COSA guidelines for fertility preservation for people with cancer

Author(s):

COSA Fertility Preservation Guidelines Working Group

First Published: May 2022

Summary of recommendations

Part One: Fertility Preservation

Impact of cancer treatment on fertility

• Pregnancy and live birth
• Ovarian function
• Testicular function

Discussing risk

• Reproductive concerns
• Health professional awareness
• Role of oncology services

Referral and service provision

• Referral rates and decisional conflict
• Referral pathways
• Oncofertility service provision

Psychological support

• Fertility counselling
• Decision-making

Options for treatment

• Sperm cryopreservation
• Testicular biopsy
• Embryo cryopreservation
• Oocyte cryopreservation
• Safety of ovarian stimulation
• Ovarian tissue cryopreservation
• Ovarian transposition
• Ovarian suppression with GnRH analogues

Part Two: Reproductive Health

Impact on pubertal development

• Pubertal development

Contraception

• Contraception during cancer treatment
• Contraception after cancer treatment

Conception

• Interrupting hormone therapy to conceive
• Assisted reproduction and risk of cancer recurrence

Pregnancy

• Pregnancy and risk of cancer recurrence
• Risk of pregnancy complication

Appendices

• Guideline development process
• COSA Fertility Preservation Guidelines Working Group
• Additional resources

Endorsed by: