title: Clinical guide to fertility preservation in hematopoietic cell transplant recipients.
abstract: With broadening indications, more options for hematopoietic cell transplantation (HCT) and improvement in survival, the number of long-term HCT survivors is expected to increase steadily. Infertility is a frequent problem that long-term HCT survivors and their partners face and it can negatively impact on the quality of life. The most optimal time to address fertility issues is before the onset of therapy for the underlying disease; however, fertility preservation should also be addressed before HCT in all children and patients of reproductive age, with referral to a reproductive specialist for patients interested in fertility preservation. In vitro fertilization (IVF) and embryo cryopreservation, oocyte cryopreservation and ovarian tissue banking are acceptable methods for fertility preservation in adult women/pubertal females. Sperm banking is the preferred method for adult men/pubertal males. Frequent barriers to fertility preservation in HCT recipients may include the perception of lack of time to preserve fertility given an urgency to move ahead with transplant, lack of patient-physician discussion because of several factors (for example, time constraints, lack of knowledge), inadequate access to reproductive specialists, and costs and lack of insurance coverage for fertility preservation. There is a need to raise awareness in the medical community about fertility preservation in HCT recipients.
authors.affiliation: Nationwide Children's Hospital, Columbus, OH, USA.
authors.forename: S
authors.initials: S
authors.lastname: Joshi
authors.affiliation: Vanderbilt University Medical Center, Nashville, TN, USA.
authors.forename: B N
authors.initials: BN
authors.lastname: Savani
authors.affiliation: Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
authors.forename: E J
authors.initials: EJ
authors.lastname: Chow
authors.affiliation: Department of Haematology, St. James's University Hospital, Leeds, UK.
authors.forename: M H
authors.initials: MH
authors.lastname: Gilleece
authors.affiliation: Division of Hematology, University Hospital Basel, Basel, Switzerland.
authors.forename: J
authors.initials: J
authors.lastname: Halter
authors.affiliation: Division of Blood and Marrow Transplantation, Children's National Medical Center, Washington, DC, USA.
authors.forename: D A
authors.initials: DA
authors.lastname: Jacobsohn
authors.affiliation: Blood and Marrow Transplantation, Moffitt Cancer Center, Tampa, FL, USA.
authors.forename: J
authors.initials: J
authors.lastname: Pidala
authors.affiliation: Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA.
authors.forename: G P
authors.initials: GP
authors.lastname: Quinn
authors.affiliation: Department of Hematology, University Hospital, Grenoble, France.
authors.forename: J-Y
authors.initials: JY
authors.lastname: Cahn
authors.affiliation: Division of Hematologic Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
authors.forename: A A
authors.initials: AA
authors.lastname: Jakubowski
authors.affiliation: Center for Cancer and Blood Disorders, Children's National Medical Center, Washington, DC, USA.
authors.forename: N R
authors.initials: NR
authors.lastname: Kamani
authors.affiliation: Seidman Cancer Center, University Hospitals Case Medical Center, Cleveland, OH, USA.
authors.forename: H M
authors.initials: HM
authors.lastname: Lazarus
authors.affiliation: Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: J D
authors.initials: JD
authors.lastname: Rizzo
authors.affiliation: University Hospital Maastricht, Maastricht, The Netherlands.
authors.forename: H C
authors.initials: HC
authors.lastname: Schouten
authors.affiliation: Hopital Saint Louis, Paris, France.
authors.forename: G
authors.initials: G
authors.lastname: Socie
authors.affiliation: Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, USA.
authors.forename: P
authors.initials: P
authors.lastname: Stratton
authors.affiliation: Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
authors.forename: M L
authors.initials: ML
authors.lastname: Sorror
authors.affiliation: Department of Pediatrics, Uniformed Services University, Bethesda, MD, USA.
authors.forename: A B
authors.initials: AB
authors.lastname: Warwick
authors.affiliation: Bone Marrow Transplant, Shands HealthCare, University of Florida, Gainesville, FL, USA.
authors.forename: J R
authors.initials: JR
authors.lastname: Wingard
authors.affiliation: Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: A W
authors.initials: AW
authors.lastname: Loren
authors.affiliation: Center for International Blood and Marrow Transplant Research, National Marrow Donor Program, Minneapolis, MN, USA.
authors.forename: N S
authors.initials: NS
authors.lastname: Majhail
mesh_terms: D005260:Female; D059247:Fertility Preservation / Q000379:methods*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008297:Male; D011247:Pregnancy; D019172:Transplantation Conditioning / Q000009:adverse effects / Q000379:methods; D014184:Transplantation, Homologous