Preservation of Fertility in the Cancer Patient

Preservation of fertility is a key determinant of long-term quality of life of adolescents and young adults treated for curable forms of cancer. The risk of developing primary or secondary infertility after completion of their treatment is variable and difficult to predict. Moreover, evaluation of the extent and reversibility of gonadotoxicity of cancer therapies is currently imperfect, especially in young women. The term “oncofertility” was originally coined to describe a new discipline that bridges oncology and reproductive medicine to develop and apply new fertility preservation (FP) options for young patients with cancer. Although there is a great interest in this field for more than 20 years, the level of evidence remains low for most of the recommendations, due to the lack of large prospective cohort studies and of randomized trials. The most established methods of FP are sperm banking in men and embryo/oocyte cryopreservation in women. However, alternative options, though most experimental, are in development, can already be proposed to young patients in well-defined conditions. Despite the progress and refinement of FP techniques and the increase in educational resources, an information gap between patients and healthcare teams still persists. Concerted efforts must be made in parallel and global oncofertility programs developed to offer high-quality techniques to meet this unique need in young cancer patients.