Fertility Considerations in Female AYA Cancer Survivors
Several studies indicate that female AYA cancer patients are less likely to be offered counseling and to be referred to centers for fertility preservation than their male counterparts.(33,34) Thus, a larger population of female patients may not have received information about the impact of cancer treatment on future fertility or have undergone fertility preservation procedures before cancer treatment. After completion of therapy, the extent of ovarian damage is difficult to ascertain. Regular menses and traditional measures of ovarian function, FSH and estradiol, may not reflect the extent of damage to the primordial follicle pool and the decrease in ovarian reserve from cancer treatment. Understanding the level of risk for ovarian dysfunction related to cancer treatment therapy may help in counseling and identifying patients who need more careful or specialized surveillance. The types of surveillance offered and the frequency should be tailored to the survivor’s age, developmental stage, desire to know their fertility status and willingness to consider post treatment fertility preservation when indicated.