egg freeze or if they're not mature enough to do that.

The Patient From Hell Podcast (39:30.427)
Megan, this one's for you. What is your biggest tip for someone who's helping someone they love deal with cancer treatment?

Megan Scherer (39:40.982)
Make sure you have a support person.

The Patient From Hell Podcast (39:44.645)
Mike, one's for you. What is the best piece of advice you've received from a fellow cancer survivor?

Mike Scherer (39:53.157)
jeez.

That's a tough one. I, know, the one thing that I really tried to do was not lose a sense of humor and not take everything so seriously. Like, yes, you're going through a very serious thing. But at the same time, if you take everything so seriously, if you if you listen to the things people say and you get so angry because they are trying to relate to you desperately, yet they cannot relate.

You have to let that roll off your back and it's unfortunate that you do and so many people want to say it's not fair and I understand but often times and this is a very long -winded answer when you're the person going through the treatment you have to be the strongest person for everyone out there to you have to be their support systems to and If you get to a point where you realize that they're just trying to relate to you in any way possible

out of love most of the time, I think it makes it a little easier to stomach.

The Patient From Hell Podcast (41:01.651)
was very profound. What has been the most useful resource, either of you have done to, during the cancer experience?

Mike Scherer (41:13.569)
There's so many. I for me, I did a lot of reading on really internet forums. So I did a lot of reading on testicular cancer internet forums. I didn't participate. I just read. So, you know, doctors tell you not to Google, but I Googled and, you know, there were certainly things that I didn't want to read, but that's where I also learned a lot of things. I also, you know, there's a really wonderful group out there called Immerman Angels that

gives peer -to -peer support. And I know some of those mentor -mentee relationships can be a very valuable source of experience sharing for young adult survivors.

The Patient From Hell Podcast (41:56.839)
Megan, what about you?

Megan Scherer (41:59.764)
You know, we were in a unique situation because, you know, adolescent young adult movement.

It was a thing, but it wasn't a thing at the Comprehensive Cancer Center where Mike was treated. It is now. They have a really nice program, but there were really no resources as a caregiver that I was aware of. Now, you know, working in the nonprofit field, there's so many amazing AYA groups like Elephants in Tea, Cactus Cancer. I could go on and on, but there's a lot of resources.

The Patient From Hell Podcast (42:31.975)
What is the one thing you do to recharge or reduce burnout?

Mike Scherer (42:38.576)
well for me, it's watching sporting events with my son.

The Patient From Hell Podcast (42:47.933)
Bye bye to you Megan.

Megan Scherer (42:49.334)
And I like to do yoga and I like to read.

The Patient From Hell Podcast (42:53.427)
Alright, last question you guys. When do you wish other people would know when they're navigating fertility as a cancer survivor or a cancer caregiver?

Megan Scherer (43:08.224)
I would say you're not alone. There's a lot of people that reach out to us and they say, you know, even if you can't give us a grant, it's just amazing to hear your success story. And it gives me hope to know that other people have made it through this challenge.

Mike Scherer (43:26.689)
Yeah, I think, you know.

There were so many times that we would just talk about how hopeless it felt. And we didn't understand what the outcome would be, but we kept pushing. We kept being our own advocates. We kept exploring different options out there. And the reason being is we knew there would be an outcome.

we wanted to do everything we could to get to that outcome and then be able to accept it. So like Megan said too, you're not alone. I mean, I know people's outcomes can be dramatically different, but everyone goes through a journey and has advice to share and experiences to share and different things that they can do to help other people going through this.

The Patient From Hell Podcast (44:23.153)
Magna Mike, thank you so much for sharing your stories. Thank you for sharing all the advice. Thank you for shedding light on, I think areas that as a community, we're just starting to talk more about. And thank you for doing what you do to help the AYA community and the broader oncology community. So thank you.