From Urgent Questions to Lasting Pathways: Fertility Care at SickKids
For many children and adolescents with cancer, treatment is lifesaving. But these treatments can also impact something deeply personal — their future fertility and the potential for biological children. For years, nurses have heard similar questions from patients and families:
Will I be able to have children one day? Are there options? What are those options? Is it too late?
Without clear pathways, these questions were often left unanswered, and solutions were not always available. The need was clear: fertility preservation had to become timely, equitable, and normalized within pediatric oncology care.
In 2024, SickKids took a significant step forward by building a formal Fertility Preservation Program. The goal was to create an interdisciplinary, sustainable care pathway that facilitated standardized and timely access to fertility preservation for patients across varied diagnoses, ages, and urgency levels. Over 60 clinicians across disciplines — nursing, oncology, hematology, gynecology, endocrinology, pathology, urology, fertility specialists, informatics, social work, education, implementation science, and survivorship — with patient and parent partners, joined focused working groups to design care pathways that made sense in clinical settings. The group created detailed workflows to address referral processes, urgent and non‑urgent pathways, education, and survivorship considerations. Pathways for ovarian tissue cryopreservation (OTC), egg freezing, sperm banking, electroejaculation, and testicular sperm extraction (TESE) were clearly defined and implemented as standard of care.
The Nursing Role in Fertility Preservation
Nursing has been central to this work. In the first days of a new cancer diagnosis, nurses are consistently present at the bedside, making them instrumental in fertility pathways. Education and normalization were key early priorities. By equipping nurses with language, resources, and straightforward flow charts, the aim was to make these conversations informative and less uncomfortable for patients, caregivers, and the medical team. While fertility preservation counselling is often done by physicians, nurse practitioners, or physician’s assistants, nurses play an active role in identifying eligible patients, normalizing fertility discussions, reinforcing education, and supporting families through complex, emotional decisions.
The program also recognizes patients who are unable to undergo fertility preservation, whether due to treatment urgency, age, cultural/personal reasons, or medical contraindications. Nurses remain essential supports for these patients, both during treatment and in survivorship, validating grief, answering evolving questions, and reconnecting families with fertility resources, as needs change over time.
Collaboration at Its Core
A key strength of the program is collaboration with Mount Sinai Fertility, allowing SickKids’ patients timely access to specialized fertility expertise. Importantly, some aspects of fertility preservation are covered through provincial funding or hospital budgets; others are not, highlighting ongoing inequities in access.
At its heart, the SickKids Fertility Preservation Program reflects something nurses have always known: fertility matters. It matters to patients thinking about their future, to families planning for life beyond illness, and to survivors redefining what that future might look like. For nurses, this work is about more than procedures — it’s about listening, normalizing, advocating, and making space for hope, even in the hardest moments.
For more information and resources, visit the SickKids Fertility Preservation Program website.
This story was written for the spring 2026 issue of The RePORTer, POGO’s Nursing Newsletter, by SickKids staff Rebecca Côté, RN, Clinical Program Coordinator, Sarah Gabura, RN, MN, NP-Pediatrics, Dr. Kriti Kumar, Staff Oncologist, Haematology/Oncology.
New POGO Clinic Helps Teen Stay Connected with Friends
In September 2018, at the launch of the new POGO Pediatric Oncology Satellite Clinic at Peterborough Regional Health Centre (PRHC), Theresa Serracino-Inglott, husband Mario and son Anthony spoke on behalf of the parents and young patients who will be receiving care.
Last year in late August, Anthony was gearing up to start his Grade 11 year when he was diagnosed with acute lymphoblastic leukemia (ALL). Anthony spent most of his first six months at SickKids hospital because of complications and an extremely tough protocol for his high-risk diagnosis. Throughout the past year – and more so in the last six months – the Pediatric Outpatient or POP Clinic at PRHC has been our second home.
In April, Anthony was here for supportive care close to 20 days, and every day he was greeted with a smile and the exceptional care we have come to know from Shay Cannon and the POP Clinic Team. This was such a relief because as parents of children with a cancer diagnosis, we are continually being bombarded with difficult and gut-wrenching fears – and leaving the safety of SickKids Hospital is one of them.
Having to take your child to a new place for their care and allowing unfamiliar medical staff to provide treatment leaves us parents feeling vulnerable and scared – but once we walked through the doors of the POP Clinic and met Shay and the POP Clinic team, our fears subsided. Anthony immediately made a connection with the staff that has only strengthened over the months. Being closer to home to attend to such things as his fevers and blood work has meant a lot to Anthony. When he was admitted with a fever and had to stay at PRHC for more than a couple of days, it meant that his friends could easily come and keep him company to pass the time.
Throughout this time, the POP Clinic team was already beginning the transition to become an official POGO Satellite Clinic, which included staff training in all of the specialized areas of care we knew Anthony would need.
Now that this is an official POGO Satellite site, I can’t help but think of “future POGO families” in our area. Perhaps today, the news of the new clinic may not even register, but when they are burdened with their child’s diagnosis, they will have these things to ease their journey:
- Closer access to chemo treatments
- A “fever card” that is our direct route to the in-patient unit, allowing us to bypass emergency
- Coordinated care between PRHC and SickKids that meets the high standard of care that POGO Satellite Clinics deliver
- A trusting relationship with qualified staff that go above and beyond for patients in their care
- Support from other POGO families that become lifelong friends because of this journey they’ve shared together
Having a POGO Clinic close to us makes life as a parent a whole lot easier. Feeling financially strapped is a common thread among families of children with cancer and satellite clinics give some relief to that. The shorter distance helps us save money on gas for the car, the need to eat out, motel costs, and childcare needed for siblings.
Anthony has already benefitted from shorter clinic visits. This is important because as a teen with cancer, many occasions have been missed because of treatment. Having the accessibility of the POGO Clinic gets him back to his friends who play a very important part in his recovery.
Parents of children with cancer certainly would have never chosen this path for our children, but because this is where we find ourselves, I want to say how grateful we are to POGO and to Peterborough Regional Health Centre for making it possible for families like ours to have an official POGO Satellite Clinic right in our community. We can’t thank you enough for easing the burden by keeping many aspects of our child’s cancer treatment closer to home. Thank you.
