Establishing oncofertility care in limited resource settings: a narrative review.

Purpose: While the literature has addressed the implementation of oncofertility care at developed institutions, minimal advice exists for those seeking to build oncofertility programs in limited resource settings (LRS). Our research offers a promising conversation on establishing oncofertility care in such settings from the perspective of a practitioner working to establish care in Latin America. We propose practices that have the potential to significantly improve access to and quality of care in these challenging settings.

Methods: PubMed was used to identify articles on fertility preservation (FP) in LRS for this narrative review. Eligible articles were published between January 2010 and May 2023, available in English and include two or more key phrases: "oncofertility care," "limited resources," "low-income settings," "limiting access," and "fertility preservation."

Results: As each institution faces a unique profile of medical, financial, geographical, cultural, and legal considerations, it is difficult to generalize an approach to optimizing care. However, the success of many programs is underpinned by collaborative efforts to educate and support healthcare specialists across the globe. National and international clinical guidelines, an unparalleled opportunity to promote the maintenance of a high level of care, do not exist for many Oncofertility practices. It is necessary that future guidelines consider barriers unique to implementing care in LRS as historically, guidelines have not done so, leaving LRS practitioners to deviate from the standard of care without consensus on how to best do so.

Conclusion: It is crucial to consider the unique challenges in low-resource settings when strategizing the expansion of oncofertility efforts, optimizing care, and developing clinical guidelines. Addressing the diverse barriers to care requires multifaceted initiatives at local, national, and international levels.