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Bone Marrow Transplant. 2014 Apr;49(4):477-84. doi: 10.1038/bmt.2013.211. Epub 2014 Jan 13.

Clinical guide to fertility preservation in hematopoietic cell transplant recipients.

Author information

  • 1Nationwide Children's Hospital, Columbus, OH, USA.
  • 2Vanderbilt University Medical Center, Nashville, TN, USA.
  • 3Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
  • 4Department of Haematology, St. James's University Hospital, Leeds, UK.
  • 5Division of Hematology, University Hospital Basel, Basel, Switzerland.
  • 6Division of Blood and Marrow Transplantation, Children's National Medical Center, Washington, DC, USA.
  • 7Blood and Marrow Transplantation, Moffitt Cancer Center, Tampa, FL, USA.
  • 8Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA.
  • 9Department of Hematology, University Hospital, Grenoble, France.
  • 10Division of Hematologic Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
  • 11Center for Cancer and Blood Disorders, Children's National Medical Center, Washington, DC, USA.
  • 12Seidman Cancer Center, University Hospitals Case Medical Center, Cleveland, OH, USA.
  • 13Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI, USA.
  • 14University Hospital Maastricht, Maastricht, The Netherlands.
  • 15Hopital Saint Louis, Paris, France.
  • 16Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, USA.
  • 17Department of Pediatrics, Uniformed Services University, Bethesda, MD, USA.
  • 18Bone Marrow Transplant, Shands HealthCare, University of Florida, Gainesville, FL, USA.
  • 19Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
  • 20Center for International Blood and Marrow Transplant Research, National Marrow Donor Program, Minneapolis, MN, USA.


With broadening indications, more options for hematopoietic cell transplantation (HCT) and improvement in survival, the number of long-term HCT survivors is expected to increase steadily. Infertility is a frequent problem that long-term HCT survivors and their partners face and it can negatively impact on the quality of life. The most optimal time to address fertility issues is before the onset of therapy for the underlying disease; however, fertility preservation should also be addressed before HCT in all children and patients of reproductive age, with referral to a reproductive specialist for patients interested in fertility preservation. In vitro fertilization (IVF) and embryo cryopreservation, oocyte cryopreservation and ovarian tissue banking are acceptable methods for fertility preservation in adult women/pubertal females. Sperm banking is the preferred method for adult men/pubertal males. Frequent barriers to fertility preservation in HCT recipients may include the perception of lack of time to preserve fertility given an urgency to move ahead with transplant, lack of patient-physician discussion because of several factors (for example, time constraints, lack of knowledge), inadequate access to reproductive specialists, and costs and lack of insurance coverage for fertility preservation. There is a need to raise awareness in the medical community about fertility preservation in HCT recipients.

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