title: Fertility preservation in pediatric, adolescent and young adult female cancer patients.
abstract: Advancements in chemotherapy and radiation therapies have increased survival rates in cancer patients. Late effects of therapy, including infertility, become increasingly more important with increased survival. High dose alkylating agents, total body irradiation and radiation to the gonads have the greatest effect on fertility. Fertility preservation therapies improve the reproductive potential of adolescent and young adult cancer patients receiving cancer therapies. Gonadal shielding, ovarian transposition and embryo cryopreservation are standard fertility preserving therapies. Oocyte and ovarian tissue cryopreservation have proven successful and the latter may be implemented under IRB approval. Gonadal suppression with gonadotropin releasing hormone agonist (GnRH) therapy has yielded conflicting results and larger prospective trials in both adolescents and adults are necessary. A team approach involving oncology, gynecology and reproductive endocrinology and infertility provides the best outcome for patients.
authors.affiliation: Division of Pediatric & Adolescent Gynecology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave ML 2026, Cincinnati, OH 45229, USA. Leslie.Ayensu-Coker@cchmc.org
authors.forename: Leslie
authors.initials: L
authors.lastname: Ayensu-Coker
authors.forename: Dvora
authors.initials: D
authors.lastname: Bauman
authors.forename: Steven R
authors.initials: SR
authors.lastname: Lindheim
authors.forename: Lesley
authors.initials: L
authors.lastname: Breech
mesh_terms: D000293:Adolescent; D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects; D002648:Child; D003376:Counseling; D015925:Cryopreservation; D005260:Female; D059247:Fertility Preservation / Q000379:methods / Q000523:psychology; D007987:Gonadotropin-Releasing Hormone; D006801:Humans; D007247:Infertility, Female / Q000209:etiology / Q000517:prevention & control; D009369:Neoplasms / Q000628:therapy*; D009865:Oocytes; D010053:Ovary; D011183:Postoperative Complications; D011878:Radiotherapy / Q000009:adverse effects
chemical_list: D000970:Antineoplastic Agents; D007987:Gonadotropin-Releasing Hormone