Fertility preservation in patients with medical indications: a committee opinion
Practice Committee of the American Society for Reproductive Medicine
Committee members:Clarisa Gracia, Paula Amato, Jacob Anderson, Rebecca Flyckt, Karl Hansen, Micah Hill, Tarun Jain, Sangita Jindal, Suleena Kalra, Bruce Pier, Denny Sakkas, Anne Steiner, Cigdem Tanrikut, Mark Trolice, Suneeta Senapati, Ryan Smith, Torie C Plowden, Belinda Yauger, Robert Brannigan, Elizabeth Ginsburg, Jared Robins, Chevis N Shannon, Jessica Goldstein, Madeline Brooks, …
Published February 2026Fertility and sterility, 125(2), 247-259
Practice Committee of the American Society for Reproductive Medicine (2026). Fertility preservation in patients with medical indications: a committee opinion. Fertility and sterility, 125(2), 247-259. https://doi.org/10.1016/j.fertnstert.2025.12.001
Practice Committee of the American Society for Reproductive Medicine. Fertility preservation in patients with medical indications: a committee opinion. Fertility and sterility. 2026;125(2):247-259. doi:10.1016/j.fertnstert.2025.12.001
Practice Committee of the American Society for Reproductive Medicine. "Fertility preservation in patients with medical indications: a committee opinion." Fertility and sterility, vol. 125, no. 2, 2026, pp. 247-259.
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Abstract
Patients preparing to undergo therapies that pose a risk to their fertility or who are at risk of premature ovarian insufficiency should be provided prompt counseling regarding available options for fertility preservation. Fertility preservation can best be provided by comprehensive programs designed and equipped to confront the unique challenges facing these patients. This document replaces the document entitled "Fertility preservation in patients undergoing gonadotoxic therapy or gonadectomy: a committee opinion," last published in 2019.
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Guidelines by Clinical Area · Fertility and Infertility Guidelines
Practice Committee of the American Society for Reproductive Medicine. Electronic address: asrm@asrm.org, 2023·Fertility and sterility
Sexually transmitted infections are of major concern to reproductive specialists. Heading the list are human immunodeficiency virus types 1 and 2 and hepatitis B and C viruses. These pathogens, which may cause incurable chronic infections, can be transmitted through assisted reproductive technologies and from infected mothers to the fetus or newborn. This document replaces the document of the same name, last published in 2020.
Practice Committee of the American Society for Reproductive Medicine, 2021·Fertility and sterility
Diagnostic evaluation for infertility in women should be conducted in a systematic, expeditious, and cost-effective manner to identify all the relevant factors with an initial emphasis on the least invasive methods for detecting the most common causes of infertility. The purpose of this committee opinion is to provide a critical review of the current methods and procedures for the evaluation of in fertile women, and it replaces the document of the same name, last published in 2015 (Fertil Steril 2015;103:e44-50). This guidance is intended for any provider evaluating women for infertility.
Guidelines by Clinical Area · Fertility and Infertility Guidelines
Practice Committee of the American Society for Reproductive Medicine. Electronic address: asrm@asrm.org, 2021·Fertility and sterility
To provide evidence-based recommendations to practicing physicians and others regarding the efficacy of oocyte cryopreservation (OC) for donor oocyte in vitro fertilization and planned OC. The American Society for Reproductive Medicine conducted a literature search, which included systematic reviews, meta-analyses, randomized controlled trials, and prospective and retrospective comparative observational studies published from 1986 to 2018. The American Society for Reproductive Medicine Practice Committee and a task force of experts used available evidence and through consensus developed evidence-based guideline recommendations. MAIN OUTCOME MEASURE(S): Outcomes of interest included live birth rate, clinical pregnancy rate, obstetrical and neonatal outcomes, and factors predicting reproductive outcomes. RESULT(S): The literature search identified 30 relevant studies to inform the evidence base for this guideline. RECOMMENDATION(S): Evidence-based recommendations were developed for predicting the likelihood of live births after planned OC, autologous OC in infertile women, and donor OC, as well as factors that may impact live birth rates. Recommendations were developed regarding neonatal outcomes after using fresh vs. cryopreserved oocytes in cases of autologous or donor oocytes. CONCLUSION(S): There is insufficient evidence to predict live birth rates after planned OC. On the basis of limited data, ongoing and live birth rates appear to be improved for women who undergo planned OC at a younger vs. older age. Although there are no significant differences in per transfer pregnancy rates with cryopreserved vs. fresh donor oocytes, there is insufficient evidence that the live birth rate is the same with vitrified vs. fresh donor oocytes. Neonatal outcomes appear similar with cryopreserved oocytes compared with fresh oocytes. Future studies that compare cumulative live birth rates are needed.
Guidelines by Clinical Area · Fertility and Infertility Guidelines
Practice Committee of the American Society for Reproductive Medicine, 2020·Fertility and sterility
Ovarian reserve is defined as the number of oocytes remaining in the ovary, or oocyte quantity (oocyte number). Markers of ovarian reserve include hormone levels and sonographically measured features of the ovaries. These markers can be useful as predictors of oocyte yield following controlled ovarian stimulation and oocyte retrieval. However, they are poor predictors of reproductive potential independently from age. This document replaces the document of the same name last published in 2012 (Fertil Steril 2012;98:1407-15).
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Ethics Committee of the American Society for Reproductive Medicine, 2016·Fertility and sterility
This opinion addresses the ethics of providing fertility treatment to women at elevated risk from fertility treatment or pregnancy. Providers ethically may treat women at elevated risk provided that they are carefully assessed; that specialists in their medical condition are consulted as appropriate; and that patients are fully informed about risks, benefits, and alternatives, including oocyte and embryo donation, use of a gestational surrogate, not undergoing fertility care, and adoption. Providers also may conclude that the risks are too high for them to treat particular patients ethically; such determinations must be made in a medically objective and unbiased manner and patients must be fully informed of the decision. Counseling of women who wish to initiate fertility treatment with underlying medical conditions that confer increased risk during treatment or pregnancy should incorporate the most current knowledge available, being cognizant of the woman's personal determinants in relation to her reproductive desires. In such a way, both physician and patient will optimize decision making in an ethically sound, patient-supportive context.
Cancer and Fertility · Fertility Preservation Before Treatment
Errasti T et al., 2025·European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·Free to read
Gynaecological cancer incidence in children and prepubertal girls is low but the risk of losing fertility potential is high due to the oncological treatments' toxicity. Consequently, fertility preservation is a top concern for survivors. This narrative review aims to summarize the best way of approaching each tumor treatment during prepubertal age with the goal of preserving fertility, and to discuss the latest methods used for fertility preservation for each gynaecological cancer. These procedures do not lack risks or uncertainities and offer a broad area of research.
Ethics Committee of the American Society for Reproductive Medicine, 2018·Fertility and sterility
Planned oocyte cryopreservation ("planned OC") is an emerging but ethically permissible procedure that may help women avoid future infertility. Because planned OC is new and evolving, it is essential that women who are considering using it be informed about the uncertainties regarding its efficacy and long-term effects.
Okeke T et al., 2013·Annals of medical and health sciences research·Free full text on PubMed Central
Premature menopause affects 1% of women under the age of 40 years. The women are at risk of premature death, neurological diseases, psychosexual dysfunction, mood disorders, osteoporosis, ischemic heart disease and infertility. There is need to use simplified protocols and improved techniques in oocyte donation to achieve pregnancy and mother a baby in those women at risk. Review of the pertinent literature on premature menopause, selected references, internet services using the PubMed and Medline databases were included in this review. In the past, pregnancy in women with premature menopause was rare but with recent advancement in oocyte donation, women with premature menopause now have hoped to mother a child. Hormone replacement therapy is beneficial to adverse consequences of premature menopause. Women with premature menopause are at risk of premature death, neurological diseases, psychosexual dysfunction, mood disorders, osteoporosis, ischemic heart disease and infertility. Public enlightenment and education is important tool to save those at risk.
Clarisa Gracia, Paula Amato, Jacob Anderson, Rebecca Flyckt, Karl Hansen, Micah Hill, Tarun Jain, Sangita Jindal, Suleena Kalra, Bruce Pier, Denny Sakkas, Anne Steiner, Cigdem Tanrikut, Mark Trolice, Suneeta Senapati, Ryan Smith, Torie C Plowden, Belinda Yauger, Robert Brannigan, Elizabeth Ginsburg, Jared Robins, Chevis N Shannon, Jessica Goldstein, Madeline Brooks
C Gracia, P Amato, J Anderson, Becky Flyckt, R Flyckt, K Hansen, M Hill, T Jain, S Jindal, S Kalra, B Pier, D Sakkas, A Steiner, C Tanrikut, M Trolice, S Senapati, R Smith, T Plowden, B Yauger, Bob Brannigan, Rob Brannigan, Bobby Brannigan, R Brannigan, Liz Ginsburg, Beth Ginsburg, Betsy Ginsburg, E Ginsburg, J Robins, C Shannon, Jess Goldstein, J Goldstein, M Brooks
PMID 41494900 41494900 DOI 10.1016/j.fertnstert.2025.12.001 10.1016/j.fertnstert.2025.12.001 Practice Committee of the American Society for Reproductive Medicine et al. 2026, Practice Committee of the American Society for Reproductive Medicine 2026
Cite this article
Practice Committee of the American Society for Reproductive Medicine (2026). Fertility preservation in patients with medical indications: a committee opinion. Fertility and sterility, 125(2), 247-259. https://doi.org/10.1016/j.fertnstert.2025.12.001
Practice Committee of the American Society for Reproductive Medicine. Fertility preservation in patients with medical indications: a committee opinion. Fertility and sterility. 2026;125(2):247-259. doi:10.1016/j.fertnstert.2025.12.001
Practice Committee of the American Society for Reproductive Medicine. "Fertility preservation in patients with medical indications: a committee opinion." Fertility and sterility, vol. 125, no. 2, 2026, pp. 247-259.