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Fertility preservation and reproductive health in the pediatric, adolescent, and young adult female cancer patient

Trudgen, Kourtneya; Ayensu-Coker, Leslieb

Current Opinion in Obstetrics and Gynecology: October 2014 - Volume 26 - Issue 5 - p 372–380
doi: 10.1097/GCO.0000000000000107

Purpose of review As treatments for malignancies become increasingly successful, emphasis on quality of life in survivorship becomes important. Of equal importance is the role of gonadotoxic agents in the management of chronic medical conditions, such as nonmalignant blood disorders and rheumatologic and genetic conditions. Gonadotoxic agents have long-term effects to include ovarian insufficiency, pubertal arrest and subsequent infertility.

Recent findings In 2004, ovarian tissue cryopreservation emerged as an investigational but viable option for prepubertal patients and those unable to undergo ovarian stimulation. In 2012, oocyte preservation became standard therapy for patients without a partner or who elected not to use donor sperm or freeze embryos. Ovarian reserve testing with antimullerian hormone to assess fertility after gonadotoxic therapy is a rapidly growing area of interest with potentially significant benefits in personalizing the approach to fertility preservation.

Summary A systematic approach to fertility preservation prior to treatment in all patients receiving gonadotoxic agents optimizes care. Fertility preservation strategies can restore hormonal function and preserve reproductive potential. Future research in personalizing approach to care is critical to meeting the needs of this patient population.

aUniversity of Kentucky College of Medicine

bDivision of Gynecologic Subspecialties, Department of Obstetrics and Gynecology, University of Kentucky College of Medicine, Lexington, Kentucky, USA

Correspondence to Leslie Ayensu-Coker, MD, Division of Gynecologic Subspecialties, Department of Obstetrics and Gynecology, UK Healthcare, University of Kentucky College of Medicine, 800 Rose Street Room C358, Lexington, KY 40536, USA. Fax: +1 859 257 6886; e-mail:

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