When a child or adolescent is diagnosed with cancer, there are many issues to consider. Often the focus is on survival, so children, teens and parents may not think about fertility. However, the majority of young people survive cancer, and fertility may become important as they reach puberty (sexual maturity) and adulthood.
Some cancer treatments do not affect a child’s growing reproductive system. Others can damage a girl’s ovaries, which contain eggs, or a boy’s testes, which contain sperm. Sometimes this damage is temporary, but sometimes it’s permanent. In many cases, decisions on fertility preservation need to be made before treatment begins.
For young people under 18, parents will be required to consent to procedures. If the young person is old enough to understand puberty and fertility, they should be involved in the discussion.
Topics on this page:
Resources for young people
Fertility options for girls
Options will depend on whether the girl has been through puberty. Most girls go through puberty between 9 and 15 years old.
- Undeveloped, immature eggs may be collected, matured in a laboratory, then frozen. This technique is experimental and not widely available at this stage.
- Ovarian tissue can be removed and frozen, and transplanted later when needed. This is called ovarian cryopreservation.
- Mature eggs can be removed and frozen.
- Taking GnRH may reduce activity in the ovaries and protect eggs from damage.
- Hormone levels can be checked to assess fertility. It’s possible for young women to be fertile, but then go through early menopause.
Before or after puberty
- The abdominal area can be shielded during radiotherapy to the pelvis.
- The ovaries can be surgically relocated so they are out of the radiation area (ovarian transposition). If the ovaries aren’t protected, the risk of ovarian failure is higher.
Fertility options for boys
Options will depend on whether the boy has been through puberty. Most boys go through puberty by the age of 13. At this stage, mature sperm is present in the semen.
- There are no proven fertility preservation methods for boys who have not gone through puberty.
- Testicular sperm extraction is being tested on young boys. Immature sperm cells are removed, frozen and stored for later use with IVF. This technique is still experimental and not widely available at this stage.
- Sperm banking (cryopreservation) can be used to collect, freeze and store mature sperm for future use.
- Testicular sperm extraction can remove sperm cells, which are frozen and stored for later use with IVF. This technique is still experimental and not widely available.
Before or after puberty
- The testicles can be shielded during radiotherapy to the pelvis. If this area is not protected, sperm production may be affected, which could make the boy infertile.