Fertility options for children and adolescents
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 reproductive system. Others can damage a girl’s ovaries, which contain eggs, or a boy’s testicles, which make sperm. Sometimes this damage is temporary, but sometimes it’s permanent. For a general overview of how cancer treatments affect fertility, see the affects of cancer treatment on women’s fertility or on men’s fertility. You can also talk to the health care team about how cancer treatment will affect fertility.
For an overview of ways to prevent or lower the risk of infertility, see the tables below. Some of these procedures are experimental and available only in specialised centres. In many cases, decisions about fertility preservation are made before treatment begins. This is a difficult time, and often the decision involves a multidisciplinary team of specialists, parents of the young person and the young person.
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Listen to our podcast on Coping with a Cancer Diagnosis
Resources for young people
CanTeen’s resource Maybe later baby? provides age-appropriate information about the impact of cancer on fertility. To download a copy of the book, visit canteen.org.au and search for the resource.
You can also read information specific to children and adolescents at futurefertility.com.au.
Fertility options for girls
The options will depend on whether the girl has been through puberty. Most girls go through puberty between 9 and 12 years of age.
Before puberty
- Ovarian tissue can be removed and frozen,and transplanted later when needed. This is called ovarian cryopreservation. The ovarian tissue contains underdeveloped immature eggs. Experiments are being done to mature the eggs in a laboratory before freezing, but this technique is under development and not widely available. There has only been one birth worldwide for ovarian tissue removed before puberty.
After puberty
- Mature eggs can be removed and frozen.
- Taking a long-acting hormone called GnRH may reduce activity in the ovaries or ovarian tissue and protect eggs from damage.
- Hormone levels can be checked to assess fertility (see pages 57–58). 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 radiation therapy 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 (premature ovarian insufficiency).
Fertility options for boys
The options will depend on whether the boy has been through puberty. Most boys go through puberty by the age of 13–14. At this stage, mature sperm is present in the semen.
Before puberty
- There are no proven fertility preservation methods for boys who have not gone through puberty.
- Freezing testicular tissue (testicular tissue cryopreservation) is being tested on young boys at high risk of infertility. Tissue that contains cells that make sperm is removed from the testicles through a small cut. This technique is experimental and there are no successful pregnancies to date.
After puberty
- 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 IVF. This technique is not widely available.
Before or after puberty
-
The testicles can be shielded during radiation therapy to the pelvis. If this area is not protected, sperm production may be affected, which could make the boy infertile.
Click on the icon below to download the booklet Fertility and Cancer.
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To download an EPUB file to your Kobo from a Windows computer:
- download and save the EPUB directly onto your desktop.
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- connect your Kobo to your computer using the USB cable and tap “Connect” on your eReader.
- open your “Finder” application.
- select “Kobo eReader” from the listed devices to view the contents of your Kobo.
- navigate to where you have stored your EPUB file in “Finder”, probably in documents or downloads, and drag and drop it into the Kobo window. You can now disconnect your Kobo to read the eBook.
Turn on your Kobo and your EPUB will be located in “eBooks”, while a PDF will be located in “Documents”.
Need more information? Visit: http://www.kobo.com/help/koboaura/response/?id=3784&type=3
Sony Reader
To download an EPUB file on your Sony Reader™:
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- connect the Reader™ to your computer.
- open the Reader™ Library software and click “Library” in the left-hand pane and select the eBook to view it.
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Amazon Kindle 2nd Generation devices
EPUB files can’t be read on the Amazon Kindle™. However, like most eReaders, Kindle™ 2nd Generation devices are able to display PDFs. We recommend that you download the PDF version of this booklet if you would like to read it on a Kindle™.
To transfer a PDF to your Kindle™ via USB cable from your computer or Mac:
- download the PDF directly onto your computer.
- connect the USB cable to your computer’s USB port, and the micro USB end of the cable to your Kindle™. Note: the Kindle™ won’t be available as a reading device while it is connected to your computer until it has been disconnected.
- open the Kindle™ drive and several folders will appear inside. The “Documents” folder is where you will need to copy or drag the PDF to.
- safely eject your Kindle™ from your computer and unplug the USB cable. Your content will appear on the Home Screen.
Kindle also provides a Kindle Personal Documents Service that allows users to send documents as an attachment directly to your eReader. For more information on this service, visit http://www.amazon.com/gp/help/customer/display.html/ref=help_search_1-1?ie=UTF8&nodeId=200767340&qid=1395967989&sr=1-1
For more information on accessing a PDF on your Kindle™, visit www.amazon.com/manageyourkindle, log in to your account and click on Personal Document Settings.
Need more help? Visit https://www.amazon.com/gp/help/customer/display.html?nodeId=200375630
Android and PC
You can also download and open eBooks on Android devices and PCs with appropriate apps or software installed. Suitable eReader apps for Android include Google Play Books, FBReader and Moon+ Reader. Suitable software for PCs include Calibre and Adobe Digital Editions.
This information was last reviewed in May 2018
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