Oncofertility: A Review of Recent Advances in Woman Fertility Preservation for Adolescents and Young Adults with Cancer

Abstract

The growing population of adolescent and young adult cancer survivors has intensified the need for effective fertility preservation strategies, as cancer treatments often pose a significant threat to future reproductive potential. This review focuses on recent advances in oncofertility, highlighting the critical importance of integrating fertility preservation into comprehensive cancer care. It addresses the multifaceted challenges—including technological, psychosocial, and systemic barriers-that impact access and decision-making for young patients. The aim is to provide a consolidated resource for clinicians and researchers to improve care delivery and outcomes in this vulnerable population. This review was necessitated by rapid advancements in fertility preservation techniques and a concurrent increase in awareness of the long-term quality-of-life issues faced by young cancer survivors. There is a pressing need to consolidate emerging evidence on the efficacy and utilization of various preservation methods. Furthermore, disparities in access to care and a lack of standardized guidelines underscore the urgency of a comprehensive evaluation of the current landscape. Addressing these gaps is essential to ensure equitable and patient-centered oncofertility care. The following topics are covered in depth: the impact of cancer treatments on fertility, current established techniques such as oocyte, embryo, and ovarian tissue cryopreservation, and emerging methods including in vitro maturation and artificial ovaries. Psychosocial considerations and emotional challenges surrounding fertility preservation decisions are examined, along with systemic and financial barriers that limit access to services. Clinical outcomes and success rates from recent studies are summarized, and the role of multidisciplinary collaboration and patient-centered counseling is emphasized. Ethical issues and variations in clinical guidelines are also discussed to provide a holistic overview. Future efforts should focus on standardizing fertility preservation protocols and expanding access to underserved populations through policy change and increased funding. Research must prioritize the refinement of experimental techniques and long-term follow-up of survivorship and reproductive outcomes. Additionally, integrating patient-reported outcomes and cultural competence into care models will be essential to advance the field and improve the quality of life for young cancer patients.