Multidisciplinary consensus on the criteria for fertility preservation in cancer patients

A Santaballa,I Zeberio-Etxetxipia,L Vázquez,M Andrés,L Bassas,Á Rodríguez-Lescure,E Ceballos-Garcia,J Domingo,D Manau-Trullas,C Márquez-Vega,Á Rovirosa

doi:10.1007/s12094-021-02699-2

Abstract

Infertility is one of the main sequelae of cancer and its treatment in both children and adults of reproductive age. It is, therefore, essential that oncologists and haematologists provide adequate information about the risk of infertility and the possibilities for its preservation before starting treatment. Although many international clinical guidelines address this issue, this document is the first Spanish multidisciplinary guideline in paediatric and adult oncological patients. Experts from the Spanish Society of Medical Oncology, the Spanish Fertility Society, the Spanish Society of Haematology and Haemotherapy, the Spanish Society of Paediatric Haematology and Oncology and the Spanish Society of Radiation Oncology have collaborated to develop a multidisciplinary consensus.

Highlights

The survival of patients with cancer has increased in recent years and is expected to continue improving [1, 2]
Cryopreservation of between 10 and 15 oocytes is recommended as the probability of preg‐ nancy is higher with a greater number of oocytes; this correlation is not so clearly observed after the age of 35 years due to the effect of age on oocyte quality and the increase in aneuploidies
Patients with haematological diseases require a specific approach to fertility preservation since (i) the incidences of acute lymphoblastic leukaemia (ALL) and Hodgkin’s lym‐ phoma (HL) are very high in adolescents and young adults; (ii) many patients present with medical complications that prevent the use of standard fertility preservation techniques and, in some cases, contraindicate them; (iii) many patients will undergo haematopoietic stem cell transplantation (HSCT), which is associated with a high risk of infertility

Summary

Introduction

The survival of patients with cancer has increased in recent years and is expected to continue improving [1, 2]. When considering the indica‐ tions for and performance of fertility preservation, both the age of the patient and her ovarian reserve must be assessed.

Results

Conclusion