Fertility after Treatment of Childhood Cancer: A Narrative Literature Review

Abstract

Advances in the treatment of childhood cancer have markedly improved survival rates over the past decades. Consequently, there is growing concern regarding the long-term effects of the different therapeutic modalities, including the potential for impaired fertility. This literature review summarizes current evidence on fertility outcome in childhood cancer survivors (CCS), focusing on the impact of chemotherapy, radiotherapy and immunotherapy. Fertility outcome in CCS is influenced by age at diagnosis and treatment modality, with the highest infertility rates observed in patients treated with high cumulative doses of alkylating agents and/or abdominal/pelvic radiotherapy. This review also emphasizes the importance of early counselling on infertility risk and fertility preservation methods as an essential component of comprehensive cancer care.