As professionals involved in the field of fertility, we often hear our clients say, “I just didn’t know”. They didn’t know about the age at which fertility begins to decline, they didn’t know how expensive advanced fertility treatments can cost, they didn’t know how difficult it can be to adopt, they just didn’t know how significant the road blocks might be to family building.

With respect to fertility preservation, based on data presented recently, younger women tells us that they  didn’t know that sexually transmitted diseases can lead to fertility struggles, that riskier lifestyles as young women can lead to challenges with respect to later family building efforts.

But what else about our reproductive selves do we not know? Recently, my oldest girlfriend (we have been friends for more than 30 years, the sort of friendship that blurred the lines and crossed over to “family’ decades ago) was diagnosed with advanced stage fallopian tube cancer. I cannot tell you how many “didn’t knows” have come up since the diagnosis. The most shocking of all, dear friends, was that she was completely asymptomatic until a minor fender-bender coincidentally led to a scan which then led to the diagnosis of a metastasized and pervasive cancer. My friend “didn’t know” that her reproductive organs had developed a malignancy….she just didn’t know.

It was suggested, by her oncologist, that because my friend is of Ashkenazi Jewish descent that there may be a genetic link to her cancer, it was also suggested that because my friend delayed child-bearing, that she was, therefore, at higher risk. Guess what, despite regular gynecological visits and standard screens, my friend did not know that genetically or with respect to lifestyle choices she was more likely to develop this rare cancer, some have suggested to me that likely, ever her gynecologist didn’t know.

Given the connection to the nature of my friend’s cancer and the work that I do, I immediately began to reach out to colleagues. Powerful, well-informed and high-profile folks have responded with exclamations of not knowing, as well. “I’ve never even heard of fallopian tube cancer” said one very well-know known IF professional and another said, “my only guess is that it is related to ovarian cancer”. It is true, even within the gynecological oncology community that little is known about fallopian tube cancer. Because it is so rare, little funding is made available for research, minimal, if any, efforts are being undertaken for awareness.

I am pondering, this morning, this big picture question about how much we, as women, just do not know about our reproductive risks and wondering what that means for our girlfriends, our sisters, our daughters, ourselves. “I just didn’t know” cannot be acceptable, particularly with matters like fertility and gynecological cancers because not knowing until it is too late is just, well, it seems, too late.