Objective: To examine the impact of potential infertility that often affects adolescent and young adult cancer survivors (AYA) attributable to late effects of gonadotoxic treatment. Method: This paper examines the psychosocial, legal, and ethical concerns that hinder conversations around potential infertility and considerations of fertility preservation with an AYA cancer patient. Results: Although recent guidelines advocate for providers to address the potential loss of fertility and fertility preservation with every AYA cancer patient prior to treatment, evidence suggests that many clinicians either do not discuss or discuss in a manner that does not facilitate patient decision making. Conclusions: Suggestions are offered to guide communication best practices to ensure AYA and their families receive relevant and timely information about cancer related infertility and family building options.
Implications for Impact Statement
Survival rates for adolescents and young adults (AYAs) with cancer continue to improve, and there is great need for psychological support services for decision making about potential infertility and fertility preservation. Despite national recommendations from leading societies, there is variation in the quality and frequency of discussions regarding fertility preservation among AYA patients and their health care providers. Improved training on the recognition of implicit bias and methods for overcoming it may increase these discussions and ultimately alleviate present and future psychological burden to the patient.
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