Cancer-related infertility and young women: Strategies for discussing fertility preservation

A cancer diagnosis is a life-altering event and since cancer treatment can impair future fertility capacity, cancer can also change a patient’s parenting plans and family goals. There has been increased attention to the issue of cancer-related fertility impairment in recent years [1, 2], including the establishment of best practice guidelines from ASCO (American Society of Clinical Oncology) [3], ASRM (American Society for Reproductive Medicine) [4], and AAP (American Academy of Pediatrics) [5], as well as advocacy groups aimed at both patients and doctors to educate on the issue of fertility preservation (including Fertile Hope and the Oncofertility Consortium). There has even been increased coverage in entertainment and popular media on post-cancer parenthood, including notable high-profile cases such as Lance Armstrong. Despite these strides, there is continued concern that cancer patients are not always informed about potential impairment or available fertility preservation options that can help to safeguard their future fertility. Earlier studies in the growing field of oncofertility have indicated that many patients, particularly adolescent and pediatric patients [6], do not recall discussing fertility or fertility preservation options prior to beginning chemotherapy and/or radiation [1]. As a result, researchers are examining the barriers to the exchange of fertility-related discussions between patients and doctors (particularly oncologists) prior to potentially damaging cancer treatment (see [1] for review).