What is the determining factor for preservation of fertility? Why can some women get pregnant after treatment and others cannot or do not? Is fertility preservation based on what chemotherapy one is receiving? — Tiffany Hunter, RN, York, PA.

Preservation of fertility in cancer patients depends on the patient’s age, disease, sex, type of chemotherapeutic agents used, radiation fields, dose, dose-intensity, methods of administration (oral versus intravenous), and pretreatment fertility (J Clin Oncol. 2006;24:2917-2931). Infertility should be discussed as early as possible with all patients as a potential risk of therapy. Fertility preservation options should be explained and patient interest ascertained before initiating treatment. Male and female infertility are highly associated with chemotherapy regimens involving alkylating agents and total body irradiation. — Jiajoyce R. Conway, DNP, FNP-BC, NP-C ONA

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