Fertility Considerations in Female AYA Cancer Survivors
Several studies indicate that female AYA cancer patients are less likely
to be offered counseling and to be referred to centers for fertility
preservation than their male counterparts.(33,34) Thus, a larger
population of female patients may not have received information about
the impact of cancer treatment on future fertility or have undergone
fertility preservation procedures before cancer treatment. After
completion of therapy, the extent of ovarian damage is difficult to
ascertain. Regular menses and traditional measures of ovarian function,
FSH and estradiol, may not reflect the extent of damage to the
primordial follicle pool and the decrease in ovarian reserve from cancer
treatment. Understanding the level of risk for ovarian dysfunction
related to cancer treatment therapy may help in counseling and
identifying patients who need more careful or specialized surveillance.
The types of surveillance offered and the frequency should be tailored
to the survivor’s age, developmental stage, desire to know their
fertility status and willingness to consider post treatment fertility
preservation when indicated.