PHILADELPHIA (May 31, 2025) — A new study from researchers at Fox Chase Cancer Center released at the American Society of Clinical Oncology’s (ASCO) Annual Meeting demonstrates that a simple addition to the electronic medical record (EMR) system can assist fertility preservation efforts for young adult cancer patients.
As incidence of cancer has increased in adults ages 18 to 49 over the past decade, this growing patient population faces unique challenges while undergoing treatment for cancer, including its impact on fertility and family planning goals. The EMR intervention helps to ensure that these individuals understand how cancer treatment may affect their family planning goals and the options they have to preserve their fertility before starting treatment.
“This is a young population facing life-changing diagnoses,” said Christopher Cann, MD, Director of the Young Adult Cancer Program and Assistant Professor in the Department of Hematology/Oncology at Fox Chase, the study’s lead author. “Fertility preservation isn’t just a medical issue, it’s a quality-of-life issue. And yet, too often these conversations never happen. We wanted to look into a way to change that.”
Up to 75% of young cancer survivors are concerned about their future fertility, yet as few as 28% of these patients report receiving information on fertility risk associated with cancer treatments such as chemotherapy. To address this gap, Cann and his team implemented a Best Practice Advisory (BPA) in Fox Chase’s EMR in July 2024. When providers placed an order for chemotherapy or immunotherapy in the EMR for patients between the ages of 18 and 50, they received a BPA alert asking, “Would you like to refer this patient to the oncofertility team?”
They could then choose to send a direct message to the Fox Chase oncofertility team for referral or select one of several options for declining the alert, including “medically inappropriate” or “patient declined.” If they placed a referral, the oncofertility team, which is comprised of nurses and social workers trained in fertility counseling, reached out to the patient within 48 hours to discuss potential fertility preservation options, associated costs, and to help the patient schedule an appointment with a local fertility clinic.
Within six months of BPA implementation, oncofertility referrals at Fox Chase increased by 450% compared to the center’s average over the previous 12 years. Fourteen patients successfully preserved their fertility through sperm banking, egg cryopreservation, or other means in that same six-month period, compared to just 22 patients completing fertility preservation in the five years before the BPA was introduced.
According to Cann, the BPA addressed one of the main barriers to fertility discussions: time. “In the initial outpatient visit, clinicians are often trying to cover many components of the patient’s care, including diagnosis, treatment plans, and prognosis, which can result in fertility discussions being overlooked,” he said. “The BPA integrates that reminder into the clinical workflow and makes referrals easier.”
The team hopes the findings will inspire other institutions to adopt similar practices. “It’s a scalable intervention,” said Cann. “Ultimately, we want to ensure every patient of reproductive age understands their options and has a chance to preserve their fertility, if they wish, before starting treatment.”
The study, “Increase in Oncofertility Referrals and Fertility Preservation Through an Electronic Medical Record (EMR) Best Practice Advisory (BPA),” was accepted as an online publication for the 2025 ASCO Annual Meeting, which is being held May 30-June 3 in Chicago.