Survivorship issues surrounding conception and gestational outcome have gained recognition as the management and outcome of childhood malignancies has become increasingly successful. Issues surrounding future fertility are likely multifactorial including both direct and indirect effects of therapy on the pituitary system as well as the end organs. Radiation therapy impairs normal function of both the ovaries and the uterus. The magnitude of risk is related to the age and menarchal status at the time of treatment. Although all treatment for malignant disease is a balance between successful therapeutic outcome and minimized toxicity, it appears that the threshold for radiation is considerably lower than initially perceived. As cancer treatment and cures improve, assisted reproductive technology strives to keep pace. Oocyte cryopreservation, in vitro maturation, ovarian tissue cryopreservation, and uterus and ovary transplantation are all evolving to treat secondary infertility in cancer patients. Because of the rapidly changing field, it has become of paramount importance to educate both the parents and the patient with pediatric malignancy as to the impact their treatment may have on fertility and pregnancy outcome.
- Cancer and fertility
- Cancer survivorship and fertility
- Chemotherapy and fertility
- Radiotherapy effects on the uterus
- Uterus and chemotherapy
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