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.

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New article identifies female patients don’t receive enough fertility information - blog post image

New article identifies female patients don’t receive enough fertility information

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Many young adult female cancer survivors want children in the future, but, for a variety of reasons, are unable to undergo fertility preservation before treatment. For those who maintain ovarian function after treatment but are at risk for premature ovarian failure, fertility preservation after treatment may be an option. However, patients cannot avail themselves of this technology if they are not informed of their risks and options.

I led a team at Memorial Sloan Kettering to survey young adult female cancer survivors from across the US about a variety of reproductive issues, including informational needs, reproductive concerns, and decisional conflict. Of the 346 patients who completed the survey, 179 wanted children (or were unsure) in the future, had not been told they were infertile, and had not previously undergone fertility preservation with egg or embryo freezing or ovarian transposition. Among this subgroup, the majority of respondents believed they did not have enough information about their risk of infertility (58%), risk of early menopause (60%), options to assess their fertility (62%), and options to preserve their fertility (51%). These unmet needs for information were all related to greater decisional conflict when prompted to consider the option of pursuing fertility preservation in the future (p’s<.01).

I, and my co-authors, believe that the findings from this study highlight the need to better address fertility issues in post-treatment survivorship care.

We recommend more comprehensive counseling for young adult female cancer survivors about fertility risks and fertility preservation options to ensure they do not miss their narrowed window of reproductive opportunity.

References

  1. Young adult female cancer survivors’ unmet information needs and reproductive concerns contribute to decisional conflict regarding posttreatment fertility preservation.