Risks

Men

Women

Children

Role of Clinicians

Document Overview

Design and created by Guideline Central in participation with the American Society of Clinical Oncology.

Fertility Preservation in Patients With Cancer

American Society of Clinical Oncology

Publication Date: Mar 19, 2025

Page Last Updated: May 5, 2026

Recommendation Rating Definitions

Quality of Evidence
Term		Definitions
H	- High	We are very confident that the true effect lies close to that of the estimate of the effect
M	- Moderate	We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different.
L	- Low	Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect.
VL	- Very Low	We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect.
Ins	- Insufficient	Evidence is insufficient to discern the true magnitude and direction of the net effect. Further research may better inform the topic. Reliance on consensus opinion of experts may be reasonable to provide guidance on the topic until better evidence is available.

Strength of Recommendation
Term		Definitions
S	- Strong	In recommendations for an intervention, the desirable effects of an intervention outweigh its undesirable effects. In recommendations against an intervention, the undesirable effects of an intervention outweigh its desirable effects. All or almost all informed people would make the recommended choice for or against an intervention.

C W	- Conditional - Weak	In recommendations for an intervention, the desirable effects probably outweigh the undesirable effects, but appreciable uncertainty exists. In recommendations against an intervention, the undesirable effects probably outweigh the desirable effects, but appreciable uncertainty exists. Most informed people would choose the recommended course of action, but a substantial number would not.
GPS	Good Practice Statement	Good practice statements represent the consensus of the Expert Panel and are used when high quality indirect evidence is available, but it would not be a good use of the Expert Panel’s resources to conduct a formal systematic review
NR	- Not Rated

Brozek JL, Akl EA, Compalati E, et al: Grading quality of evidence and strength of recommendations in clinical practice guidelines part 3 of 3. The GRADE approach to developing recommendations. Allergy 66:588-95, 2011

Document Overview

Document Title: Fertility Preservation in Patients With Cancer

Authoring Society: American Society of Clinical Oncology

Document Publication Date: Mar 19, 2025

Page Last Reviewed/Updated: May 5, 2026

Document Type: Guideline

Country of Publication: United States

Full Text Freely Available: Yes

Full Text Guideline: ascopubs.org/doi/10.1200/JCO-24-02782

Source Citation: Su HI, Lacchetti C, Letourneau J, et al. Fertility Preservation in People with Cancer: ASCO Guideline Update. J Clin Oncol. 2025 March 19. doi: 10.1200/JCO.24.02782

Supplemental Implementation Resources

Document Scope, Criteria, and Use Cases

Document Objectives: To provide current recommendations about fertility preservation for adults and children with cancer.

Scope: Management, Prevention

Keywords: anticancer treatment, cancer, fertility preservation, infertility

Target Patient Population: Patients with cancer at risk for infertility due to anticancer treatment.

Target Provider Population: Medical oncologists, radiation oncologists, gynecologic oncologists, urologists, hematologists, pediatric oncologists, surgeons, nurses, social workers, psychologists, and other nonphysician providers.

Inclusion Criteria: Male, Female, Adolescent, Adult, Child

Health Care Settings: Ambulatory, Hospital, Outpatient, Radiology Services

Intended Users: Nurse, Nurse Practitioner, Physician, Physician Assistant, Psychologist, Social Worker

Recommendation Development Processes & Methodology

PICO Questions

What are fertility preservation options for patients with cancer who will receive anticancer treatment?

Supplemental Methodology Resources: Data Supplement Methodology Supplement

Number of Source Documents: 48

Literature Search Start Date: Tuesday, January 1, 2013

Literature Search End Date: Sunday, December 31, 2017

Includes peer/external review process?: Yes

Includes public comment process?: No

Methodologist involvement?: Yes

Patient involvement?: Yes

Includes multi-disciplinary group?: Yes

Includes systematic review?: Yes

Grades quality of strength of evidence?: Yes

Grades quality of strength of recommendation?: Yes

Discloses funding source?: Yes

Discloses conflicts of interest?: Yes

Includes benefits/harms analysis with recommendations?: Yes

Identifies study selection process?: Yes

Identifies study selection criteria?: Yes

Identifies methods used to evaluate and analyze the evidence?: Yes

Identifies key questions addressed by the systematic review?: Yes

Identifies search strategy?: Yes

Fertility Preservation in Patients With Cancer

Risks

Discussing Risk of Infertility With Patient

Recommendation 1.1.

Recommendation 1.2.

Recommendation 1.3.

Recommendation 1.4.

Risks of Infertility from Cancer Treatment

Recommendation 2.1.

Men

Fertility Preservation in Males

Recommendation 3.1. Sperm Cryopreservation

Recommendation 3.2. Testicular Sperm Extraction (TESE)

Recommendation 3.3. Hormonal Gonadoprotection

Recommendation 3.4. Other Methods to Preserve Male Fertility

Recommendation 3.5. Post-Treatment Setting

Women

Fertility Preservation in Females

Recommendation 4.1. Embryo Cryopreservation

Recommendation 4.2. Mature Oocyte Cryopreservation

Recommendation 4.3. Post-Treatment Setting

Recommendation 4.4. In Vitro Maturation (IVM)

Recommendation 4.5. Ovarian Transposition

Recommendation 4.6. Uterine Transposition

Recommendation 4.7. Conservative Gynecologic Surgery

Recommendation 4.8. Ovarian Suppression

Recommendation 4.9. Ovarian Suppression

Recommendation 4.10. Ovarian Tissue Cryopreservation and Transplantation

Children

Fertility Preservation in Children

Recommendation 5.1.

Role of Clinicians

Recommendation 6.1.

Recommendation 6.2.

Recommendation 6.3.

Recommendation 6.4.

Recommendation Rating Definitions

Document Overview

Supplemental Implementation Resources

Document Scope, Criteria, and Use Cases

Recommendation Development Processes & Methodology