Victory in the Aloha State

After more than a decade of advocacy by Hawaiian patient and provider advocacy organizations, Hawaii Governor Josh Green signed HB 1864 into law on July 9, 2026. This legislation requires state-regulated health insurers to cover standard fertility preservation services for individuals facing iatrogenic infertility, including cancer patients. The new law will cover procedures such as sperm banking and egg and embryo freezing and go into effect for health plans issued or renewed in Hawaii after December 31, 2026.

Due to Hawaii’s Prepaid Health Care Act of 1974 (PHCA) – the nation’s only state employer health coverage mandate that predates federal ERISA law – coverage will reach a broader percentage of Hawaii’s population compared to other state fertility preservation laws. We estimate that more than 700,000 Hawaiians, approximately half of the state’s population, will now have fertility preservation coverage should they ever need it.

The Alliance for Fertility Preservation would like to thank every patient advocate and organization that has been fighting tirelessly for this coverage since the first Hawaii bill was introduced in 2012. We are especially grateful for the Hawaii Society of Clinical Oncology, ASCO, Fertility Institute of Hawaii, Breast Cancer Hawaii, ACS CAN, Blood Cancer United, Susan G. Komen and all of the patient advocates who bravely shared their stories throughout this long journey.

Fertility Preservation Toolkit

Thank you for your interest in our toolkits. Please read our Terms of Use carefully as we include information that applies to all our toolkits.

All toolkits are publicly available for individual use without licensing or royalty fees. Such use of toolkits is “single use,” meaning solely for the User’s research, clinical, educational, or other application. User’s email may be added to an email distribution list to receive scientific and updated information about the toolkit(s).

We encourage use of our toolkits. User agrees not to adapt, alter, amend, abridge, modify, condense, make derivative works, or translate toolkits without prior written permission from the Provider. User agrees not to sell or incorporate toolkits into materials that could be sold without prior written consent from the Provider. To inquire about permissions, please email info@a4fp.org.


AFP Statement After the Overturn of Roe v. Wade

The Alliance for Fertility Preservation was founded on the premise that ability to have (biologic) children and the timing of building a family is a basic human right. We recognized that cancer patients often had to sacrifice that right because they had to undergo lifesaving treatment that might leave them sterile or significantly impair their ability to have children in the future. Fortunately, recent scientific breakthroughs have allowed patients to retain their future potential fertility either by freezing their eggs, fertilized eggs with their partner, or pieces of an ovary. As reproductive and cancer health care professionals, we understand that information about and access to fertility preservation is critical to patients and their families so that they might transcend their disease and build a more “normal” life after cancer. The ability to have children and become a parent is a fundamental part of that life. We believe that a cancer diagnosis or treatment should not preclude parenthood.

We recognize that the seismic shifts in our legal landscape that are now occurring threaten access to medical services that cancer patients need in order to protect their future fertility. Minor changes in definitions and wording can be interpreted to make procedures such as IVF increasingly difficult to obtain, and patients’ access to timely, appropriate reproductive care will be severely curtailed. During this uncertain time, we will continue to advocate for patients’ access to these important medical services which protect their reproductive autonomy and future ability to build their families as they desire. We remain committed to assisting patients in finding and fighting for the fertility preservation services they need and deserve.