Introduction
STEPHANIE SIROTA: Picture this. You're a woman in your early 30s with your whole life ahead of you. One day you receive a cancer diagnosis. The doctor says chemotherapy could leave you infertile. Egg freezing costs between $15,000 and $20,000. It's not covered by insurance, and you have to decide now if you want to have a family.
Our guest today lived that moment firsthand. This is a story about a gap in the healthcare system and what it takes an operator and an advocate to close that gap between what women need and what insurance will pay for.
Welcome to The RTW Podcast, where we aim to keep our audiences healthy, wealthy, and wise.
I'm your host, Stephanie Sirota, Partner and Chief Business Officer at RTW Investments. Today we're excited to welcome Amanda Rice, three-time cancer survivor, and the Founder and CEO of The Chick Mission, a nonprofit helping women with cancer diagnoses preserve their fertility. Amanda, thank you for joining us.
AMANDA RICE: Thank you for having me, Stephanie.
"You Aren’t Infertile Yet": The Insurance Call
STEPHANIE SIROTA: Set the stage for us, please. What happened on that phone call with your insurance company?
AMANDA RICE: This was the third time I was diagnosed with cancer, second time with breast cancer, and I couldn't avoid chemotherapy. And so when I had the phone call from my oncologist, quickly thereafter was a phone call from the social working team to say, “Just so you know, one of the side effects of chemotherapy is the potential of infertility. And so we encourage you to go and pursue this before you start treatment, if you want to have that option in the future."
When I called my insurer, I actually worked for a hedge fund that had fertility benefits. So I felt really lucky, but when I called, they told me I did not qualify for the benefits because I wasn't infertile yet.
I was like, "Wait, what? Who am I talking to? Like, are you new? Do you not understand what I'm saying? Am I not being clear because I'm confused and my world is crumbling around me?"
STEPHANIE SIROTA: Even though the benefits were there to be had and to be used, they said that you weren't infertile yet?
AMANDA RICE: Almost acknowledging that I would be infertile. And so I just got… I was so upset.
STEPHANIE SIROTA: So that's what insurance said. What is really the subtext behind that?
AMANDA RICE: It’s basically, “You aren't worth our time and efforts, and we're just thinking about getting you through this but not thinking about my whole life.” It was still Stage I cancer. I was going to be okay.
But the quality of my life, you know, not just the depression and anxiety that was felt in that moment, but also what was going to come later when I realized the loss.
From Insurance Denial to The Chick Mission
STEPHANIE SIROTA: Your solution was to build a company, The Chick Mission, which could help other women who also survive cancer, potentially become mothers. How did your work in finance, specifically, investing and fundraising, inform building The Chick Mission?
AMANDA RICE: You know, I have spent my entire career in fundraising. So I'm not afraid to ask for the business or the dollars. But the power of network is one of the most important things that somebody can realize that they have when they're going through a challenging time. And this network I had built up over two dozen years at work and in volunteer situations is full of very powerful people, you know, people that know people.
It was the network that could make this exponential change that was necessary to solve our problem over time.
STEPHANIE SIROTA: So you had three cancer diagnoses before the age of 40. That must have changed the urgency of what you were building.
AMANDA RICE: Absolutely. I didn't have time to think about this or process it. I had to act.
STEPHANIE SIROTA: What stage were you at in your diagnosis journey when you started building The Chick Mission?
AMANDA RICE: I had just been diagnosed for the third time in January.
And I did this hiking trip in between the first unsuccessful egg freeze attempt and the second. I was so hopeless and I just needed to get out in nature and get inspired, because I knew I had this fight ahead of me.
But, because I was an established woman with a career, with savings, I could go into my pocket and freeze my eggs. And, when I was out hiking, the name “The Chick Mission,” came to me when thinking about my friends and family who I knew didn't have this type of money and also the 19-year-olds, the 22-year-olds, who are just starting out in their lives. They might be still in college and they had no resources.
I continued on this long, long hike and almost skipped home to get cell service so that I could buy the domain name. That was, like, "Okay, I got my name." I know what this is about, and there's no turning back.
STEPHANIE SIROTA: Were you working at that time?
AMANDA RICE: Yeah.
STEPHANIE SIROTA: So starting Chick Mission was not your day job. You had a day job. The name is so clever, by the way. I love the double entendre. What did people say in the beginning? Who gave you the first no?
AMANDA RICE: My oncologist at the time said, "Are you sure you want to do this? You're going to be putting yourself out there as somebody who had cancer. What if an employer doesn't hire you because you have cancer?" And I quickly sold him on the idea. I said, "Lar, I don't care. I do not care, and if I'm unemployable, I'll find my own way because this is a part of me. This is my journey." My husband at the time also was hesitant. My close family, my mom, my besties, my reproductive endocrinologist all said, "Yes." And that was it. I mean, off to the races.
STEPHANIE SIROTA: That's great that you had plenty more yeses that could drown out some of the noes. One thing that I think is really exciting;
The 48-Hour Hope Grant
STEPHANIE SIROTA: you have this 48-hour grant approval. That's a design choice that says a lot about you and your values. Where did that come from, and what did you have to do to build such a quick and efficient process?
AMANDA RICE: The motivation behind that was you can't waste time in this moment. People have to make life or death decisions before they begin.. We can't throw a lotta red tape in the middle of this decision.
So we work hand in hand with over 100 fertility clinics and we work with their billing team or their patient support team or their nurses or their social workers who are gonna be on the front lines with the patient so that they can get all of the answers from the patient before they even apply.
Make it easy on us to give you an answer. And we decided that our committee, our grants committee was gonna be really small and they were always going to have to respond. It still remains a committee of three to this day.
STEPHANIE SIROTA: And everyone is committed to move fast.
AMANDA RICE: Yes.
STEPHANIE SIROTA: That's amazing. What does one grant actually cover?
AMANDA RICE: A grant covers an entire egg freeze cycle, so from your initial consultation to all the blood work and monitoring to the anesthesia and the retrieval, and to that first year of storage of your eggs. We require that our fertility clinics provide one year of storage, and that's at a minimum. And then recently, we partnered with a company that is going to provide three additional years of storage that we're gonna cover the cost of for every grant recipient if they are willing to move their eggs to this long-term storage facility.
STEPHANIE SIROTA: How many women have you funded?
AMANDA RICE: We're almost at 900. You know, we're going to blink and it'll be here.
CEO of Your Own Body
STEPHANIE SIROTA: The last time we spoke, you said something that stuck with me. You used the phrase "CEO of your own body." Can you dive into that?
AMANDA RICE: It is a way to reframe your power in a medically challenging moment. You know, I'm in charge of my body, and it's on me to notice and to get familiar with what my cycle looks like. Do I get frequent headaches or not? Am I staying out of the sun or using sunblock? Those are my decisions that I need to make. I need to be responsible. And that goes hand in hand with your appointments. You gotta prepare for them. I remember going in to talk to this breast surgeon after I felt a lump and realized it was cancer for the third time. I had this list of questions, and I got to question three or four and I stopped talking. Because you're in this environment where you're in the paper gown naked, and they're in the jacket. Of course, they know your body better than you do. False. You absolutely know your body better. I was dismissed so many times along the way.
"No. You're too young for cancer. This is not cancer." No, I was right every single time. And my body told me. And anybody who's listening, like, you need to fight for yourself. Nobody knows your body better than you. Treat your doctor like they're a part of your team, but they don't dictate. They're there to listen and collaborate with you, so be forthcoming.
STEPHANIE SIROTA: It's natural to feel so scared, and just defer to the authority figure in the room because they've seen this before and you haven't. But, you're saying that we're our own best advocates.
AMANDA RICE: We are. Doctors are incredible, but just think about how many people they see in such a short period of time. And they're basing it on statistics. And I really respect and admire statistics, but they only take you so far. They need your input. Can't just all be statistics.
Putting Ourselves Out of Business: The State-by-State Playbook
STEPHANIE SIROTA: In a previous interview you said, "We ultimately want to put ourselves out of business by changing all the state laws." What does that actually look like for The Chick Mission? What's your timeline and how are you progressing?
AMANDA RICE: If I had known how complicated this was when we first started, I probably would have estimated the timeline a little bit differently. Little bit longer. There are nuances to state government, changing laws, and changing things at the federal level.
And, there's a difference between private insurance and state employees, and Medicaid. But the most inspiring thing I could think of was that over time, with enough hard work, enough advocates, enough survivors, enough family members, our collective group effort could lead us to that intangible thing, right?
Twenty years from now, this can just be part of cancer care. We did borrow this playbook from the women and men who decided that women who had breast cancer deserved reconstruction after a mastectomy.
That wasn't covered by insurance back in the day. They had to go state by state and change these laws, to get people the bodies back that they wanted. Plenty of people decide not to, but it's their choice. I really, really, really can't wait until we put ourselves outta business and we're gonna throw one heck of a party.
STEPHANIE SIROTA: You've passed mandates in 21 states. Do you have a playbook that you follow?
AMANDA RICE: A coalition of folks from different organizations that focus on fertility, infertility, cancer, young adult cancer, have been working so hard for so many years. And we got so inspired by the work that was being done. When I was first diagnosed, I was living in the suburbs of New York City in Connecticut.
the first advocate that I came across, she went to her state legislator who was a young adult cancer survivor and said, "How messed up is this? our fertility preservation is not covered by insurance." And he was the first legislator to introduce legislation that actually passed and became law. That was back in 2017, the year that I started The Chick Mission. I found her, and I found this effort and that was what rounded out our mission.
Texas, Arizona, and the Medicaid Gap
STEPHANIE SIROTA: What state so far has proved to be the hardest?
AMANDA RICE: Texas was probably the hardest so far, although we had a little setback in Arizona and that was really frustrating. Our bill went to the first committee in the house, passed unanimously, and it was going to the second committee. And a legislator there who was the chair of the committee, he’s not shown up for work since April 23rd. So no bills that were sitting in his committee passed after that date.
I'm still digesting that, but what I told all the advocates there, all of the locals, all of these incredible young women who put their hearts on the line, "We're not going anywhere. We're gonna pick you up. We're gonna hug you, and we're gonna get this done next year."
STEPHANIE SIROTA: That must be so frustrating because on one hand you're trying to run this very tight ship. And you're doing everything because time is of the essence. And then on the policy side so many things are out of your control.
AMANDA RICE: Yeah. Those temporary setbacks are painful. After the bill didn't pass in Texas for the second session, I lied down on the floor and cried. But you have to believe this will happen. I know deep down in my gut and in my heart that it's going to happen. For the third go-around, we came back with an even better plan.
STEPHANIE SIROTA: With Medicaid being the biggest gap, what is it actually gonna take to solve that?
AMANDA RICE: So Medicaid is, it's tricky. You have to decide when you're starting, what you're going to try to get legislators to introduce.
Do you include Medicaid or not? Because if the state is in a fiscal deficit, it's gonna be really hard to pass an insurance mandate that includes Medicaid patients. So sometimes we have to start with private insurance or state employees to almost set the stage.
The insurers try very hard to say that, "Every single person that's diagnosed in this state is gonna use this benefit," which is false. Utilization rates are much lower than you would think with this.
This is patients from teens to late 30s, early 40s. Some of them have already had kids. Some of them, like me the first time, had a mastectomy and reconstruction. That doesn't impact my fertility.
But Medicaid is tricky because we passed legislation in New York state last year, but none of our clinics take Medicaid. So now we're on the hunt for the right group of people in New York state to cover the Medicaid population. And I think we're getting closer.
Resilience After "Cancer-Free"
STEPHANIE SIROTA: You've beaten cancer three times. What have you learned about resilience?
AMANDA RICE: The cancer treatment taught me a lot about having to dig out of just the depths of despair and keep fighting. And I'm not saying I just jumped outta bed and was, like, "Yippee." No. It took a while, but I know I can dig deep.
STEPHANIE SIROTA: Were there just days where you felt like "I can't do this" or "this is not gonna work? It's too much, too much on me."
AMANDA RICE: I had a couple of those days in the beginning.
I did go through, you know, a really deep dark depression, and I always bring that up when I'm talking to other people who have been diagnosed because I don't want anybody to get caught off guard by how deeply dark you can go after you quote-unquote "beat" cancer.
Like, you're a whole different human, and the things that brought you joy before cancer are different.
But I think very early on in our journey of creation was my mom, who's a retired project manager, who just kept chipping away. And our founding board, they all have incredible strengths. And then our volunteer corps. All of these people being around me, like, just reminded me: just take that grit that you've always had and apply it towards what you're building, what you continue to build. And that’s so cool.
900 Women, 14 Babies
STEPHANIE SIROTA: You're on this hero's journey, and you're changing lives literally. What is your interaction with the chicks that join The Chick Mission and the patients that you help?
AMANDA RICE: I'll never forget meeting the first grant recipient at a breast cancer charity event.
She came over to me, and she's, like, "Hey! You froze my eggs." And we just embraced, and we cried. We get letters very often from people that, even before they start their treatment, they're like, " I've gotten bad news for the last X number of months and finally somebody is saying they believe in me and my future. You're giving me hope," which is why we call them hope grants.
And getting the call, like, "Oh yeah, I forgot to tell you, I just had a baby." Like, what? We have 14 babies that we know of, and we don't require that they tell us who they are.
They truly don't owe us any explanation, but the stories and the pictures are awesome.
Following the Science
STEPHANIE SIROTA: That's extraordinary. I'm curious just because RTW is a healthcare investment firm and at ASCO 2026 there was incredible data around this RAS mutation that is a driver behind almost a third of cancers. How closely do you follow the science?
AMANDA RICE: We love following along. And there are so many incredible doctors that really break down the science on Instagram.
I am so encouraged by what is coming next out of cancer land, out of fertility land. I like to brag that I'm the smallest LP in stature and in dollars, but I do invest in firms that are trying to innovate in both places.
And I try to spread the word just given my big mouth and my fundraising chops. If I believe in what they're doing, I'm gonna tell all of the investors that I know that work on healthcare about them, because this is how we solve problems.
I did not hesitate to do this podcast because of just the phenomenal work you guys are doing. Our industry sometimes gets such a bad rap, and I disagree wholeheartedly because we're trying to really put the money behind the things that will make a difference.
STEPHANIE SIROTA: That's exactly right. The money behind the things is what makes it all tick. We're coming out of this four or five year bear market.
And the data, especially what we've seen at ASCO and across other areas of innovation is actually better than it has been ever. And it is still incredibly underinvested in most investors' portfolios. But I think humanizing the great work of what industry is doing is really important.
AMANDA RICE: Because of AI, and because of just how far we've come in oncology. Wow is this gonna be a time we look back on and say, "This is the golden age."
My oncologist was the former president of ASCO, and every time I go to see him, we talk about what's the next thing. And so there's just so much. I remember him recognizing that I work in hedge fund land, and him saying, "Oh, well, you must know my friend "Jim Simons." (LAUGH) And I said, "Nope, I don't know your friend Jim, but I know of Jim. And he's like, "You know, this AI thing is really gonna…it's gonna do wonders for our industry."
STEPHANIE SIROTA: It is gonna do wonders for the industry. It's like when the genome was sequenced, and then it took a little bit of time for the cost of the genome to come down so that so many more labs could afford to use it.
Rewriting the First Oncologist Conversation
STEPHANIE SIROTA: And now we have AI that's gonna unleash the same if not more power on discovery. So I love how you bring up, you know, your relationship with your oncologist. If you could rewrite the standard of care, walk us through a young woman meeting her oncologist for the first time and receiving the diagnosis. What should that conversation look like?
AMANDA RICE: Not only do you want to survive this diagnosis, you want to have a very high quality of life. Oncologists are trained to get you to that five-year NED moment, so no evidence of disease.
And at the five-year mark for most cancers, the recurrence rates dip really, really, really low. That's great, but we want to talk about what happens after treatment and where you are.
Don't just make any assumptions about, you know, say I walk in the door and I'm 32 and I'm married with three kids. Don't assume I don't want another child. Don't assume I want to go into premature menopause.
When you're put into medically induced menopause, you know, there's a whole long transition period to be productive and have your brain work at full capacity. So I think you just need to humanize that interaction.
I was very intimidated by my oncologist at the start. But boy, did he step up for me when I was feeling those deep dark thoughts and I was able to share with him that I wanted to step in front of the subway one day.
And he, all of a sudden, this man that was on a pedestal became a human being that helped put my mind at ease. And immediately, we formed an action plan. Set an appointment with the MSK mental health group.
Let's take you off this medication, then maybe put you on this other medication. So I think start that appointment not only about your disease and all the facts and figures, but ask them a personal question. They may not answer you, but talk about your dog. I bring my dog to my appointments.
STEPHANIE SIROTA: What kind of dog do you have?
AMANDA RICE: I have a the best Cavapoo on the planet.
STEPHANIE SIROTA: Well, we have a Dog Days of Summer event coming up at RTW. It's in honor of my dog Albert's birthday, so you'll have to bring your dog to the party.
AMANDA RICE: Nola will be there with bells on.
STEPHANIE SIROTA: We'll send you details. So really it's not about just survival. It's about aspiring to have the best quality of life and humanizing that experience.
AMANDA RICE: Absolutely. You are worthy of that. I feel lucky to have survived. That's one way to look at it, but you deserve more. You deserve to feel better, to get your energy back. It takes time, and I'm an impatient girl, but I did run a marathon again, 2024. And maybe I was a little slower than when I was 20-whatever, but, the thing that hurt the most the next day was my jaw because I smiled the entire day. Not even my body. My jaw.
Worthy of More Than Survival
STEPHANIE SIROTA: You are incredibly worthy, and what you're doing is so noble. Thank you for giving hope and life to so many people out there.
AMANDA RICE: It's my privilege. Thank you so much.
Credits
The RTW podcast was produced and directed by me, Devon Leaver, at the RTW headquarters in New York and edited by Dominique Guerra, with production coordinator YingYu Lin and production support by Annabelle Chan. Our sound engineer was Stephanie Polonio.
Executive editorial advisor was our partner, chief business officer, Stephanie Sirota. Special thanks to John Wasilewski. Our theme music was “Ganymede” by Yehezkel Raz. Additional music was by APM Music. To make sure you never miss an episode, you can subscribe wherever you get your podcasts.
Watch this podcast on YouTube or read the transcript at rtwfunds.com/podcasts. Follow us on LinkedIn at RTW Investments, LP, and check our website for the latest updates and insights. This interview was given by Amanda Rice, Founder and CEO of The Chick Mission, and moderated by Stephanie Sirota, Partner and Chief Business Officer at RTW Investments.
Statements reflect RTW's views and opinions as of the date hereof and not as of any future date. All expressions of opinion are subject to change without notice and are not intended to be a forecast of future events or results. The views expressed by guests are their own, and their appearance on the program does not imply an endorsement of them or any entity they represent.
Editor’s note: fertility preservation coverage legislation has passed in additional states since this episode was recorded; the "21 states" figure heard in the interview reflects the count as of the date of recording.
