Female fertility preservation in the pediatric and adolescent cancer patient population

Best Pract Res Clin Obstet Gynaecol. 2018 Apr;48:147-157. doi: 10.1016/j.bpobgyn.2017.10.009. Epub 2017 Oct 26.

Abstract

The 5-year survival rate for childhood cancer is over 80%, thereby increasing the number of young women facing infertility in the future because of the gonadotoxic effects of chemotherapy and radiation. The gonadotoxic effects of childhood cancer treatment vary by the radiation regimen and the chemotherapeutic drugs utilized. Although the American Society of Clinical Oncology guidelines recommend fertility preservation for all patients, there are several barriers and ethical considerations to fertility preservation in the pediatric and adolescent female population. Additionally, the fertility preservation methods for pre- and postpubertal females differ, with only experimental methods available for prepubertal females. We will review the risk of chemotherapy and radiation on female fertility, the approach to fertility preservation in the pediatric and adolescent female population, methods of fertility preservation for both pre- and postpubertal females, barriers to fertility preservation, cost, and psychological and ethical considerations.

Keywords: Adolescent; Cancer; Cryopreservation; Fertility preservation; Pediatric.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Age Factors
  • Antineoplastic Agents / adverse effects*
  • Child
  • Female
  • Fertility Preservation / ethics
  • Fertility Preservation / methods*
  • Humans
  • Infertility / etiology
  • Neoplasms / therapy
  • Puberty
  • Radiotherapy / adverse effects*

Substances

  • Antineoplastic Agents