Oncofertility patterns after the overturn of Roe v. Wade

The 2022 U.S. Supreme Court decision Dobbs v. Jackson Women's Health Organization raised concerns about access to fertility care for patients with cancer, yet there is limited evidence of its real-world impact. We conducted a national survey of National Comprehensive Cancer Network (NCCN) Member Institutions to evaluate changes in fertility preservation access and utilization in the 24 months following Dobbs. Of 33 institutions surveyed, 24 (72.7%) responded. Most institutions (83.3%) reported that reproductive care remained a clinical priority, and 62.5% reported increased fertility preservation utilization. Nearly all respondents reported stable or expanded institutional resources and staffing to support oncofertility services. Institutions in less restrictive states appeared to absorb increased demand, however notable non-response from institutions in restrictive policy environments limited our findings. This study suggests relative resilience among academic cancer centers, but highlights the need for further study to ensure equitable access to fertility preservation in the post-Dobbs era.