Category » Fertility Preservation

New Article Calls for Female Fertility Preservation Best Practice Guidelines

Fertility concerns should be addressed with all newly diagnosed reproductive age cancer patients before their treatment begins. Although some treatment courses are thought to be more damaging to fertility than others, it is imperative that every patient is well-versed about the potential impact their treatment may have on their reproductive future in order to make informed decisions regarding fertility preserving procedures. In a new article in the Journal of Assisted Reproduction and Genetics, entitled, “Recommendations for Fertility Preservation in Patients with Lymphoma, Leukemia, and Breast Cancer,” the authors, ISFP Practice Committee, Kim SS, Donnez J, Barri P, Pellicer A, Patrizio P, Rosenwaks Z, Nagy P, Falcone T, Andersen C, Hovatta O, Wallace H, Meirow D, Gook D, Kim SH, Tzeng CR, Suzuki S, Ishizuka B, Dolmans MM, discuss different types of cancer and their treatment and the corresponding affect on fertility arguing for the importance of standardized fertility preservation counseling prior to treatment.

In “Recommendations for Fertility Preservation in Patients with Lymphoma, Leukemia, and Breast Cancer,” the authors discuss specific types of cancer (luekemia, lymphoma & breast cancer) incident and survival rates, as well as effects on gonadal function. For newly diagnosed breast cancer patients, factors affecting gonadotoxicity are age of the patient, and dose and number of cycles of some types of chemotherapeutics, called alkylating agents. The authors further clarify that many studies measure future fertility risk based on the likelyhood of amenorrhea, which can vary greatly depending on the types of chemotherapy.

In many cases, young breast cancer patients require additional cancer treatment given after the primary treatment, such as chemotherapy after surgery (mastectomy or lumpectomy), to lower the risk that the cancer will come back. The best time for fertility preservation is after surgery and before subsequent chemotherapy or radiation treatment begins. Egg or embryo banking is often recommended as a fertility preservation option for women before chemotherapy. Cryopreservation of embryos or oocytes requires hormonal stimulation which increases the levels of hormones, such as estrogen, in a woman’s body. For women with breast cancer, especially estrogen receptor positive types, this may cause proliferation of the cancer cells and the authors state that these risks should be discussed before the treatment. In addition, they state that women who require urgent cancer treatment, cryopreservation of ovarian tissue should be considered.

All patients who desire to preserve fertility should be counseled and informed about currently available fertility preservation options by their healthcare team. Recommendations should be individualized to the patient dependent on their diagnosis and treatment plan. The authors of “Recommendations for Fertility Preservation in Patients with Lymphoma, Leukemia, and Breast Cancer” state that, in general, fertility preservation before cancer treatment is strongly recommended if the chance of losing fertility is over 30 % with cancer therapy. Patients or clinicians interested in learning more about fertility preservation for a particular case can call the Oncofertility Consoritum’s FERTline for tailored information.



The National Cancer Institute Focuses on Oncofertility

About 70,000 adolescents and young adults (ages 15-39) are diagnosed with cancer each year in the United States. During cancer treatment, adolescents and young adults (AYA) may focus all of their energy on getting through treatment. Some may not have spent much time talking or thinking about life after cancer treatment, and the impact their cancer treatment may have on their survivorship. Life after treatment often presents a new set of challenges and fertility may be one of the challenges that survivors face once treatment ends and family planning begins.

The importance of fertility options for AYA’s diagnosed with cancer has not been lost on the National Cancer Institute (NCI), which is one of 11 agencies that compose the Department of Health and Human Services (HHS). The NCI, established under the National Cancer Institute Act of 1937, is the Federal Government’s principal agency for cancer research and training. Recently, the NCI featured oncofertility in the NCI Cancer Bulletin, a distinguished news source for the latest in cancer research, in an article entitled, “So Others May Benefit: Young Cancer Patients and Survivors Take Part in Oncofertility Research.”

Understanding fertility outcomes for the AYA cancer population is imperative to improving the cancer treatment process and ensuring that fertility preservation discussions become standard procedure in comprehensive cancer care. Fertility preservation is of special concern for AYA cancer patients, a group that historically has been underrepresented in clinical research studies. “So Others May Benefit: Young Cancer Patients and Survivors Take Part in Oncofertility Research,” explores the unique approach that the Oncofertility Consortium used to get their attention and increase AYA participation in clinical studies: social media.

The success of this new outreach effort can be seen in the Consortium’s Fertility Information Research Study (FIRST). FIRST is a fertility information research study for young women who are facing or have faced cancer treatment. Researchers want to learn more about how cancers and treatments affect the reproductive health of young survivors, and whether or not cancer survivors wish to have children in the future or not.

When FIRST was initially launched, researchers had some difficulty recruiting study participants, due to the challenges AYA’s pose to researchers (in other words – they can be hard to track down). After some initial brainstorming, they decided to utilize their relationships with some of the leading AYA advocacy groups such as Stupid Cancer and Imerman Angels to reach the AYA population. After the first posting about the study on Twitter and Facebook, researchers received 15 calls from cancer patients willing to participate. Today, FIRST has 200 participants and counting, many of them learning about the study via social media.

To learn more about how the Oncofertility Consortium is changing the face of comprehensive cancer care through social media, read “So Others May Benefit: Young Cancer Patients and Survivors Take Part in Oncofertility Research.”

New Report: 2012 Cancer Facts, Figures & Survivorship Information

The number of Americans with a history of cancer is growing due to the aging and growth of the population, as well as improving survival rates. In response to this demographic trend, The American Cancer Society (ACS) and the National Cancer Institute (NCI) compiled a comprehensive survivorship report providing current and projected cancer prevalence estimates for the United States, information on the common effects of cancer and it’s treatment, and survivorship resources.

The ACS defines a cancer survivor as any person who has been diagnosed with cancer, from the time of diagnosis through the balance of life. There are at least three distinct phases associated with cancer survival, including the time from diagnosis to the end of initial treatment, the transition from treatment to extended survival, and long-term survival. In reality though, survivorship encompasses many different scenarios including:

  • Living cancer-free for the remainder of life
  • Living cancer-free for many years, but experiencing one or more serious complications of treatment
  • Living cancer-free for many years, but dying after a late recurrence
  • Living cancer-free after the first cancer is treated, but developing a second cancer
  • Living with intermittent periods of active disease requiring treatment
  • Living with cancer continuously without a disease-free period

According to the NCI, an estimated 13.7 million Americans with a history of cancer were alive on January 1, 2012, and of that total, 10% are men and women under the age of 39. The three most common cancers among male survivors are prostate (43%), colon and rec- tum (9%), and melanoma (7%). Among female survivors, the most common cancers are breast (41%), uterine corpus (8%), and colon and rectum (8%). As of January 1, 2022, it is estimated that the population of cancer survivors will increase to almost 18 million: 8.8 million males and 9.2 million females.

Many children, adolescent and young adult cancer survivors must cope with the long-term effects of treatment, such as infertility and sexual dysfunction. For younger survivors, the loss of fertility can be life-changing, with irreversible consequences that can affect quality of life. Women under 35 are at risk for infertility and premature menopause, even when their menstrual cycle resumes. Toxic effect of chemotherapy on the ovaries increases with older age, higher doses, and longer duration of treatment. Male infertility from cancer surgery or radiation can result from anatomic changes, hormonal imbalances, or lower production and quality of sperm. Cancer patients, caregivers, and survivors must have the information and support they need to play an active role in decisions that affect treatment and quality of life.

For a list of cancer care resources, including survivorship information, please visit our Patients page. To read  Cancer Treatment & Survivorship Facts & Figures, please click here.

New Fertility and Cancer Study from Oncofertility Consortium Member, Jennifer Mersereau, MD

Advances in cancer treatments give young women more hope for survival than ever before, but many treatments can leave women unable to naturally conceive a child.  The University of North Carolina (UNC) Fertility Preservation Program, a member of the National Physicians Cooperative, provides options for female patients of reproductive age newly diagnosed with cancer, but the decision to initiate fertility preservation must be made quickly, before cancer treatment begins.  General lack of knowledge about reproductive functioning, stress related to processing the cancer diagnosis, urgency, and insufficient support while attempting to make the decision, all serve to degrade this process often leading to later decisional regret.

As a result, Oncofertility Consortium member, Dr. Jennifer Mersereau, and UNC Fertility are conducting a multidisciplinary research study that evaluates a ‘Decision-Aid” designed to help reproductive-aged women (age 18-42) make decisions about fertility and cancer. This collaborative project between a reproductive endocrinologist, clinical psychologist, and oncology experts involves a new interactive, web-based decision aid that is used in concert with fertility preservation counseling.  If this decision aid proves to be beneficial, this web-based tool may potentially be used for patients who do not have easy access for a full fertility preservation consultation.

Study Details:

  • Study participants will have a routine consultation appointment with a fertility specialist at UNC Fertility to discuss fertility, cancer, and treatment options for fertility preservation. Note that this visit is considered part of routine medical care.
  • Participants will plan for an additional 45-60 minutes at the time of their consultation to watch a web-based presentation about fertility preservation and decision-making.  They will also complete questionnaires at that time.
  • Participants will be asked to complete 2 additional web-based surveys, one approximately one week after the consultation, and one approximately 6 months later.

Findings from this pilot evaluation will support a grant application for a multi-site study to investigate community effectiveness and accessibility. Study participants will receive a $50 gift card for full participation, to compensate for their time and effort. If you are in the Chapel Hill area and interested in taking part in this study, please call for a consultation appointment (919-966-1150) or send an email to jem *at* with your name, phone number and times that you can be reached. Your contact information will not be shared with anyone outside the study. For more information about this study, please click here.

*Supported by a grant from the UNC Lineberger Cancer Center.

Teal Diva Shares Her Story of Cancer, Fertility, and Resilience

As part of our guest blog series, the Oncofertility Consortium would like to introduce our readers to Shannon Routh, and her organization for young survivors of ovarian and gynecologic cancers, Teal Diva, founded in 2009. Below is a post she wrote about her experience with cancer, fertility and finding the “new normal” in her life.

By Shannon Routh

Remember the MASH (Mansion-Apartment-Shack-House) game you used to play when you were a little girl, to predict what your life would be like when you grew up? The game where you choose your husband, how many kids you will have, where you will live, etc.  It’s funny how the words cancer, infertility or hysterectomy were never a part of my outcome.   My story ends a little differently than I had hoped…dreamed.

My husband and I were married just shy of 3 years when we got the news…you have ovarian cancer.  A few months prior to being diagnosed, I had abdominal pain.  I went to my gynecologist.  After reviewing my ultrasound, she noticed a cyst the size of a grapefruit on my ovary.  She referred me to a Gynecologic Oncologist.  As he prepped us for surgery, he told us we had 3 scenarios: 1-remove the cyst, 2- cancer, removal of cyst and ovary, and 3-cancer, hysterectomy, etc, etc, etc.  After surgery, I woke up asking if he did a hysterectomy and I was told he did not.  Oh my goodness…I was so relieved, so thankful.  The day I was released from the hospital is the day I learned I had stage IIa Clear Cell Carcanoma. I was 32.  And because of my age and cancer type, he wanted to be certain prior to taking both ovaries.  Wait…does that mean?…yep.  A 2nd surgery was scheduled.  We went home…devastated.  In an effort to remain positive, I thought we could harvest eggs and pursue other options.  We went in for a consultation a few days before the radical hysterectomy and asked hopeful questions about our options, but we were told my cancer type feeds off of hormones. Unfortunately, you will not be able to bare children.  So not only do I have cancer, I can’t have kids.  WOW…talk about depressing.  But I didn’t have time to feel sorry for myself because I had to prepare for the hardest fight of my life.

My world was turned upside down by having cancer and learning I would never bare children, but I have found a new normal…one I didn’t plan for.  Throughout my journey, I needed desperately to connect with someone. So, one night I started writing and before I knew it, Teal Diva was born.   The mission of Teal Diva is to celebrate life!  As survivors of ovarian and other gynecological cancers, we understand the reason to celebrate every sunrise.  We are bound by our experiences and challenges and form a sorority which we never intended to join.  The primary beneficiary of our fundraising efforts are research programs seeking reliable screening tests for gynecologic cancers.

*To learn more about Teal Diva and other community resources for cancer survivors, please visit our Patients webpage.

Clinic 101: Building a Fertility Preservation Program

Fertility Preservation (FP) programs are imperative to comprehensive cancer treatment plans, but not all providers are able to offer this level of care to their patients. Often, this is not for lack of want, but rather it results from a scarcity of resources or insufficient knowledge regarding FP.  Training hospitals often have the right people and networks in place to incorporate FP into cancer care, however smaller operations such as community cancer centers and local hospitals may have more challenges establishing an FP program for a variety of reasons, namely their size.

In an effort to assist providers, clinicians and healthcare facilities nationwide, the Oncofertility Consortium developed a one-day, small-group training course to give practitioners the tools to develop their own fertility preservation program from scratch or strengthen an existing program. The course is titled, Clinic 101: Building a Fertility Preservation Program, and includes the following:

  • Welcome and Overview of the Key Pieces in a Fertility Preservation Program
  • The Ins and Outs of Setting Up a Local Oncofertility Community
  • Timing, Turnaround, and Practical Considerations
  • Clinical Exercises: Discussing Fertility Preservation with Patients
  • Pediatric Fertility Preservation
  • One Case Study in Program Development: One Doctor’s Experiences
  • The Oncologist’s Perspective

The next Clinic 101 is Wednesday, September 26, 2012 at Northwestern University in Chicago, IL. The clinic will be held the day before the 2012 Oncofertility Conference: Dialogues in Oncofertility concurrent with our course for researchers, Oncofertility 101: A Training Course in in vitro Follicle Growth Using Alginate Hydrogels. Please sign up early if you’re interested as the class is filling up quickly. There is a $30 fee for the course which covers supplies, print materials, and lunch for attendees.

Click here to register for Clinic 101, or to get more information. We look forward to hearing from you!

New Tool for Fertility Preservation in Community Cancer Centers

In 1974 a small group of physicians seeking to dispel the myth that community physicians were uninterested in and incapable of participation in state-of-the-art cancer care came together to form the Association of Community Cancer Centers (ACCC). ACCC was born to give oncology practitioners in the community a voice in the national oncology forum and it would become the mechanism through which clinical protocols and other oncology standards of care were developed and disseminated to community cancer programs across the nation. ACCC promotes the entire continuum of quality cancer care for both patients and communities.

Most recently, Faye Flemming, RN, BSN, OCN, member of ACCC, created Nicole’s Oncofertility Toolkit to help facilitate the development of a formalized oncofertility program in community cancer centers. Faye initiated the project as a direct result of the pain and suffering her 28year old newly married niece, Nicole, endured when her oncology team failed to address her oncofertility needs immediately after diagnosis. Ultimately, Nicole’s fertility needs were recognized, but it wasn’t until months later after she found an oncology provider that was equipped with the tools, resources and knowledge to facilitate this. It also took persistence on Nicole’s part to seek out a cancer care team that would ensure she had fertility options prior to undergoing fertility impairing treatment.

Nicole’s Oncofertility Toolkit is a resource for both patients and healthcare professionals. It provides each with general information (statistics, cost, procedures, assessment), tools for establishing a program and resources for fertility preservation information so that both the provider and the patient are well informed. According to Faye, “Many cancer patients experience unnecessary emotional turmoil due to a lack of attention, knowledge, support, resources, planning and preparation related to oncofertility issues and both the providers and payers are to blame.” Therefore, this toolkit was created to empower both patients and providers to take control of the fertility options available to men, women and children.

In a community-based setting, it can be challenging to meet the fertility needs of cancer patients, but with the addition of Nicole’s Oncofertility Toolkit, it opens up a much needed dialogue about oncofertility, increasing the likelihood that fertility will be addressed at diagnosis in age appropriate patients.


iSaveFertility Canadian Invasion!

As you may already know, The Oncofertility Consortium partnered with the Endocrine Society to release the free, iSaveFertility iPhone App nearly a year ago this week.  iSaveFertility was developed to give oncologists and fertility specialists a quick reference guide for preserving the fertility of children, women and men diagnosed with cancer. In today’s world, more and more health care professionals are using smartphone technology as part of their daily lives, with apps being designed in lieu of cumbersome pocket-guides to meet their diagnostic and medical information needs. In oncology and fertility care, access to the most recent information and tools available at the point-of-care is critical for both providers and patients in the fight against cancer, thus iSaveFertility was born!

In July of last year, the Oncofertility Consortium partnered with the Cancer Knowledge Network (CKN), an affiliate of the Canadian journal, Current Oncology, to reach the larger  population of oncology professionals in an effort to provide insight into the complex health care and quality-of-life issues that concern cancer patients whose fertility may be threatened by disease or its treatment. As a result of this partnership, CKN is working with us to help disseminate information about fertility and cancer awareness across Canada by utilizing the iSaveFertility iPhone app in healthcare settings. It is the objective of all those involved with CKN and the Onocfertility Consortium to provide an open-access, multi-disciplinary forum for oncologists and cancer-care professionals to connect, become informed and initiate discourse.

Utilizing new technology, such as the iSaveFertility, is helping to change the face of comprehensive cancer care. Providers rely on the apps to give them the most up-to-date healthcare information, which in turn benefits the patient by ensuring they are well-informed and in control of their cancer treatment. We are excited to engage with the larger oncology community and to improve care to cancer patients with the help of CKN and iSaveFertility.

To learn more about iSaveFertility, visit and download the free app. To learn more about CKN, please read our past blog post or visit, Cancer Knowledge Network.


Fertility Preservation and Sex Disparities

Infertility has been associated with psychological distress and can have a negative impact on quality of life in cancer survivors.  Reproductive concerns are often sited among young cancer survivors prior to, and following cancer treatment. A number of fertility preservation (FP) options are available to preserve patients’ future reproductive ability. For men, sperm banking is a clinically established method, and a relatively straightforward procedure in comparison to FP for women, which is more complex. In a new article published in the Journal of Clinical Oncology by authors Gabriela M. Armuand, Kenny A. Rodriguez-Wallberg, Lena Wettergren, Johan Ahlgren, Gunilla Enblad, Martin Ho ̈glund, and Claudia Lampic, entitled, “Sex Differences in Fertility-Related Information Received by Young Adult Cancer Survivors,” the authors investigate male and female cancer survivors’ perception of fertility-related information and use of FP in connection with cancer treatment during reproductive age.

The authors used a sample of 484 survivors diagnosed from 2003 to 2007 identified in population-based registry in Sweden. Inclusion criteria included survivors who were age 18 to 45 years at the time of diagnosis and had lymphoma, acute leukemia, testicular cancer, ovarian cancer, or female breast cancer treated with chemotherapy. Study participants were asked to fill out a questionnaire assessing their experience with FP and knowledge of FP techniques following a cancer diagnosis.

The majority of male participants reported having received information about treatment impact on fertility (80%) and more than half of the men banked frozen sperm (54%). Among women, less than half reported that they received information about treatment impact on fertility, and 14% reported that they received information about FP. Only seven women, or 2%, underwent FP.  Sex was the single most important predictor for receipt of information about FP; a man was 14 times more likely to report having received such information than a woman. The results of this study are even more interesting when you take into account that in Sweden, infertility treatment is part of the tax-funded health care system; therefore, FP is available to all patients with cancer. Nonetheless, this did not seem to have an impact on female access to FP information and services.

The results of this study suggest significant sex differences when conveying fertility-related information and the use of FP. As a result, the authors argue that there is an urgent need to develop fertility-related information adapted to female patients with cancer to improve their opportunities to participate in informed decision-making regarding their treatment and future reproductive options. In an effort to meet the needs of young female cancer patients, the Oncofertility Consortium developed educational materials to help young women and their families better understand their fertility preservation options. Read, “Sex Differences in Fertility-Related Information Received by Young Adult Cancer Survivors.”

May 17th Live Podcast: Reproductive Technology at the Office of Research on Women’s Health

A person’s health is influenced by many factors; including, sex, gender, culture, environment, and income. Researchers are discovering the critical roles that sex and gender identity play in health, wellness, and disease progression. The discoveries being made through the study of women’s health and sex differences are key to advancements in personalized medicine for both sexes.

The Office of Research on Women’s Health (ORWH) was established in September 1990 in response to congressional, scientific, and advocacy concerns that a lack of systemic and consistent inclusion of women in National Institutes of Health (NIH) supported clinical research could result in clinical decisions being made about health care for women based on findings from studies of men—without evidence that they were applicable to women. Since that time, the Office has been the focal point for guiding the national research effort on women’s health issues and is responsible for ensuring that women’s health research priorities are integrated into the wider NIH research agenda. The mission of ORWH is to:

  • Advise the NIH Director on matters relating to research on women’s health
  • Strengthen and enhance research related to diseases, disorders, and conditions that affect women
  • Ensure that research conducted and supported by NIH adequately addresses issues regarding women’s health
  • Ensure that women are appropriately represented in biomedical and biobehavioral research studies supported by NIH
  • Develop opportunities for and support recruitment, retention, reentry, and advance- ment of women in biomedical careers
  • Support research on women’s health issues.

ORWH works in partnership with the 27 NIH Institutes and Centers to ensure that research on women’s health is part of the scientific framework at NIH, and throughout the scientific community. ORWH develops and supports scientific seminars, symposia, and workshops that highlight scientific advances, career development, and promising as well as accomplished researchers in this expanding field. This Thursday, May 17th, Oncofertility Consortium member, Dr. Clarisa Gracia is taking part in a seminar series sponsored by the ORWH entitled, Innovations in Reproductive Technologies from 1-3pm EST, which will be available to listeners live, via podcast. Highlights of the seminar include:

  • Ethical Issues in Emerging Technologies in Reproductive Medicine; 
Alan Decherney, MD, Head, Section on Implantation and Oocyte Physiology
Program in Reproductive and Adult Endocrinology
  • Emerging Technologies in Infertility; 
Clarisa Garcia, M.D., M.S.C.E, Assistant Professor Obstetrics and Gynecology
  • Technology in Reproductive Medicine; 
Alicia Armstrong, M.D., Associate Fellowship Program Director
Reproductive Endocrinology and Infertility
  • Multipurpose Prevention Technology for HIV, STIs, and Pregnancy
; Gustavo Doncel, M.D., Ph.D., Professor of Obstetrics and Gynecology
  • New Technology in Contraception Research
; Regine Sitruk-Ware, M.D., Reproductive Endocrinologist

Mark your calendars and tune in tomorrow to at 1pm EST to listen live!

Page 13 of 27« First...1112131415...20...Last »
© Oncofertility Consortium Blog