Options in oncofertility: an interdisciplinary discussion

Abstract

Background: Long-term survivorship in pediatric and young patients has vastly improved over the years, leading to research looking beyond acute treatment risks. Post-treatment quality of life assessments have found a gap in the fertility needs of these individuals. Aside from the physical issues surrounding fertility assistance prior to cancer therapy, a number of other issues arise such as psychological factors, social concerns, and ethical considerations that warrant a discussion all on their own. Objective: Barriers to reproductive medicine when presented with a cancer diagnosis come from a lack of basic science, translational, and clinical research. It is the duty of the oncologist to familiarize themselves with options in fertility preservation. This thesis hopes to consolidate pieces of convincing data and provide an analysis of the options to diffuse some of the uncertainty surrounding these discussions. Additionally, suggestions will be made, where applicable, for supplemental research to bridge gaps in current knowledge. Findings: Several options are available, with significant caveats and limitations. With few established techniques and more that are under investigation, not many can be confidently and fairly promoted to all cancer patients. Often, logistics of timing and personnel coordination get in the way of utilizing this technology. Even so, there is a lack of open dialogue between the treating physician and cancer patients of childbearing age regarding the field of oncofertility. Conclusion: There is a need to protect the autonomy and vulnerability of each patient who is diagnosed with any form of cancer. The field of oncofertility should aim to serve all young cancer survivors with the opportunity to protect their fertility and long-term quality of life. In order to do so, healthcare providers from across different fields must work together to coordinate a patient’s best interest; only with constant communication and discussion between various disciplines will cancer patients receive the most appropriate information for their situation.