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A changing perspective: improving access to fertility preservation

Nature Reviews Clinical Oncology volume 8, pages 56–60 (2011)Cite this article

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Abstract

Approximately 120,000 young women are diagnosed with cancer every year in the USA. Many will have treatment that can reduce their fertility, although few will learn this fact before their treatment commences. This presents a tremendous quality of life issue post-treatment, as evidenced in this Perspectives by a personal account from a 23-year-old woman diagnosed with breast cancer. Clinicians must increase awareness about patients' desires for motherhood and awareness about their individual reproductive potential. We demonstrate novel evidence about the wide variability in ovarian reserve in women of similar age, using assessment by antral follicle count. We show how a unified approach between oncology and fertility teams can help patients better understand their risk of treatment-related infertility, as well as how to take effective measures to mitigate it. Finally, we present options for fertility preservation, based on the time point at which consultation occurs.

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Figure 1: Timeline of events.
Figure 2: Antral follicle count.
Figure 3: Options for fertility preservation and for conception.

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Acknowledgements

This project was supported by NIH/NICHD and NIH/NIA Grant Number R01 HD044876 and by NIH/NCRR UCSF-CTSI Grant Number UL1 RR024131. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH. Mr Letourneau's work was supported by a grant from the UCSF PACCTR Medical Student Research Fellowship. We would like to thank our patient for her generous and heartfelt submission. Without her work this manuscript would not have been possible.

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Authors and Affiliations

  1. Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco School of Medicine, 505 Parnassus Avenue, Box 0916, San Francisco, 94143, CA, USA

    Joseph M. Letourneau, Marcelle I. Cedars & Mitchell P. Rosen

  2. Department of Medicine, Division of Hematology and Oncology, University of California San Francisco School of Medicine, 505 Parnassus Avenue, Box 0916, San Francisco, 94143, CA, USA

    Michelle E. Melisko

Authors
  1. Joseph M. Letourneau
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Contributions

M. E. Melisko provided a substantial contribution to discussions of the content and to review and/or editing of the manuscript before submission. M. I. Cedar researched the data for the article and provided a substantial contribution to discussions of the content. J. M. Letourneau and M. P. Rosen contributed equally to research, discussion of content and writing the article and to review and/or editing of the manuscript before submission.

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Correspondence to Joseph M. Letourneau.

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Letourneau, J., Melisko, M., Cedars, M. et al. A changing perspective: improving access to fertility preservation. Nat Rev Clin Oncol 8, 56–60 (2011). https://doi.org/10.1038/nrclinonc.2010.133

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