ID #93 Your patients are our patients: embedding fertility preservation conversations into neuro-oncology pathways

Abstract Background Children and young people diagnosed with central nervous system (CNS) tumours experience substantial fertility risk due to multimodal treatments, tumour location, and hypothalamic-pituitary effects. Despite well-documented gonadotoxicity, and recommendations from established guidelines, access to timely fertility preservation (FP) discussions varies across Australia. Centres with dedicated oncofertility roles demonstrate that early, consistent FP discussions are achievable even within complex care pathways. However, early findings from the national In Time program at Royal Women’s Hospital In Melbourne Australia show gaps in awareness and referral processes across many sites. Neurosurgery, rehabilitation medicine, and neuro-oncology are often the first teams encountering these patients during the brief window in which FP is feasible and have the opportunity to advocate for FP. Aim To examine gaps in FP access for CNS tumour patients across Australia and highlight how dedicated oncofertility roles and multidisciplinary engagement can enable equitable, timely FP conversations Methods The initiative incorporates: Education Training 4,000 health professionals nationally to enabletimely, evidence-based fertility discussions. Clinical Service Establishingnational referral pathways for transport, cryopreservation, and storage of ovarian and testicular tissue. Research Advancing research to improve fertility preservation options. Results Early analysis shows that the critical time for FP in neuro-oncology patients is often lost between initial surgical management and oncology review. Centres with embedded oncofertility expertise demonstrate strong FP uptake in CNS tumour cohorts. Consumers strongly emphasised the importance of early FP discussion, including with complex and high-risk diagnoses. Multidisciplinary education will increase clinician confidence and improve timeliness of discussions. Conclusion CNS tumour patients represent a cohort at high risk of gonadotoxicity and should not face variability in FP access. Embedding FP conversations into early neuro-oncology pathways- supported by our dedicated In Time team- ensures that “your patients are our patients,” and that all young people receive timely, informed options.