A new systematic review from the Columbia University School of Nursing finds that access to fertility preservation (FP) care remains limited and unequal for girls and young women with cancer. The research paper, “Fertility preservation access for female adolescents and young adults with cancer: a systematic review,” was published in Cancer on June 23, 2026.
More than 85,000 adolescents and young adults (AYA) between the ages of 15 and 39 are diagnosed with cancer each year in the United States. After diagnosis, AYAs face an increased risk of long-term treatment-related effects such as cardiotoxicity, ototoxicity, and infertility. Among these, infertility is frequently reported as the most worrying concern for girls and young women with cancer. The American Society of Clinical Oncology published guidelines for FP care on May 1, 2006, emphasizing that FP is essential to cancer treatment. Nevertheless, the proportion of FP care provided to female patients is less than half that of male patients, as available interventions are often costly, invasive, and time-sensitive.
A review of existing literature from 2006 to 2025 reveals inconsistent implementation of these guidelines, resulting in inequalities across gender, race, geography, and socio-economic status. Of the 10,151 publications initially identified in the standard search, the Columbia Nursing Research Team found 25 publications focused on access to FP care for girls and young women with cancer. Of note, most of these studies documented barriers to FP care, but few found evidence of interventions to address them.
”FP consultation rates with healthcare providers ranged from 9% to 75%, consultation rates with fertility specialists ranged from 0.9% to 57%, and FP completion rates ranged from 0.56% to 70.3%. Factors promoting access included younger age, private insurance, unmarried status, higher socioeconomic status, specific cancer type, and recent year of diagnosis.‘, the authors report.
”This review also highlights the multifaceted nature of disparities in the provision and access to fertility preservation care. Consistent with previous literature, racial and ethnic minority patients were significantly less likely to receive counseling, referral, or complete fertility preservation. Similar inequalities have been reported in other areas of survivorship care, suggesting that barriers to fertility preservation reflect broader structural inequalities within the oncology system.. ”
The authors conclude that these inequalities highlight the need for routine integration of FP into oncology care and for interventions that address structural and geographic barriers.
This research was supported by the Reducing Health Disparities through Informatics (RHeaDI) Predoctoral and Postdoctoral Training Program Grant T32. Study authors include Marcela Algave, MPhil, Sophie Junak, MPhil, Rebecca Schnall, PhD, and Melissa Beauchemin, PhD.
sauce:
Columbia University Irving Medical Center
Reference magazines:
Algave, M. Others. (2026). Access to fertility preservation in female adolescents and young adults with cancer: A systematic review. cancer. DOI: 10.1002/cncr.70486. https://acsjournals.onlinelibrary.wiley.com/doi/10.1002/cncr.70486
