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Fertility on ice: an overview of fertility preservation for children and adolescents with cancer
Author(s) -
Hartigan Lucia,
Glover Louise E,
Wingfield Mary
Publication year - 2021
Publication title -
the obstetrician and gynaecologist
Language(s) - English
Resource type - Journals
eISSN - 1744-4667
pISSN - 1467-2561
DOI - 10.1111/tog.12753
Subject(s) - fertility preservation , fertility , oocyte cryopreservation , infertility , autotransplantation , oncofertility , malignancy , ovarian tissue cryopreservation , medicine , cryopreservation , young adult , gynecology , cancer , transplantation , pregnancy , biology , population , environmental health , genetics , embryo , microbiology and biotechnology
Key content Continued advances in oncology treatments have led to better survival rates for children and young adults with cancer. An important ‘late effect’ of cancer treatment is the loss of fertility. Although many survivors of childhood cancers go on to conceive without difficulty, the potential loss of fertility is a concern for children and young adults with cancer, their parents and caregivers. We review current options for fertility preservation (FP) for prepubertal and postpubertal girls and boys, including oocyte cryopreservation, ovarian tissue cryopreservation, sperm cryopreservation and testicular tissue cryopreservation.Learning objectives To understand the different FP methods available for children and adolescents, the barriers to FP and ethical and psychological considerations To raise awareness of the importance of early discussions about FP with patients who are at risk of infertility from their cancer treatment.Ethical Issues Autotransplantation of ovarian tissue in survivors of haematological malignancies, particularly leukaemia, carries a strong risk of re‐introducing the malignancy and should be avoided. Clinicians must consider suitability of the patient for FP, taking into account emotional maturity, patient and parent desire for FP and the physical fitness of the patient, including their immunosuppressive state.