Patient planning pregnancy within next 12 months. Triggers fertility preservation referra...

Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.

ID	`RF-PREGNANCY-PLANNING`
Type	Red flag
Status	reviewed 2026-04-27 \| pending_clinical_signoff
Diseases	None declared
Sources	`SRC-NCCN-BCELL-2025` `SRC-NCCN-BREAST-2025`

Red Flag Origin

Definition	Patient planning pregnancy within next 12 months. Triggers fertility preservation referral (oocyte/embryo cryopreservation, ovarian tissue cryopreservation, GnRH agonist co-administration, sperm banking), selection of regimens with lowest gonadotoxic burden where oncologic equivalence exists, and informed-consent emphasis on fertility outcomes.
Clinical direction	investigate
Category	reproductive-status

Trigger Logic

{
  "any_of": [
    {
      "finding": "pregnancy_planning_12_months",
      "value": true
    },
    {
      "finding": "fertility_preservation_requested",
      "value": true
    }
  ],
  "type": "composite_score"
}

Notes

ASCO 2018 fertility preservation guideline mandates discussion at diagnosis. Gonadotoxicity ranking: alkylators (cyclophosphamide, busulfan, melphalan) — high; anthracyclines + alkylators (R-CHOP, ABVD) — moderate-high cumulative; ABVD lower vs BEACOPP; FCR vs BR — BR less gonadotoxic; aromatase inhibitors require LHRH-co- administration in premenopausal. GnRH-agonist co-administration (POEMS, PROMISE-GIM6 in breast) reduces premature ovarian failure rate. Direction `investigate` because flag drives parallel fertility-preservation pathway, not alternative oncologic indication. Bridges to RF-PREGNANCY-ACTIVE if patient becomes pregnant during/after therapy.

Used By

No reverse references found in the YAML corpus.