Fertility Preservation Guidelines Urge for Early Discussions with Young Patients with Cancer

Nurses treating young patients with cancer understand that fertility preservation is an important consideration, and should be addressed early. In April 2018, the American Society of Clinical Oncology (ASCO) released updated guidelines and recommendations to help clinicians prepare for these important conversations.

ASCO’s panel of experts conducted a systematic review of the current literature—61 articles published between 2013 and 2017—and recommended that clinicians initiate discussion of the possibility of infertility and fertility preservation options with patients with cancer treated during their reproductive years or with parents/guardians of children receiving cancer treatment as early as possible.

Clinicians should be prepared to discuss fertility preservation options, such as sperm, oocyte, and embryo cryopreservation, and/or to refer patients of child-bearing age to appropriate reproductive specialists. Since there is conflicting evidence on recommending gonadotrophin-releasing hormone agonists (GnRHa) for fertility preservation, the panel advises that GnRHa may be offered to reduce chemotherapy-induced ovarian insufficiency, but should not replace proven fertility preservation methods.

The panel also noted that the field of ovarian tissue cryopreservation is advancing quickly and may evolve to become standard therapy in the future.

The guidelines, along with related resources including slide sets, patient information for men and women, a pocket guide, and a podcast, are available on the ASCO website.