What are the latest recommendations for fertility preservation in cancer patients?

[Verified against ESHRE Ovarian Stimulation Guideline 2026 for female protocol; AUA/ASRM 2021 for male] Female, ESHRE 2026: For patients facing gonadotoxic treatment, ovarian stimulation for fertility preservation should be started irrespective of the menstrual cycle phase (strong). This removes the historical delay awaiting a particular cycle day, which mattered when oncology treatment was waiting. The GnRH antagonist protocol is recommended for women seeking fertility preservation for medical reasons (strong). In oestrogen-sensitive disease, concomitant anti-oestrogen therapy such as letrozole or tamoxifen can be considered (good practice point). For final oocyte maturation in patients facing gonadotoxic treatment, a GnRH agonist is preferred (good practice point). Double stimulation can be considered for urgent fertility preservation cycles (good practice point) — relevant where the interval before treatment is very short. Male, AUA/ASRM 2021: Discuss the effects of gonadotoxic therapy on sperm production before commencing treatment (Moderate, Grade C). Encourage banking, preferably multiple specimens, before treatment (Expert Opinion). Avoid pregnancy for at least 12 months after completing treatment (Expert Opinion). Semen analysis after gonadotoxic therapy at least 12 and preferably 24 months after completion (Conditional, Grade C). Men persistently azoospermic after gonadotoxic therapy should be informed TESE is an option (Strong, Grade B). A systems finding worth acting on: only 20–50% of men bank sperm before chemotherapy, attributed to inadequate counselling before treatment. Reviewer: ASRM replaced its fertility preservation committee opinion in 2026, reportedly reframing rapid referral and financial navigation as core standards. I have not read it — obtain and reconcile.