Fertility Protection in Childhood, Adolescents and Young Adulthood Cancer Patients

Abstract

While the prognosis of cancer diseases has improved during the last decades due to improved oncological treatment regimens, it still has a persisting negative impact on future fertility in both girls and boys. The most severe effects do occur with high-dose chemotherapy before autologous bone marrow stem cell transplantation and in the case of total body irradiation. But also radiation of the pelvis and the gonads as well as cytostatic therapy with alkylating agents can lead to premature gonadal insufficiency. To avoid these severe effects in children, adolescents and young adults several fertility preserving techniques have been developed. They are presented and discussed in this chapter of the book. Fertility preserving methods which can be offered to young cancer patients are cryopreservation of ovarian tissue (in prepubescent as well as in postpubescent children), transposition of the ovaries (in the case of a radiotherapy off the pelvis in girls), hormonal gonadotrophin stimulation for retrieval and cryopreservation of oocytes (in postpubescent girls), medical ovarian suppression with GnRH agonists (in postpubescent children) and cryopreservation of semen in postpubescent boys as well as the experimental cryopreservation of testicular tissue in prepubescent boys.