{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T15:27:59Z","timestamp":1775575679350,"version":"3.50.1"},"reference-count":29,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2024,8,11]],"date-time":"2024-08-11T00:00:00Z","timestamp":1723334400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objective: Fertility preservation is an important part of oncologic care for newly diagnosed gynecologic cancers for reproductive-age women, as many treatment options negatively impact fertility. The goal of this study is to examine factors that influence access to fertility specialists for women with newly diagnosed gynecologic cancer. Methods: This institutional review board approved a retrospective cohort study investigating the impacting factors on the referral rate from gynecologic oncologists (GO) to reproductive endocrinologists and infertility (REI) specialists at a single academic institution between 2010\u20132022 for patients age 18\u201341 at diagnosis. Electronic medical records were used to identify demographics and referral patterns. Mixed logistic models were utilized to control cluster effects of the physicians. Results: Of 816 patients reviewed, 410 met the criteria for inclusion. The referral rate for newly diagnosed gynecologic malignancies was 14.6%. Younger patients were more likely to have an REI referral (p &lt; 0.001). The median time from first GO visit to treatment was 18.5 days, and there was no significant difference in those who had REI referrals (p = 0.44). Only 45.6% of patients had fertility desire documented. A total of 42.7% had fertility-sparing treatment offered by a GO. REI referral did not significantly change the time to treatment (p = 0.44). An REI referral was more likely to be placed if that patient had no living children, no past medical history, or if the referring GO was female (OR = 11.46, 6.69, and 3.8, respectively). Conclusions: Fertility preservation counseling is a critical part of comprehensive cancer care; yet, the referral to fertility services remains underutilized in patients with newly diagnosed gynecologic cancer. By demonstrating these biases in REI referral patterns, we can optimize provider education to enhance fertility care coordination.<\/jats:p>","DOI":"10.3390\/jcm13164709","type":"journal-article","created":{"date-parts":[[2024,8,12]],"date-time":"2024-08-12T11:23:46Z","timestamp":1723461826000},"page":"4709","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Window of Opportunity: Rate of Referral to Infertility Providers among Reproductive-Age Women with Newly Diagnosed Gynecologic Cancers"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8049-6434","authenticated-orcid":false,"given":"Emily H.","family":"Frisch","sequence":"first","affiliation":[{"name":"ObGyn and Women\u2019s Health Institute, Cleveland Clinic, Cleveland, OH 44124, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3341-6830","authenticated-orcid":false,"given":"Meng","family":"Yao","sequence":"additional","affiliation":[{"name":"Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH 44195, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hanna","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Reproductive Endocrinology and Infertility, Cleveland Clinic, Cleveland, OH 44106, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olivia","family":"Neumann","sequence":"additional","affiliation":[{"name":"ObGyn and Women\u2019s Health Institute, Cleveland Clinic, Cleveland, OH 44124, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Danielle B.","family":"Chau","sequence":"additional","affiliation":[{"name":"Department of Gynecology Oncology, Cleveland Clinic, Cleveland, OH 44195, USA"},{"name":"Virginia Oncology Associates, Norfolk, VA 23502, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7364-8604","authenticated-orcid":false,"given":"Elliott G.","family":"Richards","sequence":"additional","affiliation":[{"name":"Department of Reproductive Endocrinology and Infertility, Cleveland Clinic, Cleveland, OH 44106, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lindsey","family":"Beffa","sequence":"additional","affiliation":[{"name":"Department of Gynecology Oncology, Cleveland Clinic, Cleveland, OH 44195, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,8,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1007\/978-0-387-72293-1_1","article-title":"The Emergence of a New Interdiscipline: Oncofertility","volume":"138","author":"Woodruff","year":"2007","journal-title":"Cancer Treat. 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Cancers, 15.","DOI":"10.3390\/cancers15225348"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/16\/4709\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:34:56Z","timestamp":1760110496000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/16\/4709"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,11]]},"references-count":29,"journal-issue":{"issue":"16","published-online":{"date-parts":[[2024,8]]}},"alternative-id":["jcm13164709"],"URL":"https:\/\/doi.org\/10.3390\/jcm13164709","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,8,11]]}}}