In an educational session that kicked off this year's San Antonio Breast Cancer Symposium, Teresa Woodruff, PhD, noted that survivors experience depression and anxiety because of sterility. Adult survivors of childhood cancer are often afraid to begin dating because they don't want to have that conversation with someone at an early stage in the relationship but are uncertain as to when to initiate it. Young men and women have the same concerns, but these concerns are heightened among young breast cancer patients. Fortunately for me, I was already married when I learned that I had cancer. I was also the mother of a wonderful two-year-old boy named Ryan, who remains the best and brightest light in my life. That said, at 35, I was devastated when my oncologist told me that I wasn't going to be able to have more children. I had always thought I would have two or three kids and the thought of Ryan being an only child, with no sibling to grow old with, made my heart ache. It still does. Lance Armstrong announced publicly that he banked his sperm – that was one of the first public acknowledgements that cancer treatment can cause sterility and patients should do something to preserve their fertility before treatment.In regards to the logistics of preserving one's fertility, men have an easier time, but not all men have been offered sperm banking. There needs to be better patient navigation in adequate time to ensure that men are able to father future generations. Options for women have been available for some time, but are not always used. Navigation is more difficult – Women have to go from cancer care to reproductive endocrinology and then back to cancer care again which is difficult, and quite honestly, scary and stressful.Woodruff suggested that patients and doctors know that fertility conversations should happen, but she isn't convinced that all newly diagnosed patients are thinking about fertility, even if it is more widely known. What about you? Did your healthcare team bring it up? Were you given a chance to fully understand your options?