The oncologist has an important role in advising patients about infertility as a potential risk of cancer treatment and answering basic questions about fertility preservation options, according to the ASCO Recommendations on Fertility Preservation in People Treated for Cancer. An ASCO slide set associated with the published recommendations lists the following Points of Discussion Between the Patient and Physician:
1. Cancer and cancer treatments vary in their likelihood of causing infertility.
2. Consider preservation options early to maximize the likelihood of success.
3. Sperm cryopreservation and embryo freezing are the methods of fertility preservation with the highest likelihood of success.
4. There appears to be no detectable increased risk of disease recurrence associated with most fertility preservation methods and pregnancy.
5. Aside from hereditary genetic syndromes and in-utero exposure to chemotherapy, there is no evidence that a history of cancer, cancer therapy, or fertility interventions increase the risk of cancer or congenital abnormalities in the progeny.
6. Treatment-related infertility may be associated with psychosocial distress.
The ASCO guidelines also suggest that oncologists refer patients to psychosocial providers and reproductive specialists as needed. ■
Reprinted with permission from an ASCO slide set associated with Lee SJ, Schover LR, Partridge AH, et al: American Society of Clinical Oncology Recommendations on Fertility Preservation in Cancer Patients. J Clin Oncol 24:2917-2931, 2006. Copyright © 2006 by the American Society of Clinical Oncology. The slide set and full text of the ASCO Clinical Practice Guideline are available at www.asco.org/guidelines/fertility.