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Purpose: The state of limited resource settings that Coronavirus (COVID-19) pandemic has created globally should be taken seriously into account especially in healthcare sector. In oncofertility, patients should receive their fertility preservation treatments urgently even in limited resource settings before initiation of anticancer therapy. Therefore, it is very crucial to learn more about oncofertility practice in limited resource settings such as in developing countries that suffer often from shortage of healthcare services provided to young patients with cancer., Methods: As an extrapolation during the global crisis of COVID-19 pandemic, we surveyed oncofertility centers from 14 developing countries (Egypt, Tunisia, Brazil, Peru, Panama, Mexico, Colombia, Guatemala, Argentina, Chile, Nigeria, South Africa, Saudi Arabia, and India). Survey questionnaire included questions on the availability and degree of utilization of fertility preservation options in case of childhood cancer, breast cancer, and blood cancer., Results: All surveyed centers responded to all questions. Responses and their calculated oncofertility scores showed different domestic standards for oncofertility practice in case of childhood cancer, breast cancer, and blood cancer in the developing countries under limited resource settings., Conclusions: Medical practice in limited resource settings has become a critical topic especially after the global crisis of COVID-19 pandemic. Understanding the resources necessary to provide oncofertility treatments is important until the current COVID-19 pandemic resolves. Lessons learned will be valuable to future potential worldwide disruptions due to infectious diseases or other global crises.

Purpose: Oncofertility focuses on providing fertility and endocrine-sparing options to patients who undergo life-preserving but gonadotoxic cancer treatment. The resources needed to meet patient demand often are fragmented along disciplinary lines. We quantify assets and gaps in oncofertility care on a global scale., Methods: Survey-based questionnaires were provided to 191 members of the Oncofertility Consortium Global Partners Network, a National Institutes of Health-funded organization. Responses were analyzed to measure trends and regional subtleties about patient oncofertility experiences and to analyze barriers to care at sites that provide oncofertility services., Results: Sixty-three responses were received (response rate, 25%), and 40 were analyzed from oncofertility centers in 28 countries. Thirty of 40 survey results (75%) showed that formal referral processes and psychological care are provided to patients at the majority of sites. Fourteen of 23 respondents (61%) stated that some fertility preservation services are not offered because of cultural and legal barriers. The growth of oncofertility and its capacity to improve the lives of cancer survivors around the globe relies on concentrated efforts to increase awareness, promote collaboration, share best practices, and advocate for research funding., Conclusion: This survey reveals global and regional successes and challenges and provides insight into what is needed to advance the field and make the discussion of fertility preservation and endocrine health a standard component of the cancer treatment plan. As the field of oncofertility continues to develop around the globe, regular assessment of both international and regional barriers to quality care must continue to guide process improvements., Competing Interests: The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/jco/site/ifc. Alexandra S. RashediEmployment: Cigna (I) Stock or Other Ownership: Cigna (I)Antoinette AnazodoResearch Funding: Merck SeronoCassio SartorioEmployment: Vida Centro de Fertilidade Leadership: Vida Centro de Fertilidade Stock or Other Ownership: Vida Centro de FertilidadeCatharina C.M. BeerendonkTravel, Accommodations, Expenses: GoodlifeEllen M. GreenblattConsulting or Advisory Role: Ferring Pharmaceuticals, EMD Serono Travel, Accommodations, Expenses: EMD SeronoFernando M. ReisHonoraria: Politec Saúde (I) Consulting or Advisory Role: Politec Saúde (I) Speakers’ Bureau: UCB (I) Travel, Accommodations, Expenses: Abbott Laboratories (I)Johan SmitzSpeakers’ Bureau: Ferring Pharmaceuticals Travel, Accommodations, Expenses: Ferring PharmaceuticalsMaria T. BourlonLeadership: Medivation, Astellas Pharma Honoraria: Medivation, Astellas Pharma Speakers’ Bureau: Asofarma Research Funding: Bristol-Myers Squibb Travel, Accommodations, Expenses: Janssen PharmaceuticalsMichel De VosHonoraria: Cook Medical Research Funding: Cook MedicalRichard A. AndersonConsulting or Advisory Role: Roche, HRA Pharma, NeRe Pharmaceuticals Speakers’ Bureau: Roche, Beckman Coulter, IBSA Institut Biochimque Research Funding: Ferring Pharmaceuticals Travel, Accommodations, Expenses: IBSA Institut BiochimqueRoberto de A. AntunesConsulting or Advisory Role: Merck Serono Speakers’ Bureau: Merck Serono Travel, Accommodations, Expenses: Merck Serono, MSDTeresa Almeida-SantosConsulting or Advisory Role: Merck, MSD Research Funding: MerckTeresa K. WoodruffResearch Funding: Ferring Pharmaceuticals (Inst) No other potential conflicts of interest were reported., (© 2020 by American Society of Clinical Oncology.)

Purpose: In the accompanying article, "Survey of Fertility Preservation Options Available to Patients With Cancer Around the Globe," we showed that specific fertility preservation services may not be offered at various sites around the world because of cultural and legal barriers. We assessed global and regional experiences as well as the legal status of third-party reproduction and adoption to serve as a comprehensive international data set and resource for groups that wish to begin oncofertility interventions., Methods: We provide data on the legalities of third-party assisted reproductive technologies and other family-building options in the 28 oncofertility-practicing countries surveyed., Results: We found regional and country differences that will be important in the development of tailored resources for physicians and for patient brochures that are sensitive to these local restrictions and cultural norms., Conclusion: Because many patients first consult Web-based materials, the formal assessment of the availability of these options provides members of the global oncofertility community with data to which they might otherwise not have ready access to better serve their patients., Competing Interests: The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or jco.ascopubs.org/site/ifc. Alexandra S. RashediEmployment: Cigna (I) Stock or Other Ownership: Cigna (I)Antoinette AnazodoResearch Funding: Merck SeronoCassio SartorioEmployment: Vida Centro de Fertilidade Leadership: Vida Centro de Fertilidade Stock or Other Ownership: Vida Centro de FertilidadeCatharina C.M. BeerendonkTravel, Accommodations, Expenses: GoodlifeEllen M. GreenblattConsulting or Advisory Role: Ferring Pharmaceuticals, EMD Serono Travel, Accommodations, Expenses: EMD SeronoFernando M. ReisHonoraria: Politec Saúde (I) Consulting or Advisory Role: Politec Saúde (I) Speakers’ Bureau: UCB (I) Travel, Accommodations, Expenses: Abbott Laboratories (I)Flor SánchezPatents, Royalties, Other Intellectual Property: patent pendingJohan SmitzSpeakers’ Bureau: Ferring Pharmaceuticals Travel, Accommodations, Expenses: Ferring PharmaceuticalsMaria T. BourlonLeadership: Medivation, Astellas Pharma Honoraria: Medivation, Astellas PharmaRichard A. AndersonConsulting or Advisory Role: Roche, HRA Pharma, NeRe Pharmaceuticals Speakers’ Bureau: Roche, Beckman Coulter, IBSA Institut Biochimque Research Funding: Ferring Pharmaceuticals Travel, Accommodations, Expenses: IBSA Institut BiochimqueRoberto de A. AntunesConsulting or Advisory Role: Merck Serono Travel, Accommodations, Expenses: Merck Serono, MSDSergio RomeroPatents, Royalties, Other Intellectual Property: patent pendingTeresa Almeida-SantosConsulting or Advisory Role: Merck, MSD Research Funding: Merck SeronoTeresa K. WoodruffResearch Funding: Ferring Pharmaceuticals (Inst) No other potential conflicts of interest were reported., (© 2020 by American Society of Clinical Oncology.)