Today, outcomes of assisted reproductive technology therapy to overcome infertility have greatly improved and further technical refinement will lead to significant progress within the next 5 years. Therefore, fertility preservation methods should become available for all patients undergoing HSCT in the childbearing age. To reach this aim, a number of barriers have to be overcome. A great effort has to be undertaken to educate health care providers about the risk of infertility and current available practice for fertility preservation in patients undergoing HSCT. A difficult but appropriate goal will be to make the assisted reproductive technology therapy available for all patients. So far, this is not yet the case. First, for many transplant centers assisted reproductive technology is not yet widely available. Second, in many countries the cost issues are not yet resolved. Third, in many countries where HSCT is available, laws on assisted reproductive technology and on preimplantation genetic diagnostics are very restrictive. In order to fulfill the principle of equity and access to assisted reproductive technology for all patients, the transplant communities together with the societies of reproductive medicine have to work on a national level to ensure that laws move on to prevent discrimination, and that fertility preservation costs are covered for all transplanted patients either by the insurance companies or the national healthcare systems.
Expert Rev Hematol. 2013;6(4):375-388. © 2013 Expert Reviews Ltd.