An Implementation Model for Oncofertility Support in a Regional Cancer Center without an In-House Reproductive...

Fertility loss related to cancer treatment can significantly affect quality of life among pediatric, adolescent, and young adult patients. Many regional cancer centers lack an in-house reproductive medicine unit, which creates barriers to timely fertility preservation (FP). To address this gap, our hospital established a multidisciplinary Oncofertility Working Group in collaboration with nearby reproductive centers. This study evaluated referral activities and outcomes after working group establishment and aimed to propose a feasible FP support implementation model for cancer centers without reproductive medicine units.

We developed a standardized referral pathway and consultation checklist sheet in collaboration with a primary external reproductive center. We retrospectively analyzed consecutive patients referred for FP using consultation checklist sheets and medical records. Questionnaire surveys were conducted at working group launch and 4 years later to assess institutional changes.

Between April 2022 and September 2025, 45 patients (24 female and 21 male) were referred for FP. The median interval from referral to reproductive consultation was 2 days. FP was performed in 70.8% of female patients and 95.2% of male patients. Survey results showed a shift from department-dependent practices to a standardized referral system.

Even in a regional cancer treatment cooperation base hospital without an in-house reproductive medicine unit, multidisciplinary coordination and structured external collaboration can deliver timely and practical FP support. This implementation model may help reduce regional disparities in oncofertility care, although further work should strengthen information sharing and long-term follow-up.