Fertility preservation
Cancer treatments such as surgery, chemotherapy and radiation therapy can impact on a person’s ability to have children in the future.
It is important that you are given information and access to fertility preservation services.
Your child's risk of late effects depends on the type of cancer and the treatment given. It is important to discuss the risk of infertility and fertility preservation options the medical team before commencing treatment. Options are limited for children diagnosed with cancer before puberty.
Children who understand fertility should be involved in the discussion about how cancer treatment may affect their fertility. The health care team can help you with this.
Children cannot give full legal consent because of their age. But a child who can understand must generally agree before a procedure. This is called assent. Parents also must give consent before the procedure.
Chemotherapy
Alkylating agents affect fertility more commonly than other types of chemotherapy.
Other drugs may cause short-term effects on a girl's menstrual cycle.
In general, high doses of alkylating agents will cause permanent damage. But doctors typically use the lowest possible doses for children.
Radiation therapy
Radiation therapy can damage the ovaries or testes. The risk is greatest when the radiation is focused in the pelvis, abdomen or spine.
Girls
Radiation therapy may damage eggs and affect hormone production. This is called ovarian insufficiency. Girls who have not yet begun menstruation may have delayed puberty.
Boys
Radiation therapy may damage sperm and affect their hormone production.
Children who have radiation therapy to the brain may also have fertility side effects. In these cases, treatment damages the brain’s communication with the reproductive organs. If reproductive organs are not damaged, hormone treatment helps fix this problem.
Surgery
Sometimes cancer is found in a child's reproductive organs. In these cases, the doctor might suggest surgery to remove part or all of these organs. These surgeries may affect fertility.