Fertility preservation: state of the science and future research directions

OBJECTIVE: To identify issues related to fertility preservation, discuss the state of the science, and make specific recommendations to guide future research supported by the U.S. National Institutes of Health in the field of fertility preservation. DESIGN: A 1-day meeting of an expert advisory panel convened by the Eunice Kennedy Shriver National Institute of Child Health and Human Development on January 23, 2007, at the National Institutes of Health in Bethesda, Maryland. The panelists represented the disciplines of reproductive endocrinology and infertility, urology, neurobiology, physiology, radiation oncology, pediatrics, genetics, behavioral science, surgery, and occupational health. CONCLUSION(S): The panel members recognized the emerging focus on fertility preservation to help women and men have biological children. Among those who might benefit from research in this area are those at risk for impaired fertility or infertility, including not only cancer survivors but also others with genetic predispositions to infertility, environmental occupational exposure to hazardous substances or conditions, or reproductive diseases such as endometriosis. The panelists highlighted the need for education and awareness among health-care providers to help people understand options for preserving fertility, the need for technologic advances, the lack of data on long-term consequences of fertility preservation, and emerging ethical and social questions. This report describes the process for developing a multidisciplinary, collaborative approach for research in this area, summarizes the discussions of the panelists, and outlines the recommendations for future research.