Conclusions
Regardless of whether infertility risk and fertility preservation
options were presented to children and families at the time of cancer
diagnosis, fertility is an important issue to address in survivorship.
The type of fertility information may morph over time, from risk of
gonadal damage due to cancer treatment, to fertility status assessment,
to pregnancy risks and risks to offspring, to fertility options/assisted
reproductive technologies, alternative options for family building.
While counseling about risks needs to be individualized, patients should
be reassured that survivors who conceive remote from therapy do not have
an increased risk of congenital or genetic abnormalities. As
reproductive health issues are commonly cited as an important concern by
survivors of AYA cancer, multidisciplinary care teams including
oncology, endocrinology, psychology, and reproductive medicine are
advocated, with the aim of optimal provision of fertility advice and
care after cancer.
Conflict of Interest Statement: Dr. Pavone serves on the
Ferring advisory board; Dr. Kashanian is a medical advisor for Roman
Health; Dr. Anderson consults and lectures for Roche Diagnostics, IBSA,
Ferring, and Merck Serono; no other authors have any disclosures.