For pre-menopausal female patients who present with acute leukemia in need of urgent anti-neoplastic therapy, what is your preferred approach in effort to preserve fertility?

This patient would be a good candidate for ovarian tissue cryopreservation (OTC), since time would be limited to stimulate and retrieve oocytes. One can complete OTC with line placement and other procedures and be able to start chemotherapy the day after OTC. I know not every center has access to OTC, but hoping we can expand soon and train surgeons. The latest 2019 guidelines *no* longer consider OTC an experimental procedure.

Practice Committee of the American Society for Reproductive Medicine. Electronic address, a.a.o., Fertility preservation in patients undergoing gonadotoxic therapy or gonadectomy: a committee opinion. Fertil Steril, 2019. 112(6): p. 1022-1033.