New guidelines encourage discussions about cancer and fertility.

In May of this year, the American Society of Clinical Oncology (ASCO) released guidelines for addressing a fairly common, but often overlooked, side effect of cancer treatment: infertility.

According to the guidelines, doctors should talk to people with cancer, especially younger people, early on about the possibility of infertility due to treatment, or the cancer itself. Doctors should also be prepared to refer patients to specialists who can help them choose a method either for preserving their fertility or for preserving their option to have children, even if they become infertile.

The guidelines mark a shift in thinking about cancer treatment and the quality of survivorship.

"We're at this amazing crossroads where survival rates are higher than they've ever been, and at the same time, there are more reproductive options than there were before," said Lindsay Beck, co-author of the new guidelines and founder of the patient group Fertile Hope. "If you don't have that discussion early on, patients will miss their opportunity."

Beck began Fertile Hope in 2001 after her own struggles to find a way to preserve her fertility in the face of cancer treatment. The group provides information and financial assistance to young cancer patients who need fertility preservation procedures.

The new ASCO guidelines are informative for oncologists who may not know very much about modern methods of fertility preservation. The guidelines list the various cancer treatments that can cause infertility, and detail both proven and experimental methods of fertility preservation, many of which go beyond sperm and embryo freezing. (See the article in this issue Having cancer doesn’t mean not having children.)

Most of the technologies for preserving fertility or preserving the option to have children even if infertility occurs, have not been around for very long and therefore don’t have a track record or supportive data. The good news, however, is that many of these methods are promising and people facing cancer and its treatment need to know about them.