COSA:AYA cancer fertility preservation/Options for fertility preservation

Guidelines contents

Introduction

Recommendations

Discussing fertility

Management

Impact

Options

Follow-up

Resources

Options for fertility preservation

Recommendation	Recommendation grade
The most effective and established means of preserving fertility in young people with cancer are: oocyte and embryo cryopreservation where appropriate for females sperm cryopreservation for males before cancer treatment starts.	B
If the efficacy of a particular treatment option is not established then this needs to be discussed with the AYA patient and their family. Where possible, investigational procedures should be undertaken in the context of a clinical trial.	PP
The use of fertility preservation measures must be individualised and personalised in consultation with the patient and their family and the multidisciplinary treatment team.	PP

Overview

There is a range of procedures and processes to preserve or protect the fertility of young men and women diagnosed with cancer. The options available depend on many factors including the patient’s gender, age, current relationship status, type of cancer and type of treatment.

• The most effective and established means of preserving fertility in young people with cancer are:

• oocyte and embryo cryopreservation where appropriate for females
• sperm cryopreservation for males before cancer treatment starts

Most other procedures are still investigational. Some may be costly and not publicly funded.

• If the efficacy of a particular treatment option is not established then this needs to be discussed with the AYA patient and their family. Where possible, experimental procedures should be undertaken in the context of a clinical trial.

Discussion about fertility preservation options should include an explanation of the process, success rates, risks and side effects and costs, as described in this section.

While these recommendations and plans of management are based on the best available evidence, each AYA facing cancer therapy will present with a different life situation and different priorities.

• The use of fertility preservation measures must be individualised and personalised in consultation with the patient and their family and the multidisciplinary treatment team.