Fertility preservation should be considered and discussed prior to treatment initiation.
Cyclophosphamide and ifosphamide are both associated with a high risk of future infertility - especially in males - but females are also at risk.
Pelvic radiotherapy (RT) is also associated with a very significant risk of infertility. This can be limited by:
- Shielding testes during RT with metal shielding devices that fit around the testes (significantly reduces scattered RT to testes).
- Ovaries can be moved or "transposed" as far away from the RT field as possible.
Sperm donation and cryopreservation should be pursued for post-pubertal boys prior to any chemotherapy.
Egg harvesting may be possible for post-pubertal girls (though this technology has been associated with very few successful pregnancies thus far).
Reproductive technology continues to improve and new options for fertility preservation even in pre-pubescent females, including ovary harvesting, are being explored.
Links:
Fertility preservation (female)
