Young adults with primary brain tumors: predictors of referral to a fertility specialist for fertility preservation counseling and the impact on tumor treatment.

purposePrimary brain tumors and their treatment can affect fertility, and fertility preservation offers a way to protect future childbearing options for young adults. We investigate factors associated with referral to fertility specialists and explore the impact of fertility preservation on treatment.

methodsRetrospective review of patients aged 18–44 with primary brain tumors was performed. Patients were included if they underwent surgery and chemotherapy and/or radiation between 1/2022 and 5/2025 at our institution. Demographics, treatment modalities, and fertility-related data were collected. Statistical analyses included descriptive and comparative analysis with Fisher’s exact test and t-test.

resultsWe identified 55 patients (53% female, 55% nonwhite) who met inclusion criteria. The most common tumor type was glioma (71%); 42% of patients had WHO grade IV tumors. Thirteen patients (24%) were referred to fertility specialists, with 9 (16%) undergoing preservation (7 male, 2 female). Referred patients were younger (29 vs. 36 years, p < 0.01) and less likely to have prior children (8% vs. 43%, p = 0.02). No differences in referral patterns by sex, marital status, tumor grade, or insurance were identified. Fertility preservation resulted in slight delays in adjuvant therapy for two female patients.

conclusionFertility preservation referral rates for young adults with primary brain tumors were low, though most patients who were referred pursued preservation. Younger patients and those without children were more likely to be referred. The pursuit of fertility preservation may be associated with slight treatment delays, particularly for female patients, highlighting the need for streamlined evaluation and further study of the impact on disease trajectory.