Focus on fertility preservation

In the spring of 2001, I was diagnosed with a malignancy which required surgery and then a number of sessions of radiotherapy to cure. Thankfully it worked, and I am still here, but looking back it was quite a surreal and stressful experience; and certainly not one I would like to repeat. However, what was interesting about the whole affair was how it made me think about the obvious threat to my fertility – something I subsequently wrote about (Pacey, 2003). Fortunately, I was in charge of a large regional sperm bank at the time and so it was relatively easy for me to arrange the banking of my own sperm. However, not everyone is as lucky.

Since then, I have been fortunate enough to have the opportunity to work voluntarily with the Teenage Cancer Trust and run workshops about fertility with young cancer patients from all over the UK. This has given me a unique insight into their own experiences and has even led to some research (Yeomanson, Morgan, & Pacey, 2013). In that study, we found that whilst male cancer survivors were generally satisfied about the frequency and timing of discussions about fertility, females were not. We hypothesised that this may reflect the approach to female fertility preservation by healthcare professionals or may simply be a consequence of the absence (at the time) of effective fertility preservation strategies for girls and women. Therefore, it is with great pleasure that we have been able to publish five papers back-to-back in this issue of Human Fertility which address various aspects of fertility preservation for girls and women.

The first is a landmark policy and practice paper on the topic by the British Fertility Society. In this paper, Yasmin et al. (2018) propose a number of recommendations for UK practice. They also remind us that fertility preservation is not just an issue for oncologists and cancer patients but should be a routine part of care in all areas of medicine where the premature loss of fertility is a major threat. The second paper by Abdallah, Briggs, Jones, Horne, and Fitzgerald (2018) is a report of data collected by a combination of questionnaire, registry data and freedom of information legislation to demonstrate a relatively poor level of female fertility preservation in the UK. The third, a commentary by Vitale, La Rosa, Rapisarda, and Laganà, (2018), argues that more studies are needed concerning the impact on quality of life and psychological outcomes of fertility preservation counselling and fertility preservation treatments in women with gynaecologic cancer. The fourth, by Peddie and Maheshwari (2018), describes the complexities involved in providing fertility preservation for a young girl of 14 years diagnosed with myelodysplastic/pre-malignant clone with monosomy 7 with pathophysiology like that of chronic myeloid leukaemia (CML). The final paper reports the results of an online survey undertaken by 155 former female cancer patients from English and German speaking countries. This shows that, whilst knowledge and attitude did not differ according to language or healthcare system, the confidence of knowledge was significantly higher in those women who had undergone fertility preservation compared to those who had not (Urech et al., 2018). I hope that these five papers provide a useful and timely collection of work which can influence this increasingly important aspect of reproductive medicine and open up more and better opportunities for girls and women to get timely access to fertility preservation when they need it.

Finally, also in this issue, we publish the titles and authors of the abstracts from the recent (and excellent) Fertility 2018 meeting held in Liverpool. The full text of each abstract is available as a supplementary file.

Disclosure statement

No potential conflict of interest was reported by the author.