Distance from hospital does not reduce utilization of fertility preservation in men.

Fertility preservation (FP) is underutilized in adult, young adult, and adolescent males with cancer or other diseases requiring gonadotoxic therapies. Two possible contributing reasons for low referral rates are perceived lack of access or patient unwillingness to travel to distant FP centers. We sought to evaluate whether patient distance from FP center affected rates of providing a semen analysis after referral. We performed a retrospective analysis of all males who were referred for FP at a single institution between 2013 and 2021. For each patient, we determined whether he provided a semen sample for cryopreservation. Patient zip codes, number of semen samples, and number of vials frozen were also collected. Distance from patient zip code to FP center was calculated using zipcodeR and geosphere packages in R. Distances were compared between men who utilized their FP referral and men who did not. Total number of cryopreserved vials versus distance from center was fit to a linear regression model. All between-groups values were assessed for equivalency using the two one-sided test. A total of 471 males referred to our center had a valid zip code on file. The average age was 25.8 ± 8.9 years. Of these patients, 332 (70 %) provided a semen sample after referral and 139 (30 %) did not. Disease breakdown did not differ between the groups. The mean travel distance for patients who provided a sample was 48 ± 125 miles, and the mean distance for patients who did not provide a sample was 44 ± 62 miles (equivalency test, p < 0.05). Additionally, there was no inverse association observed between distance and number of successfully cryopreserved vials (equivalency test, p < 0.05). Notably, 26 of 38 men (70%) referred from > 100 miles provided at least 1 semen sample, consistent with the percentage submitting samples from < 100 miles (304 of 430, 70%). These 26 men submitted an average of 2.1 ± 0.8 samples, and 20 (77%) submitted ≥ 2 samples. The average distance to FP center did not differ between men who submitted semen samples after FP referral and those who did not. Additionally, a high percentage of men from greater than 100 miles away from our center submitted semen samples after referral. These results suggest that far distance from patient residence to FP center should not preclude referral.