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.


Frequently Asked Questions About Fertility Preservation and Cancer

This page answers common questions about fertility preservation (FP) for people facing cancer and other serious medical conditions. The goal is to provide clear, patient-friendly information so you can understand your options and feel supported in making decisions.

References
  1. Su, H.I., Lacchetti, C., Letourneau, J., et al. (2025). Fertility preservation in people with cancer: ASCO guideline update. Journal of Clinical Oncology, 43(12), 1488–1515.
  2. Li, Q., Lan, Q.Y., Zhu, W.B., et al. (2024). Fertility preservation in adult male patients with cancer: a systematic review and meta-analysis. Human Reproduction Open, 2024(1), hoae006.
  3. Yang, E.H., Strohl, H.B., & Su, H.I. (2024). Fertility preservation before and after cancer treatment in children, adolescents, and young adults. Cancer, 130(3), 344–355.
  4. Razik, M., Bator, P., Rozwadowska, P., et al. (2024). Fertility preservation strategies in cancer patients: a comprehensive review. Journal of Education, Health and Sport, 61, 129–139.
  5. Satılmış, İ.G., Potur, D.C., Kaydırak, M.M., & Eroğlu, S.A. (2024). Fertility preservation in patients with cancer: nurses’ views and perceptions. Oncology Nursing Forum, 51, 71–79.
  6. Dima, D.C., Boyko, S., Torchetti, T., et al. (2025). Fertility information perceptions and needs of people with cancer and caregivers. Supportive Care in Cancer, 33(9), 770.
  7. Abel, M.K., Wang, A., Letourneau, J.M., et al. (2024). Changing the perspective on fertility preservation for women with advanced cancer. Current Oncology Reports, 26(6), 583–592.
  8. Chitoran, E., Rotaru, V., Mitroiu, M.N., et al. (2024). Fertility preservation options in gynecological cancers. Cancers, 16(12), 2214.
  9. Leonard, L.J. (2024). Fertility preservation options for children and young adults with cancer. Pediatric Nursing, 50(4), 192–199.
  10. Leavitt, A.P., Albritton, K.H., Cazzell, M., & Stevenson, E. (2024). Expansion of fertility preservation programs for prepubertal patients. Journal of Pediatric Hematology/Oncology Nursing, 41(3), 212–219.
  11. Grimes, A.C., Sugalski, A.J., Nuño, M.M., et al. (2024). Management of fertility preservation in pediatric cancer patients. Journal of Adolescent and Young Adult Oncology, 13(5), 776–784.
  12. Lehmann, V., Vlooswijk, C., van der Graaf, W.T., et al. (2025). Pre-treatment fertility preservation and post-treatment reproduction in cancer survivors. Journal of Cancer Survivorship, 19(4), 1143–1154