Fertility Preservation for Pediatric and Adolescent Patients With Cancer: Medical and Ethical Considerations

Pediatrics. 2020 Mar;145(3):e20193994. doi: 10.1542/peds.2019-3994. Epub 2020 Feb 18.


Many cancers presenting in children and adolescents are curable with surgery, chemotherapy, and/or radiotherapy. Potential adverse consequences of treatment include sterility, infertility, or subfertility as a result of gonad removal, damage to germ cells as a result of adjuvant therapy, or damage to the pituitary and hypothalamus or uterus as a result of irradiation. In recent years, treatment of solid tumors and hematologic malignancies has been modified in an attempt to reduce damage to the gonadal axis. Simultaneously, advances in assisted reproductive technology have led to new possibilities for the prevention and treatment of infertility. This clinical report reviews the medical aspects and ethical considerations that arise when considering fertility preservation in pediatric and adolescent patients with cancer.

MeSH terms

  • Adolescent
  • Antineoplastic Agents / adverse effects
  • Cancer Survivors*
  • Child
  • Counseling
  • Cryopreservation
  • Fertility Preservation* / ethics
  • Humans
  • Infertility / etiology*
  • Insurance Coverage
  • Insurance, Health
  • Male
  • Neoplasms / therapy*
  • Oocytes / cytology
  • Radiotherapy / adverse effects
  • Spermatozoa


  • Antineoplastic Agents