Female fertility preservation: a fertile future?

Key content Fertility preservation is a rapidly evolving branch of reproductive medicine. Ovarian senescence, whether physiological or pathologically accelerated, limits the reproductive capacity of women. Given the increasing numbers of young women surviving cancer, along with increasing numbers of women deferring childbearing for social reasons, the possibility of fertility preservation is assuming ever increasing importance.Learning objectives To be aware of all fertility preservation options available to young women. To acknowledge the appropriate indications or contraindications of individual fertility preservation techniques. To gain understanding of the key components central to counselling women requesting advice on fertility preservation.Ethical issues Encouraging cancer patients to undergo fertility preservation treatments could have the potential to negatively impact their disease prognosis. Whether fertility preservation is an appropriate allocation of health resources, given that a proportion of women undergoing preservation procedures may remain fertile, may ultimately choose not to pursue parenthood, or, in the case of malignancy, may not even survive their diagnosis. The availability of fertility preservation for social reasons could encourage women to delay childbearing, creating a society of ‘older mothers’ reproducing beyond their natural reproductive lifespan, and thereby potentially creating a new medical burden on society.