Children and young people with cancer in the UK are experiencing a postcode lottery for fertility preservation services, according to a new study published in the Archives of Disease in Childhood. The research reveals significant variation in the availability and funding of treatments such as egg, sperm, and tissue freezing across different regions.
While survival rates for childhood cancer have improved dramatically, with over 80% of patients living for decades, around one in five face fertility problems as adults due to their disease or treatment. International guidelines recommend offering fertility preservation, including storage of ovarian tissue or eggs and testicular tissue or sperm, but access to these services is inconsistent.
The study surveyed 18 of the UK's 20 paediatric cancer units. All had referred patients for fertility preservation in the past year, but patterns varied widely. For example, no centres in the Midlands and east of England had referred for mature egg storage, compared with a quarter in the south, half in the north, and 60% in devolved nations. Funding sources also differed: sperm freezing was typically NHS-funded, but only nine centres said the same for egg storage. Half reported ovarian and testicular tissue storage relied on charitable funding, especially in England.
Lead author Professor Adam Glaser, a specialist in paediatric and adolescent oncology at Leeds Teaching Hospitals NHS Trust, said: “Urgent action is required to ensure that NHS funding is available for all to provide the appropriate security and hope for these individuals while permitting delivery of accepted and NHS mandated standards of care.” The researchers concluded that a lack of formal government funding leads to geographical variation and heavy reliance on charities, calling for centralised NHS funding to ensure equitable access across the UK.
