Reproductive cancer cryopreservation services: Patient information, clinical advice, and support

Fertility preservation services must offer information to patients, prior to their visit, so that they have time to read and digest the information, and also have the opportunity to write down any questions they wish to ask at the oncofertility consultation appointment. Appointments must be offered immediately, based on a specifically designed referral form. Each fertility service providing oncology cryopreservation should have a robust map of the patient's journey to include referral, counseling session, medical consultation, informed consent, treatment plan, and follow-up. Consent for fertility preservation should only be obtained after thorough assessment and discussion with the patient. It must contain basic aspects such as duration of storage, right to dispose or choose alternatives, wishes about stored material if death occurs, and need for patient contact on an annual basis. Appropriate legal advice should be sought in the process of establishing oncology cryopreservation services, most importantly related to patient consent. Ethical and legal aspects of fertility cryopreservation must be considered in the provision of care for cancer patients. Cancer patients attending for cryopreservation have significant concerns in relation to the success of the process, time frame to return for cancer treatment, and safety. Two major nonmedical aspects, coping ability and mortality, are best addressed by counselors and highlight the need to offer this type of psychological support to all cancer patients attending for fertility preservation. The role of genetic counseling is to discuss any potential risks of transmission of the disease to the resulting offspring and offer genetic testing when appropriate. A service based on availability of comprehensive information coupled with in-house implications counseling will have a positive impact and improve the overall care of patients attending for fertility cryopreservation and this should be standard care.