title: Fertility preservation and reproductive health in the pediatric, adolescent, and young adult female cancer patient.
abstract: OBJECTIVE
  As treatments for malignancies become increasingly successful, emphasis on quality of life in survivorship becomes important. Of equal importance is the role of gonadotoxic agents in the management of chronic medical conditions, such as nonmalignant blood disorders and rheumatologic and genetic conditions. Gonadotoxic agents have long-term effects to include ovarian insufficiency, pubertal arrest and subsequent infertility.
  
  
  RESULTS
  In 2004, ovarian tissue cryopreservation emerged as an investigational but viable option for prepubertal patients and those unable to undergo ovarian stimulation. In 2012, oocyte preservation became standard therapy for patients without a partner or who elected not to use donor sperm or freeze embryos. Ovarian reserve testing with antimullerian hormone to assess fertility after gonadotoxic therapy is a rapidly growing area of interest with potentially significant benefits in personalizing the approach to fertility preservation.
  
  
  CONCLUSIONS
  A systematic approach to fertility preservation prior to treatment in all patients receiving gonadotoxic agents optimizes care. Fertility preservation strategies can restore hormonal function and preserve reproductive potential. Future research in personalizing approach to care is critical to meeting the needs of this patient population.
authors.affiliation: aUniversity of Kentucky College of Medicine bDivision of Gynecologic Subspecialties, Department of Obstetrics and Gynecology, University of Kentucky College of Medicine, Lexington, Kentucky, USA.
authors.forename: Kourtney
authors.initials: K
authors.lastname: Trudgen
authors.forename: Leslie
authors.initials: L
authors.lastname: Ayensu-Coker
mesh_terms: D000293:Adolescent; D054304:Anti-Mullerian Hormone / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects*; D002648:Child; D015925:Cryopreservation / Q000379:methods; D005260:Female; D059247:Fertility Preservation / Q000379:methods; D006801:Humans; D007247:Infertility, Female / Q000517:prevention & control* / Q000628:therapy; D009369:Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000532:radiotherapy*; D054315:Oocyte Retrieval / Q000379:methods; D010062:Ovulation Induction / Q000379:methods; D011788:Quality of Life; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects*; D060728:Reproductive Health; D012099:Reproductive Techniques; D017741:Survivors; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D054304:Anti-Mullerian Hormone