ASCO University®, in partnership with the LIVESTRONG Foundation, has created a collection of materials about fertility preservation issues in patients of childbearing age. These materials are part of the Focus Under Forty™ series (university.asco.org/focus-under-forty), a collection of resources that cater to the specific needs of patients ages 15-39 diagnosed with cancer. The fertility preservation resources, which include two ASCO University eLearning courses and two videos, coincide with a recent update to the ASCO guideline on fertility preservation.

ASCO University is offering these resources in response to a growing body of evidence that shows that cancer care providers, as a whole, are not sufficiently discussing with their patients how fertility can be affected by cancer treatments. ASCO's 2012 Quality Oncology Practice Initiative (QOPI®) has exposed statistics that further suggest that this is a largely unaddressed need. According to 2012 QOPI statistics, less than 33% of patients of reproductive age had discussions with their cancer care providers regarding fertility risks as a result of treatments, and less than 16% had discussions regarding fertility preservation options or were referred to a fertility specialist.

Cancer Care Providers in ASCO University® Fertility Preservation Videos
Male Fertility Preservation
David L. Graham, MD, Medical Director for Multispecialty Clinical Research Services at Carle Physicians Group
Marcia Leonard, RN, PNP, Co-Director of the Survivorship Program at University of Michigan Comprehensive Cancer Center
Female Fertility Preservation
Carolyn B. Hendricks, MD, breast medical oncologist, Bethesda, Maryland
Carey K. Anders, MD, Assistant Professor of Medicine at University of North Carolina, Chapel Hill

The videos, separate versions that address male- and female-specific fertility preservation needs, each incorporate insight from one practicing oncologist and one cancer care provider who has specific experience in dealing with fertility preservation. The goal is to facilitate more proactive discussions with patients by providing first-hand testimonials and advice. Both videos are available at university.asco.org/videos.

The videos emphasize that cancer care providers themselves do not need to be experts in fertility preservation since they can refer interested patients to specialists. What is critical, however, is that oncologists and advanced practice providers develop a system to ensure that fertility preservation is routinely addressed so that patients are aware of their options early in the process.

"What we've tried to do at our center is introduce the concept of fertility preservation from the very first phone call," said Carey K. Anders, MD, who participated in the female fertility preservation video. "Many of our patients are initially unaware of that risk."

Courses help practices adhere to updated guideline

The May 2013 update to the ASCO guideline about fertility preservation emphasizes that as part of education and informed consent before cancer therapy, all oncology health care providers should have a documented discussion with patients treated during their reproductive years (or with parents or guardians of children) about the possibility of infertility. Oncology care providers should be prepared to discuss fertility preservation options and/or to refer all potential patients to appropriate reproductive specialists. Sperm and embryo cryopreservation as well as oocyte cryopreservation are considered standard practice and are widely available. This ASCO guideline update and many clinical tools and resources are available at asco.org/guidelines/fertility.

To aid practices in adhering to these guideline updates, ASCO University offers two courses on fertility preservation—one for males and one for females. The goals of both courses are to help cancer care providers explain the effects of infertility when treating adolescent and young adult patients with cancer, recognize how cancer treatments may affect reproductive outcomes in these patients, compare fertility preservation techniques and factors that may influence applicability/availability of specific interventions, and identify resources for patients in order to facilitate fertility interventions when desired. The courses are available on ASCO University (university.asco.org/focus-under-forty) and may be taken for continuing medical education/continuing education credit.

Patient information and resources about fertility preservation can also be found on Cancer.Net, the LIVESTRONG Foundation's website (livestrong.org), and on the LIVESTRONG Foundation's Fertile Hope Initiative site (fertilehope.org).