Fertility preservation guidelines for cancer patients reviewed

(HealthDay)—No major, substantive revisions were necessary, but clarifications were added to update the American Society of Clinical Oncology (ASCO) guidelines on fertility preservation for children and adults with cancer, according to a report published online May 28 in the Journal of Clinical Oncology.

Alison W. Loren, M.D., of the University of Pennsylvania in Philadelphia, and colleagues used MEDLINE and the Cochrane Collaboration Library to perform a systematic review of the medical literature published from March 2006 through January 2013. An Update Panel reviewed the evidence and drafted updates to the previous ASCO guidelines on fertility preservation in cancer patients.

The researchers found 222 new publications, including 18 randomized clinical trials, as well as observational studies, cohort studies, and case series or case reports, that met the inclusion criteria. After reviewing the evidence, the panel made minor revisions to the guidelines and clarified the language. Health care providers should discuss the possibility of infertility with adults of reproductive age, or the parents or guardians of children and adolescents, and address fertility preservation as early as possible, before treatment for cancer. Cancer patients should be referred to reproductive specialists for fertility preservation. Cryopreservation of oocytes, sperm, and embryos is considered standard practice.

"After a systematic review and analysis of the literature for the preservation of fertility for patients with cancer, the Update Panel concluded that there was no new evidence compelling enough to warrant substantial changes to any of the guideline recommendations. However, minor adjustments were made to reflect progress in the field (e.g., oocyte cryopreservation is no longer investigational)," the authors write. "Information has been added to address role of psychosocial providers, fertility preservation concerns, and options for children and adolescents with cancer, as well as considerations for patients receiving targeted and biologic therapies."

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