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Assessment for fertility risk
• I ntrinsic factors
• Health of patient, now and after treatment • Consent (patient/parent)
• Age
• Assessment of ovarian reserve
• Extrinsic factors
• Nature of predicted treatment
• high/medium/low/uncertain risk • Practicalities
• Time/Expertise/funding available
Adapted from Wallace WH, Critchley HO and Anderson RA J Clin Oncol 2012; 30: 3-5.
Conclusions
Cancer treatment can have a major impact on female fertility • With treatment any age
• But many women (and most girls) will retain fertility
• Age is the final arbiter of fertility
• Remember non‐ovarian effects too • Broader issues than gonadal toxicity
• changing priorities, postchemo endocrine treatment
• Pre‐treatment assessment is valuable
• Post‐treatment assessment: there will be surprises!
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