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Prepubertal Oncofertility

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Preserving Fertility in Young Cancer Patients

If you’re facing situations that may impact your child's future fertility, prepubertal fertility preservation offers hope. While a complex and evolving field, these techniques aim to safeguard a child's potential to have biological children later in life.

Timing can be crucial – especially for treatments like radiation and chemotherapy that can affect your child’s long-term reproductive health. If possible, it’s important to discuss fertility preservation before cancer treatment or surgery occurs.

At Sylvester, we’re here to guide and support you with dedicated prepubertal oncofertility care focused on cancer treatment and child fertility.


What is Prepubertal Oncofertility?

Many cancer and blood disorder treatments – including chemotherapy, radiation, surgery, and blood and marrow transplants – can harm a child’s ability to have children in the future. This is because these treatments may damage the ovaries or testes.

Prepubertal oncofertility combines cancer treatment with fertility care to help improve your child’s chances of becoming a parent later in life. This includes proactive fertility preservation treatments that can offer a possible solution.

Those who might consider prepubertal fertility preservation include:

  • Children facing medical treatments. Conditions like cancer treatment can damage reproductive organs. Preserving fertility options beforehand offers a chance at parenthood after recovery.
  • Children with certain genetic disorders. Certain genetic conditions may affect future fertility. Exploring prepubertal options can provide peace of mind.

How Cancer Treatments Affect the Fertility of Prepubertal Children

Cancer treatments can impact children’s reproductive health in different ways. The changes may be temporary or permanent. Here are some possible effects:

  • Chemotherapy and child fertility. Chemotherapy drugs can affect children’s reproductive organs. For example, some chemotherapy drugs may damage boys’ testicles and impact their ability to produce sperm. For girls, some types of chemotherapy can affect their ovaries and stop the release of eggs. This can cause irregular menstruation, or their periods may stop altogether.
  • Radiation therapy and child fertility. For girls, radiation treatments to the whole body or to the pelvic and abdomen can impact their uterus. This may make it more difficult to carry a baby to full term later in life. For boys, radiation close to the groin or abdomen may damage the testicles and affect sperm production. Children with brain tumors who need radiation to the brain may also experience fertility effects. This is because radiation can affect the pituitary gland, which controls certain hormones affecting pregnancy and reproductive function.

Doctors and researchers are continuing to learn more about cancer treatment and child fertility. Talk with your child’s doctor about the possible fertility impacts of your child’s treatment.


Fertility Preservation Options for Prepubertal Cancer Patients

If your child has been diagnosed with cancer, fertility preservation treatments may include the following:

  • Ovarian tissue cryopreservation (for girls). This is experimental and done for research purposes. It may be used for girls who have not yet gone through puberty and are not yet producing eggs. With this approach, immature ovarian tissue is surgically removed and frozen. This can potentially allow for future development of mature eggs through research advancements. Mature tissue can then be reimplanted in the body to enable the possibility of pregnancy.
  • Testicular tissue cryopreservation (for boys). Similar to girls, immature testicular tissue is frozen, with the hope of future technology enabling sperm development from this tissue. It is also experimental and performed only for research purposes.
  • Gonadal shielding (for boys). This fertility preservation method puts a protective shield over reproductive organs on the outside of the body during radiation therapy. It aims to protect the testicles from the possible damaging effects of radiation.
  • Ovarian shielding (for girls). Similar to gonadal shielding for boys, this procedure puts a shield over the ovaries to protect them during radiation therapy.
  • Ovarian transposition (for girls). This is a surgical procedure to protect the ovaries during radiation therapy by moving them to another area of the body.

Benefits of Prepubertal Oncofertility

The biggest benefit of prepubertal oncofertility is improving reproductive options to have a biological child later in life. There are no guarantees. Still, it can address concerns about the impact of cancer treatment on fertility and bring hope to many patients and families.


Risks and Side Effects of Fertility Preservation in Young Cancer Patients

Ensuring the safety of fertility preservation is a top priority. Still, these procedures may involve some risks for young patients. Fertility preservation risks and side effects depend on the treatment. They may include:

  • Bleeding, pain, and infection following fertility preservation procedures.
  • Medications (which may present risks).
  • For ovarian tissue replacement, there may be a risk of reintroducing cancerous cells when the tissue is reimplanted in the body.

Success Rates of Fertility Preservation Techniques for Prepubertal Cancer Patients

It is early to define fertility preservation effectiveness for young cancer patients because this is a relatively new and evolving field. Still, science is moving forward to improve potential reproductive outcomes for children with cancer. Procedures such as ovarian and testicular freezing – though still in the research phase – show signs of promise.

Talk with your child’s doctor to learn more about prepubertal fertility preservation success rates and what to expect.


Preparing for Fertility Preservation Procedures for Children

One of the first steps you’ll take in fertility preservation preparation is a consultation with our oncofertility team. We know you’ll have many questions, and we’ll do our best to explain everything so you can feel comfortable making medical decisions. A consultation may include discussions about:

  • Medical evaluations your child may need.
  • Possible fertility preservation treatments.
  • Child patient preparation.
  • Tips to prepare for fertility preservation procedures.
  • Steps to take before the procedure.

Support Services at Sylvester Comprehensive Cancer Center

When you come to Sylvester, you have a whole team to support you and your child. Our support services include:

  • Counseling. At Sylvester, we understand that your child’s treatment involves more than just physical care. You may also need support as you manage your concerns about their cancer treatment and fertility. Our experts are available to work with you and your family to help answer questions about fertility support and your child’s cancer diagnosis. Your child may also benefit from our young adult cancer services, including support groups, child life specialists, and more.
  • Follow-up care. When your child’s cancer treatment is complete, you may continue to have questions about their health. They may also have questions of their own, especially if they decide they want to start a family one day. You and your child can count on our expert care providers and our survivorship services to help guide you through your treatment and fertility journey.

What Happens After Fertility Preservation?

If your child has tissue freezing (cryopreservation), several steps follow as part of the freezing and post-preservation process.

  • The frozen tissue is stored and monitored in a special facility.
  • Your child has needed cancer treatment such as radiation or chemotherapy.
  • When your child’s cancer treatment is completed, they may be eligible to have their thawed tissue reimplanted in their body.
  • After the tissue is implanted, your child may experience restored fertility and may begin to resume puberty.
  • In the future, they may possibly be able to have a child naturally or with support from procedures such as in vitro fertilization (IVF).

Pregnancy is not guaranteed, but fertility treatment may offer hope to have a biological child later in life. Medical professionals continue to gather more information about experimental treatments.


Is Fertility Preservation Covered by Insurance for Prepubertal Cancer Patients?

Fertility preservation is not typically covered by insurance. Still, check with your insurance provider to confirm your coverage. At Sylvester, we offer self-pay and financing options to help make care more accessible.



Finding Hope and Guidance

If you're considering prepubertal fertility preservation for your child, here are some resources to help you navigate this path:

  • Consult a pediatric fertility specialist. Seek guidance from a healthcare professional with expertise in childhood fertility preservation.
  • Support groups. Connecting with families who have made similar choices can provide valuable support and shared experiences.
  • Stay informed. Research organizations like the American Society for Reproductive Medicine (ASRM) can offer updated information on this evolving field.

We’re Here for You

Prepubertal fertility preservation offers a potential pathway for future family planning. While uncertainties exist, open communication, expert guidance, and emotional support can empower you to make informed decisions for your child's well-being.

In making decisions about cancer treatment and child fertility, our prepubertal oncofertility team is here for you.

Schedule a consultation: Learn more about fertility preservation options for your child by scheduling a consultation with our specialists. Call us at 305-243-8642.


College of American Pathologists Society for Assisted Reproductive Technology

Why Choose Sylvester Comprehensive Cancer Center?

Comforting, compassionate, comprehensive pediatric care. Our youngest patients receive expert treatment in a state-of-the-art center designed just for children and families. We’re committed to empowering cancer patients and survivors in every aspect of their care. This includes a cancer support program designed just for adolescents and young adults.

Academic and research expertise. As part of an academic medical center, we participate in research that is paving the path forward in fertility preservation. While research is still ongoing, we offer cutting-edge fertility preservation treatment options that may offer hope for young cancer survivors to achieve their dreams of parenthood in the future.

Proven pediatric cancer care. A vital part of your child’s oncofertility care involves providing effective treatment for pediatric cancers that can impact their fertility. This is an area where we excel. For instance, our pediatric blood cancer treatment is ranked among the best cancer programs in the country, per U.S. News and World Report.

Focus on urgency. Early action is key, particularly when treatments pose a risk to your child’s fertility. Our compassionate team works closely with you to explore fertility preservation options and prioritize your child’s consultations in our schedule.

Support for every part of your life. Our team of psychologists, social workers, nutritionists, pain management professionals, and others work on behalf of you and your family members. This includes dedicated therapy and health services to support you throughout treatment and beyond.

Questions? We're here to help.

Our appointment specialists are ready to help you find what you need. Contact us today.

Call 1-844-324-HOPE (4673) Request an Appointment

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