生育保留（FP），包括在性腺毒性治疗前冷冻卵子和胚胎，是全面癌症护理的紧迫和必要组成部分。在地理上靠近提供FP服务的中心是确保癌症患者有平等获得未来生育权的重要组成部分。为了描述美国提供FP服务的中心的分布情况，量化生活在地理可及范围之外的自我识别生育年龄女性个体数量，并调查地理可及性与州FP法规之间的关联。该横断面分析根据纬度和经度坐标为每个中心计算了2小时旅行时间等值线图。在这项研究中使用了基于人口的美国地理空间分析。通过2018年疾病控制和预防中心生育诊所成功率报告确定了认定为癌症生育中心的生育诊所，满足以下4个条件：（1）提供卵子和胚胎冷冻，（2）2018年至少完成1个FP周期，（3）为没有伴侣的人提供服务，（4）拥有一个获得认证的实验室。县级数据来自2020年美国人口普查，以生育年龄15到44岁的女性个体作为主要高风险人群。分析时间为2021年至2022年。在癌症生育中心的2小时旅行时间等值线之外。癌症生育中心与未满足条件的中心进行比较，并按美国地区、州FP法规状态、辅助生殖技术周期数量和FP周期数量进行分类。识别生活在州内可获得服务区域之外的高风险患者数量和比例。在456个疾病控制和预防中心报告的生育诊所中，86个（18.9%）未满足癌症生育中心的条件。共有363万（5.70%）生育年龄女性个体在地理上无法获得癌症生育中心的服务。具有FP法规的州具有具有地理可及性的合格女性患者的最高比例（98.54%），而没有现行或即将生效立法的州的比例最低（79.57%）。在地理可及性方面的差距最集中在山西和西北中西部地区。患者面临诸多障碍，包括无法地理可及的提供FP服务的中心。这项横断面研究识别了地理可及性的差距并提供了可能的战略扩展机会。

Fertility preservation (FP), including oocyte and embryo cryopreservation prior to gonadotoxic therapy, is an urgent and essential component of comprehensive cancer care. Geographic proximity to a center offering FP is a critical component of ensuring equitable access for people with cancer desiring future fertility.To characterize the distribution of centers offering FP services in the US, quantify the number of self-identified reproductive-age female individuals living outside of geographically accessible areas, and investigate the association between geographic access and state FP mandates.This cross-sectional analysis calculated 2-hour travel time isochrone maps for each center based on latitude and longitude coordinates. Population-based geospatial analysis in the US was used in this study. Fertility clinics identified through the 2018 Centers for Disease Control and Prevention Fertility Clinic Success Rates Report were defined as oncofertility centers by meeting 4 criteria: (1) offered oocyte and embryo cryopreservation, (2) performed at least 1 FP cycle in 2018, (3) served people without partners, and (4) had an accredited laboratory. County-level data were obtained from the 2020 US Census, with the primary at-risk population identified as reproductive-age female individuals aged 15 years to 44 years. The analysis was performed from 2021 to 2022.Location outside of 2-hour travel time isochrone of an oncofertility center.Oncofertility centers were compared with centers not meeting criteria and were classified by US region, state FP mandate status, number of assisted reproductive technology cycles performed, and number of FP cycles performed. The number and percentage of at-risk patients, defined as those living outside of accessible service areas by state, were identified.Among 456 Centers for Disease Control and Prevention-reporting fertility clinics, 86 (18.9%) did not meet the criteria as an oncofertility center. A total of 3.63 million (5.70%) reproductive-age female individuals lack geographic access to an oncofertility center. States with FP mandates have the highest rates of eligible female patients with geographic access (98.54%), while states without active or pending legislation have the lowest rates (79.57%). The greatest disparities in geographic access to care are most concentrated in the Mountain West and West North Central regions.Patients face numerous barriers to comprehensive cancer care, including a lack of geographic access to centers capable of offering FP services. This cross-sectional study identified disparities in geographic access and potential opportunities for strategic expansion.