Fertility Preservation Services for Adolescents and Young Adults: 2022 National Cancer Institute Community Oncology Research Program Landscape Assessment

Erin M. Mobley, Department of Surgery, College of Medicine Jacksonville, University of Florida, Jacksonville, FL.
Julie Anna Wolfson, Division of Pediatric Hematology-Oncology, University of Alabama at Birmingham, Birmingham, AL.
Jennifer Levine, Center for Cancer and Blood Disorders, Children's National Medical Center, Washington, DC.
Lingyun Ji, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA.
Subhash Ramakrishnan, Children's Oncology Group, Los Angeles, CA.
Chandylen L. Nightingale, Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC.
Emily V. Dressler, Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC.
Carol Kittel, Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC.
David R. Freyer, Children's Hospital Los Angeles and USC Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA.
Aaron J. Sugalski, University of Texas Health Science Center San Antonio, San Antonio, TX.
Pinki Kumari Prasad, LSU Health Sciences Center - New OrleansFollow
Jessica Sheth Bhutada, Children's Hospital Los Angeles and USC Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA.
Karly Murphy, Department of Psychology, Eastern Carolina University, Greenville, NC.
Wade Kyono, Department of Pediatrics, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI.
Michael E. Roth, Department of Pediatrics, University of Texas MD Anderson Cancer Center, Houston, TX.
Susan K. Parsons, Departments of Medicine and Pediatrics, Tufts University School of Medicine, and Division of Hematology/Oncology, Tufts Medical Center, Boston, MA.
Melissa P. Beauchemin, School of Nursing, Columbia University Irving Medical Center, New York, NY.

Document Type

Article

Publication Date

6-4-2025

Publication Title

JCO oncology practice

Abstract

PURPOSE: Given the impact of cancer treatment on fertility among adolescents and young adults (AYAs: 15-39 years), it is important to ensure AYAs access to fertility preservation (FP). However, the availability of FP services for AYAs treated in community settings is unknown. We examined FP access at National Cancer Institute Community Oncology Research Program (NCORP) practice groups. METHODS: The 2022 NCORP Landscape Assessment survey captured available resources and cancer care services including FP services at practice groups. We described FP services as accessible (on-site or off-site) versus not accessible by AYA-treating status (as previously defined). Univariable and multivariable analyses were used to evaluate associations between FP services and practice characteristics (NCORP classification [minority/underserved or community] and proportion of Medicaid or uninsured above/below the national average). RESULTS: Among 271 practice groups responding to the survey, 100 were categorized as AYA-treating, of which 32% had neither male nor female FP services available. Sperm banking was available at 59 AYA-treating practices, among which 43 (73%) referred for sperm banking off-site. Although approximately half of AYA-treating practices reported accessible female FP services (embryo = 54%, oocyte = 55%, ovarian tissue = 40%), most of them referred patients off-site (embryo = 72%, oocyte = 80%, ovarian tissue = 83%). The odds of access to male FP were lower at minority/underserved practices (odds ratio, 0.34 [95% CI, 0.13 to 0.88]; P = .026; ref = community); however, this same relationship was not seen for females. CONCLUSION: Despite guidelines surrounding FP discussions before cancer therapy, and strong consensus regarding the importance of FP access, many AYA-treating practices in community settings lack access to FP services. Understanding how to leverage available services and broadly expand access is urgently needed to facilitate guideline-concordant, high-quality cancer care for AYAs.

First Page

OP2401017

PubMed ID

40466034

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