Background
Fertility preservation (FP) is a important survivorship consideration for children, adolescents, and young adults undergoing cancer treatment. National and international guidelines recommend timely, informed FP discussions for all patients at risk of gonadotoxicity. However, access to oncofertility services across Australia remains inconsistent, often influenced by local expertise, clinician confidence, and service structure. Early findings from the national In Time program at Royal Women’s Hospital, Melbourne, reveal gaps in awareness and referral processes across many sites. Centres with dedicated oncofertility roles and strong multidisciplinary integration demonstrate that early, consistent FP discussions are achievable within complex care pathways. This collaboration between oncology, reproductive medicine, nursing, and psychosocial teams enables coordinated care and reduces missed FP opportunities.
Objective
To describe In Time, a national oncofertility initiative designed to strengthen clinical leadership, improve FP access, and support equitable, timely fertility discussions for AYA cancer patients.
Method
In Time incorporates two components: a national education program for health professionals to support evidence-based FP discussions and service integration, and a referral pathway for ovarian and testicular tissue transport, cryopreservation, and long-term storage.
Findings
Services with embedded oncofertility expertise report more consistent FP discussions and improved referral timeliness. In contrast, services without these roles often experience delays, uncertainty regarding responsibility, and missed opportunities during treatment planning. Consumers consistently emphasise early, proactive fertility discussions as essential to routine oncology care.
Conclusion
Embedding oncofertility expertise, supported by our dedicated In Time team, strengthens multidisciplinary integration, improves coordination, ensures equitable FP access and affirms that “your patients are our patients”.