Access to Infertility Care and Utilization of a Regional Fertility Preservation Program for Cancer Patients

Abstract

Background. Fertility preservation (FP) prior to gonadotoxic cancer treatment is underutilized in the United States (US) due to limited access to care. Objective. We aimed to determine the utilization of a regional FP program in an underserved region in the Southeast US. Methods. We performed an institutional review board-approved retrospective cohort study of patients enrolled in the FP program at an academic tertiary medical center from 2014 to 2018. Results. Sixtynine reproductive age patients were enrolled in the FP program, including 29 men and 40 women between 20 and 49 years of age. Cancer diagnoses among the enrolled patients included hematologic (n = 34), breast (n = 14), testicular (n = 11), reproductive tract (n = 7), and gastrointestinal (n = 3) malignancies. Patients with reproductive tract malignancies were found to have approximately 9.7 times greater odds of proceeding with FP than patients with hematologic malignancies (P < .05). Conclusion. Utilization of a regional FP program should be considered to increase access to care to this critical resource for patients desiring future family building. Patients with hematologic malignancy may face unique barriers to FP.