COSA:AYA cancer fertility preservation/Managing the fertility preservation process/Protocols and pathways

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Fertility preservation for AYAs diagnosed with cancer: Guidance for health professionals. > COSA:AYA cancer fertility preservation/Managing the fertility preservation process/Protocols and pathways

Develop protocols and pathways to enable clear and timely communication

Recommendation Grade
Develop local protocols and pathways to enable clear and timely communication between all professionals and services involved in the fertility preservation process, and between the team and the patient and their family.

Cancer and fertility specialists need to work collaboratively to improve outcomes for people at risk of cancer related infertility. This requires an understanding of roles, an understanding of what information is required by each specialty to optimise outcomes and a clear plan detailing the aims, settings and timelines for the fertility preservation process.[1][2] Discussion between specialists to clarify the risks of the treatment prognosis of the cancer will help guide decision-making.

  • Ensure there is a nominated health professional responsible for managing, and communicating to other team members about, each stage of the fertility preservation process.
  • Ideally the team should be guided by written protocols that document current best practice and which also outline local standard practice related to fertility preservation processes and roles.[3][1][4][5]

Relevant information should be shared between team members at each stage. In particular, the treatment team should provide a detailed referral to a fertility specialist. The fertility specialist (or assisted reproduction service) should formally advise the cancer treatment team of the planned fertility preservation plan and the implications for the patient’s physical and psychosocial care.

Each treatment centre must determine which health professionals are responsible for particular tasks, depending on the composition of its treatment and supportive care teams and existing local protocols.

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  1. 1.0 1.1 Nagel K, Cassano J, Wizowski L, Neal MS. Collaborative multidisciplinary team approach to fertility issues among adolescent and young adult cancer patients. Int J Nurs Pract 2009 Aug;15(4):311-7 Abstract available at
  2. Woodruff TK. The Oncofertility Consortium--addressing fertility in young people with cancer. Nat Rev Clin Oncol 2010 Aug;7(8):466-75 Abstract available at
  3. Achille MA, Rosberger Z, Robitaille R, Lebel S, Gouin JP, Bultz BD, et al. Facilitators and obstacles to sperm banking in young men receiving gonadotoxic chemotherapy for cancer: the perspective of survivors and health care professionals. Hum Reprod 2006 Dec;21(12):3206-16 Abstract available at
  4. Gardino SL, Jeruss JS, Woodruff TK. Using decision trees to enhance interdisciplinary team work: the case of oncofertility. J Assist Reprod Genet 2010 May;27(5):227-31 Abstract available at
  5. Ethics Committee of the American Society for Reproductive Medicine. Fertility preservation and reproduction in cancer patients. Fertil Steril 2005 Jun;83(6):1622-8 Abstract available at

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