In this episode of The 7-2-1, Dr. Kemi Olaiya and Dr. Cheryl Mensah are joined by Dr. Leslie Appiah, a leading expert in fertility preservation, to discuss why fertility preservation matters for people with sickle cell disease. While offering curative potential, they explore how stem cell transplantation and gene therapy can also pose serious risks to reproductive health. The conversation covers options available to both prepubertal and post-pubertal girls, the differences in fertility risks between transplant and gene therapy, and why referrals don’t always happen as often as they should. This episode provides essential guidance for clinicians, patients, and families navigating the intersection of sickle cell care, future family planning, and quality of life.