Fertility preservation as a public health issue: an epidemiological perspective.

PURPOSE OF REVIEW: Over the past decade, fertility preservation has become an increasingly viable option for patients diagnosed with diseases such as cancer and systemic lupus erythematosus (SLE), whose treatment often results in impaired fertility. This review summarizes current epidemiological trends that have caused cancer-related and SLE-related infertility to be an important and growing public health burden, which may be reduced by improving access to fertility preservation services. RECENT FINDINGS: In the United States alone, over 130 000 men and women below the age of 45 were afflicted by cancer in 2008. The compromised fertility that will be faced by many of these patients can result in significant psychosocial stress and reduced quality of life, even long after the disease has been successfully treated. Although the use of fertility preservation services may help alleviate this burden, access to these services is often inadequate, because of logistical barriers and a lack of appropriate patient referral by healthcare providers. SUMMARY: Increases in cancer survival rates and the average age at which a mother will have her first child has put added emphasis on the need for fertility preservation services. Enhanced provider and patient education, as well improved coordination of oncological-reproductive care, may promote patient access to fertility preservation services.