Make Oncofertility Counselling Mandatory in India

"I'm a cancer survivor. But no one told me it could take away my chance to be pregnant or push me into early menopause."

At 36, I was diagnosed with breast cancer. My doctors discussed chemotherapy which was the first step in the treatment schedule in detail. But not once did they mention that the medicines could damage my ovaries, cause subfertility/infertility, or push me into early menopause.

I only found out because I asked during consultations. And I asked because I wanted to feel some control, some certainty, in a situation that felt like everything was slipping away. Reading up and being aware was the way I felt in control in the face of uncertainty in terms of short-term and long-term impact of the diagnosis and treatment. This knowledge helped me ask the right questions during the consultations. Reading up about my condition, treatment options and its side effects, was and still is my way to cope with trauma due to cancer. 

But not everyone gets the chance to ask. Not everyone knows what to ask. And not everyone has access to information hidden behind medical jargon and assumptions.

For many, the shock of infertility or sudden menopause comes only after the treatment is over—at a time when they are already struggling to rebuild their lives.

In my case, being 36 and single sent a signal to society—and even to my doctors—that fertility shouldn’t matter to me. But decisions about whether or not to have children are deeply personal. It should have been my choice—not theirs.

And, early menopause affects my health on various fronts.

Why Oncofertility Counselling Matters

Cancer treatments like chemotherapy, surgery, and radiation therapy have the potential to damage reproductive ovaries and testes.

Oncofertility counselling ensures that patients are:

• Told upfront how treatment may affect fertility and ovarian and testicular function.
• Given information on fertility preservation (FP) options.
• Referred to specialists who can help them protect their future choices.

This counselling need not delay or compromise cancer treatment. But it gives patients something invaluable: autonomy, dignity, hope and a shared role in medical decision-making.

Also, menopause isn't just cessation of periods. Early menopause increases the risk of oesteoporosis, cardiovascular disease, impaired brain health. Early menopause can cause an array of symptoms such as hot flashes, sexual dysfunction, mood disorders, and early menopause is also associated with premature death. 

An similar condition for male patients is hypogonadism.

Oncofertility scenario in India

Despite rising cancer cases and growing survivorship in India, especially among young people, oncofertility counselling isn't offered to everyone undergoing treatment that are gonadotoxic in nature (toxic to ovaries and testes).

Doctors tend to skip it due to bias (“She already has children” / “He’s too old” / “Let’s just focus on the cancer first”). Limited knowledge on the part of healthcare providers, time constraint in advanced cancer cases, lack of physically and financially accessible fertility preservation services, high out-of-pocket costs for patient are some of the other barriers.

There are no national guidelines or standards on Oncofertility counselling in India.

The result? Unnecessary emotional distress, stigma, and life-altering consequences that patients never had a chance to prepare for.

Why NABH?

The National Accreditation Board for Hospitals & Healthcare Providers (NABH) sets the standards that accredited hospitals in India must follow. These already include patient safety, rights, and informed consent.

By making Oncofertility Counselling a mandatory NABH standard in oncology care, every accredited hospital will be required to:

• Provide counselling to patients whose treatments carry a risk of infertility or early menopause.
• Train oncologists and healthcare staff on how to deliver this counselling.
• Ensure referrals and access to fertility preservation (FP) options.

When NABH updates its standards, hospitals across India act—because accreditation is essential for credibility and quality.

What I Demand

We call upon NABH to:

1. Mandate Oncofertility Counselling as part of accreditation standards for all cancer care.

2. Develop clear guidelines for oncologists and hospitals to implement this counselling.

3. Include monitoring and compliance checks during hospital audits.

Why You Should Sign

Cancer patients already fight one of the hardest battles of their lives. They deserve more than survival alone—they deserve a chance at a full, dignified life beyond cancer.

By signing this petition, you are urging NABH to take a bold, compassionate step—one that can transform the future of thousands of cancer patients in India.

Sign this petition to demand that NABH make Oncofertility Counselling mandatory for all accredited hospitals. Because saving lives should also mean protecting the quality of life.