Clinical Practice Guidelines for Fertility Preservation in Pediatric, Adolescent, and Young Adults with Cancer

Abstract

In recent years, more cancer patients are achieving long-term survival owing to advances in treatment. However, cancer treatment can cause gonadal dysfunction that leads to loss of fertility. Thus, it is important for clinical oncologists to consider fertility preservation in children, adolescents, and young adults with cancer who are expected to have a favorable outcome and may wish to have children in the future. Sometimes, fertility preservation has to be abandoned depending on the stage of the cancer and the general condition of the patient, because fertility preservation procedures may unacceptably delay cancer treatment or be too risky for the patient. The Clinical Practice Guidelines for Fertility Preservation in Children, Adolescents, and Young Adults with Cancer were published in 2017 as the first guidelines for this field in Japan. These guidelines cover general principles and recommendations for 8 oncological categories, which is a point of difference from other guidelines. Close coordination between clinical oncologists and reproductive medicine specialists is important over the long term from the pretreatment phase through the post-treatment phase. Therefore, the guidelines were devised to help medical staff consider the available fertility preservation therapies and determine whether performing fertility preservation is appropriate before initiating the treatment for cancer, and to ultimately improve survivorship for children, adolescents, and young adults with cancer. This article reviews the latest information concerning clinical practice guidelines around the world, including the American Society of Clinical Oncology guidelines that were the first to be published in this field.