Preserving Fertility in Adolescents

Significant progress has been made in the treatment of paediatric tumours in recent decades. A growing number of male survivors may be infertile due to the high sensitivity of testicular cells, especially germ cells, to cytotoxic agents and radiotherapy. The impact of antineoplastic therapies on fertility must thus be borne in mind by both doctors and the patients and their parents. Semen cryopreservation prior to treatment enables patients who have reached puberty to access assisted reproduction techniques at a later date, if desired. For prepubertal children, the only available method is the cryopreservation of testicular tissue, which is still experimental in this age group. The management of fertility in infancy and adolescence is problematic and often neglected, especially in the presence of acute diseases which threaten the young patient’s survival. A thorough awareness of these problems would help paediatric oncologists and endocrinologists to inform and advise their patients about resources that could preserve their chances of future fatherhood.