Originally published as JCO Early Release 10.1200/JCO.2006.06.5888 on May 1 2006

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American Society of Clinical Oncology Recommendations on Fertility Preservation in Cancer Patients

Stephanie J. Lee, Leslie R. Schover, Ann H. Partridge, Pasquale Patrizio, W. Hamish Wallace, Karen Hagerty, Lindsay N. Beck, Lawrence V. Brennan, Kutluk Oktay

From the Dana-Farber Cancer Institute, Boston, MA; Fertility Preservation Program, Center for Reproductive Medicine and Fertility, Weill Medical College, Cornell University; Fertile Hope, New York, NY; Oncology/Hematology Care, Crestview Hills, KY; American Society of Clinical Oncology, Alexandria, VA; Yale University Fertility Center, New Haven, CT; M.D. Anderson Cancer Center, Houston, TX; and the Royal Hospital for Sick Children, Edinburgh, Scotland, UK

Address reprint requests to Kutluk Oktay, MD, The Center for Reproductive Medicine and Infertility, Cornell University, 505 E 70th St, HT-340, New York, NY 10021; e-mail: guidelines{at}asco.org

PURPOSE: To develop guidance to practicing oncologists about available fertility preservation methods and related issues in people treated for cancer.

METHODS: An expert panel and a writing committee were formed. The questions to be addressed by the guideline were determined, and a systematic review of the literature from 1987 to 2005 was performed, and included a search of online databases and consultation with content experts.

RESULTS: The literature review found many cohort studies, case series, and case reports, but relatively few randomized or definitive trials examining the success and impact of fertility preservation methods in people with cancer. Fertility preservation methods are used infrequently in people with cancer.

RECOMMENDATIONS: As part of education and informed consent before cancer therapy, oncologists should address the possibility of infertility with patients treated during their reproductive years and be prepared to discuss possible fertility preservation options or refer appropriate and interested patients to reproductive specialists. Clinician judgment should be employed in the timing of raising this issue, but discussion at the earliest possible opportunity is encouraged. Sperm and embryo cryopreservation are considered standard practice and are widely available; other available fertility preservation methods should be considered investigational and be performed in centers with the necessary expertise.

CONCLUSION: Fertility preservation is often possible in people undergoing treatment for cancer. To preserve the full range of options, fertility preservation approaches should be considered as early as possible during treatment planning.

Authors’ disclosures of potential conflicts of interest and author contributions are found at the end of this article.

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