(265) BARRIERS TO FERTILITY PRESERVATION: THE ROLE OF HEALTH POLICY, COST, AND ACCESS TO SPECIALIZED CARE

Abstract Introduction Iatrogenic infertility, arising from necessary medical interventions such as gonadotoxic chemotherapy, radiation therapy, certain surgeries, biologic treatments for autoimmune conditions, and hormone therapy, presents significant reproductive challenges. Fertility preservation techniques-including the cryopreservation of embryos, oocytes, ovarian tissue, sperm, or testicular tissue-provide critical options for patients seeking to maintain their reproductive potential. Despite growing awareness and increased referrals for individuals at risk, numerous barriers impede access to fertility preservation services. Objective This study aims to identify and analyze the obstacles that patients face in accessing fertility preservation services in the context of iatrogenic infertility. Methods A comprehensive literature review was conducted using PubMed, with a focus on the terms “iatrogenic infertility,” “fertility preservation,” and “health policy.” Relevant articles were systematically reviewed and categorized by three reviewers to ensure thoroughness and accuracy in identifying key barriers. Results Key barriers to fertility preservation identified include prohibitive costs, limited access to specialized care, and inconsistent insurance coverage. The financial burden for fertility preservation ranges from $2,500 to $20,000 for initial processing and storage, with significant variability based on state and insurance policy. Additional challenges include a lack of standardized guidelines to inform policymaking, difficulties in policy implementation at the state level, and insufficient coverage in public insurance programs, including Medicaid. Conclusions The lack of attention to fertility preservation before fertility-compromising treatments can significantly impact patients' well-being and quality of life. Urologists and other healthcare providers can play a crucial role in improving patient care through advocacy, policy initiatives, and clinical practices. Future directions include advocating for policy changes at multiple levels, increasing access to specialized fertility care, and leveraging technological advancements to reduce costs. Disclosure No.