Experts call for better practices in fertility preservation

By Julie Griffiths on 05 January 2018 Cancer Fertility

The British Fertility Society (BFS) has published new guidelines for clinicians on fertility preservation for cancer patients and transgender patients.

The BFS presented the guidance at the Fertility 2018 meeting yesterday (4 January) in Liverpool.

Chair of the BFS Professor Adam Balen said: ‘There are a number of situations where the preservation of fertility is needed. This has to happen at a time before a person is ready to start a family and can sometimes be the only hope for becoming a parent in the future. Our guidelines are designed to help our members and the wider fertility community to decide on the best course of treatment, in consultation with these patients.’

For women undergoing cancer treatment, the medicine that cures them can also render them infertile, so fertility preservation is important. 

The guidance suggests that discussion of fertility preservation should happen as early as possible in the cancer treatment pathway to prevent any delay to the cancer treatment, which should be a high priority.

For people who are diagnosed with gender dysphoria (their gender identity does not match their physical sex) medical interventions, such as hormone treatment and surgery, may be necessary and can reduce or destroy fertility. 

By freezing eggs, embryos, or ovarian tissue, there is still the opportunity for transfolk to have a child who is biologically related to them, through pregnancy or surrogacy.

The guidelines also highlight a number of other conditions that lead to infertility. For example, a young person diagnosed with Turner Syndrome will be able to carry a baby in future but cannot produce her own eggs. 

Although a relatively rare condition, the BFS is finding that mothers of children with Turner Syndrome are prepared to donate and freeze their own eggs so that their daughter has an opportunity to become pregnant, if and when the time is right for her.

People who have undergone stem cell transplantation, for reasons other than cancer, such as sickle cell anaemia, for example, can also suffer infertility because of the medicines they are given during their treatment.

The BFS says that fertility preservation should be considered for all these conditions – not just for cancer patients.

The paper Fertility preservation for medical reasons in girls and women: British Fertility Society Policy and Practice guideline is published in Human Fertility here.