According to guidelines developed by the American Society of Clinical Oncology (ASCO, 2006), fertility preservation options should be addressed by oncologists and health care providers as part of standard care for patients who are in their reproductive years. Patients with hereditary cancer predisposition syndromes and/or significant family histories of cancer can have different concerns than the average cancer patient. For example, they may be concerned about their future risk of cancer or the risk to their children.
You may want to discuss fertility preservation options with patients:
- who are previvors- have not been diagnosed with cancer but are at significantly increased risk due to a hereditary cancer syndrome. These patients may be considering their different risk-reduction options, some of which affect fertility (e.g. prophylactic bilateral salpingo oophorectomy)
- who are planning a pregnancy- these patients may be interested in reproductive options, such as preimplantation genetic diagnosis (PGD)
- who have been recently diagnosed with cancer- fertility preservation discussions should occur BEFORE cancer treatment begins, so the patient has the option to preserve fertility and consider preimplantation genetic diagnosis to reduce the risk of having a child with a hereditary cancer syndrome