Latest Cancer TreatmentsDr. Mohammadreza Dabiri
Dr. Mohammadreza Dabiriفارسی
Physician lesson

Fertility preservation before cancer treatment

Freezing sperm, eggs and embryos, ovarian tissue, and ovarian protection drugs; talk before the first dose

Updated: 28 October 20261 min read2 references

Key points

  • Before starting treatment, discuss the risk of infertility and ways to preserve fertility with every patient of reproductive age, and refer early [1].
  • Men: sperm banking before the first dose [1].
  • Women: egg or embryo freezing takes about 2 weeks and is possible with stimulation started at any point in the cycle [1].
  • Goserelin during chemotherapy reduces ovarian failure but does not replace proven methods [1, 2].

Methods

Options [1]
MethodFor whomNote
Sperm freezingMen and boys after pubertyBefore chemotherapy; one to three samples
Egg or embryo freezingWomen after pubertyAbout 10 to 14 days of stimulation; in breast cancer with letrozole to keep oestrogen low
Ovarian tissue freezingGirls before puberty, or when there is no time for stimulationNeeds laparoscopic surgery
Ovarian protection drug (goserelin)Women having chemotherapyAn adjunct method
Shielding during radiotherapy and ovarian transpositionPelvic radiotherapyDepends on the radiation field

POEMS: in young women with hormone receptor-negative breast cancer, goserelin given with chemotherapy reduced ovarian failure from 22% to 8% and was associated with more pregnancies [2].

For patients: Fertility and sexual health

Related cancer types

Breast cancerLymphoma

Treatment regimens (physicians)

AC followed by paclitaxel (dose-dense and weekly)TC regimen (docetaxel and cyclophosphamide): dose and scheduleTCHP regimen: dose and schedule in HER2-positive breast cancerWeekly paclitaxel with trastuzumab (APT regimen)KEYNOTE-522 regimen: pembrolizumab and chemotherapy in triple-negative breast cancerTrastuzumab emtansine (T-DM1, Kadcyla): dose and scheduleTrastuzumab deruxtecan (T-DXd, Enhertu): dose and monitoringAdjuvant capecitabine after neoadjuvant treatment (CREATE-X)Sacituzumab govitecan (Trodelvy)Pembrolizumab with chemotherapy in metastatic triple-negative breast cancer (KEYNOTE-355)R-CHOP regimen: dose, schedule and practical pointsPola-R-CHP in DLBCL

Physician tools and lessons

Cumulative Anthracycline Dose and Doxorubicin EquivalentsTumour Lysis Syndrome: Cairo-Bishop Criteria and PreventionKhorana Score (Cancer-Associated Thrombosis Risk)HCT-CI Comorbidity Index Before Stem Cell TransplantationIPI, R-IPI, NCCN-IPI and CNS-IPI Calculator for DLBCLFollicular Lymphoma International Prognostic Index (FLIPI) CalculatorInternational Prognostic Score (IPS) for Advanced Hodgkin LymphomaMantle Cell Lymphoma International Prognostic Index (MIPI) CalculatorIndications for haematopoietic stem cell transplantation, donor selection and conditioningGraft-versus-host disease (GVHD): prophylaxis, grading and treatment

References

2 references
Show all references, 2 with a study cardClose the reference list

Numbers in the text, such as [1], refer to these sources. Sources with a “Study card” button are summarised in the site’s evidence library.

  1. 1
    Fertility Preservation in Patients With Cancer: ASCO Clinical Practice Guideline UpdateOktay K, Harvey BE, Partridge AH, et al · J Clin Oncol · 2018;36:1994-2001
    Study cardDOIPubMed Back to text: 1 2 3 4 5
  2. 2
    Goserelin for ovarian protection during breast-cancer adjuvant chemotherapyMoore HC, Unger JM, Phillips KA, et al · N Engl J Med · 2015;372:923-32
    Study cardDOIPubMed Back to text: 1 2

This page is based on reputable scientific sources and was last updated on 28 October 2026. The content of this website is for educational and informational purposes only and does not replace consultation, diagnosis or treatment by a specialist physician. Consult your treating physician about any treatment decision.

Printed from the website; the full and up-to-date version: https://drdabiri.com/en/learn/fertility-preservation-oncology/

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