Counsel patients to explore fertility preservation

Oncology nurses and other health-care personnel should refer interested patients to a reproductive endocrinologist as quickly as possible after a cancer diagnosis, as cancer treatment can cause fertility loss and some fertility-preservation strategies require 2 to 3 weeks to complete.

This is one of the key messages set forth in a recent special article on fertility preservation appearing in Mayo Clinic Proceedings (2011;86[1]:45-49, available at www.mayoclinicproceedings.com/content/86/1/45.full.pdf+html; accompanying editorial on pp. 6-7 available at www.mayoclinicproceedings.com/content/86/1/6.full.pdf+html). Of the estimated 1.5 million men and women who received a cancer diagnosis in 2010, 10% were younger than 45 years and 1% younger than 20 years. Reproductive issues are a concern to many patients in these age groups.

Although fertility preservation is an emerging field with many unanswered questions, several methods allow patients to store gametes or reproductive tissues to potentially create future offspring. Strategies vary by age and sex of the patient.

According to the report, the optimal time to attempt conception after cancer therapy has been completed is unknown, but many experts recommend waiting at least 2 years posttreatment, when the greatest risk of recurrence is speculated to have passed. Women undergoing therapy with tamoxifen or other hormones are often advised to wait 5 years—a timeline that might prove challenging due to the patient's reproductive aging and declining fertility.

 

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