Maintaining the ability to have biologic children has been identified as an important component to post cancer quality of life in survivors. Achieving this in younger cancer patients has become more feasible secondary to improvements in reproductive technology. Healthcare providers are now increasingly called upon to be familiar with the indications and options for fertility preservation in female paediatric and adolescent cancer patients. Type of cancer, age, pubertal development, severity of illness at time of diagnosis, and type of treatment all impact decision making related to fertility preservation. Patients at high risk include those receiving high-dose alkylating agents and pelvic radiation which lead to depletion of ovarian reserve and radiation to the brain that may interfere with the hypothalamic-pituitary-gonadal axis and those requiring surgical resection of reproductive structures. Patients receiving alkylating agents combined with pelvic radiation or total body irradiation and those that are older age at time of treatment are also at high risk for infertility. This chapter will give an overview of current options for fertility preservation for female paediatric and adolescent cancer patients.

Kathleen Shea, Jennifer Levine

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