Approach to fertility preservation for patients undergoing gonadotoxic therapy*

* For detailed discussions of fertility preservation techniques and their application, refer to UpToDate content on ovulation induction, in vitro fertilization, and fertility preservation.
¶ Testicular cryopreservation is under investigation and not yet routinely available.
Δ In most patients, random-start protocols allow ovarian stimulation to be initiated at any time without needing to wait for menses.
◊ Choice of agent for ovarian stimulation is impacted by the presence of an estrogen-sensitive tumor.
§ While ovarian stimulation for cryopreservation of embryos or oocytes is the most established method of fertility preservation, some women may elect ovarian tissue cryopreservation instead.