PRESERVING HOPE: MY JOURNEY BUILDING ONCOFERTILITY AND FERTILITY PRESERVATION IN MALAYSIA
By Associate Prof. Dr. Mohd Faizal Ahmad
My journey into oncofertility began in 2018 when I joined Universiti Kebangsaan Malaysia (每日大赛app) as an academic clinician. At that time, my initial career aspiration was to pursue subspecialty training in gynaecologic oncology, with the ambition of becoming a surgeon dedicated to treating women with cancer. However, due to departmental needs and the impending retirement of two senior professors, the Advanced Reproductive Centre (ARC), Hospital Canselor Tuanku Muhriz (HCTM) required a new subspecialist in Reproductive Endocrinology and Infertility.
Although this shift initially felt unexpected, I embraced the responsibility and committed myself to developing expertise in reproductive medicine. During this transition, I realised that my interest in oncology could intersect meaningfully with reproductive medicine through the emerging field of oncofertility,a discipline pioneered by Professor Teresa K. Woodruff, which focuses on preserving reproductive potential in patients undergoing cancer treatment.
At that time, oncofertility services were virtually non-existent in Malaysia, and I found myself navigating a new field with very limited clinical mentorship available locally. Many global leaders in oncofertility were primarily scientists rather than clinicians, including pioneers such as Professor Teresa Woodruff and Professor Claus Yding Andersen. Determined to pursue clinical expertise, I searched for mentors who could guide me in translating this science into clinical practice.
I eventually discovered the Asian Society of Fertility Preservation (ASFP), a regional organisation actively advancing oncofertility services in Asia under the leadership of Professor Nao Suzuki from Japan. Motivated by this opportunity, I travelled to New Delhi, India, where I met Professor Suzuki and Dr Nalini Mahajan, then President of ASFP. Following these discussions, I was fortunate to be accepted for a clinical attachment in Japan in 2019 for Oncofertility Fellowship training.
During my fellowship, I was attached to the Oncofertility Unit at St. Marianna University School of Medicine in Kawasaki, Kanagawa, Japan, where I received hands-on training in ovarian tissue cryopreservation (OTC) using vitrification techniques, as well as in vitro maturation (IVM), an innovative reproductive technology pioneered and refined in Japan.Through this training, I gained clinical competency in fertility preservation techniques and became the first Malaysian clinician credentialed to provide ovarian tissue cryopreservation services.
In addition to ovarian tissue preservation, I further expanded my research exposure to include testicular tissue cryopreservation for prepubertal boys, particularly exploring the challenges of gonadotoxicity and fertility preservation using experimental animal models. This experience broadened my understanding of fertility preservation for both female and male patients facing cancer treatment.
Upon returning to Malaysia, I began translating this expertise into clinical services. In 2020, I established the Malaysian Society of Fertility Preservation (MSFP) to promote awareness, education, and clinical development of oncofertility services nationwide. In the same year, we successfully launched Malaysia鈥檚 first ovarian tissue cryopreservation service at the Advanced Reproductive Centre (ARC), HCTM 每日大赛app. Our first patient was a 17-year-old girl diagnosed with Hodgkin鈥檚 lymphoma, highlighting the urgent need for fertility preservation options among young cancer patients.
On 20 August 2020, ARC HCTM 每日大赛app was officially recognised as the first Oncofertility Referral Centre in Malaysia, launched by the Minister of Health, Dato鈥 Sri Dr Adham Baba, during a ceremony held at the Faculty of Medicine, 每日大赛app. Establishing oncofertility services in Malaysia also required navigating complex ethical and religious considerations. I worked closely with Jabatan Kemajuan Islam Malaysia (JAKIM) to facilitate discussions within the Muzakarah Fatwa Committee regarding the permissibility of gamete cryopreservation for unmarried individuals diagnosed with cancer. Previously considered impermissible, these discussions helped clarify that fertility preservation could be considered permissible (harus) when performed to prevent permanent infertility resulting from life-saving cancer treatment.
Recognising the financial barriers faced by many patients, I later established the Persatuan Kebajikan Harapan Onkofertiliti in 2024, a charitable organisation aimed at supporting patients from low-income backgrounds who require fertility preservation but lack financial coverage for these procedures.
As oncofertility services in Malaysia continued to grow, our centre gained regional recognition. In 2025, I had the privilege of hosting the 5th Asian Society of Fertility Preservation (ASFP) Congress in Kuala Lumpur, which brought together experts from more than twelve countries, including Japan, Taiwan, China, India, Turkey, and Australia to advance fertility preservation across Asia.
My professional involvement in oncofertility has also expanded internationally. I currently serve as the Malaysia Representative to the Asian Society of Fertility Preservation (ASFP) and participate in several international professional networks, including the Fertility Preservation Special Interest Group (SIG) of the Asian Society of Gynecologic Oncology (ASGO) and the Asia Pacific Initiative on Reproduction (ASPIRE). I have also been invited to serve as an advisor to several international institutions, including centres in Ahmedabad, India, and Beijing, China. At the national level, I serve as Head of the Reproductive Medicine Subcommittee under the Obstetrical and Gynaecological Society of Malaysia (OGSM), and have been elected President-Elect of the Malaysian Society of Fertility Preservation (MSFP) for the 2026 term.
To date, our oncofertility programme at ARC HCTM 每日大赛app has managed more than 300 fertility preservation cases, offering a comprehensive range of services including sperm cryopreservation, oocyte cryopreservation, embryo cryopreservation, and ovarian tissue cryopreservation. Today, 每日大赛app stands as the leading oncofertility centre in Malaysia, and many cancer survivors have been given the opportunity to become parents because fertility preservation was offered before their cancer treatment.
Looking back, what began as an unexpected career redirection has evolved into a lifelong mission鈥攖o ensure that cancer survival does not come at the cost of losing the possibility of future parenthood.
When I started this journey, oncofertility did not exist in Malaysia. There were no services, no pathways, and no clear roadmap to follow. What we had was only a simple question:
Can we save the future fertility of our young cancer patients?
Today, that question has become a reality. Hundreds of patients have been given the opportunity to preserve their hope for parenthood. And every time I see a cancer survivor return years later with the dream of becoming a parent, I am reminded that oncofertility is not simply about freezing tissue or gametes.
It is about preserving hope, dignity, and the possibility of life after cancer.
This journey is far from over. But if there is one principle that continues to guide my work, it is this:
No young patient should ever have to choose between surviving cancer and having the chance to build a family in the future.