There are no standard options for preserving the fertility of prepubertal children; all approaches are experimental. There are some reports of oocyte cryopreservation in girls aged 13 years and older, but no reports of live births associated with later re-implantation.
Testicular tissue has also been frozen, but again, there are no reports of re-implantation.
"Efforts to preserve the fertility of children using experimental methods should be attempted only under institutional review board–approved protocols," the panel cautioned.
Data are lacking on the fertility impact of new biologic and targeted treatments, with the exceptions of bevacizumab and tyrosine kinase inhibitors.
In 2011, the Food and Drug Administration reported a 34% rate of ovarian failure in women who got bevacizumab as part of a colorectal cancer treatment regimen; 1 in 5 women regained ovarian function. This possible complication should be addressed with women.
Young patients taking tyrosine kinase inhibitors for chronic myeloid leukemia may also face later fertility problems, the panel noted, including an increased risk of complications in pregnancy or congenital anomalies. Data on these findings are incomplete, but patients should understand the possible risks, the panel wrote.
Supplements and clinical tools and resources can be found at www.asco.org/guidelines/fertility. Patient information is also available at www.cancer.net.
Neither Dr. Loren nor any of the other panel members had any financial disclosures.