The incidence of cancer in the young population and long life after the disease is increasing. Also, more than 10% of all cancers are diagnosed in young patients.

Malignancies that occur at a young age in women mainly include:

– Blood diseases

– Breast cancer

– Colorectal cancer

– Thyroid cancer

– Cervical cancer and melanoma

Progress in the treatment of these cancers has increased life expectancy. However, essential treatments can have a negative impact on future fertility. Antineoplastic agents and radiation cause extensive follicle disorders in both quantitative and qualitative aspects. Since the earliest studies,

fertility preservation in children with various options has resulted in hundreds of live births for child cancer survivors. The mechanisms of ovarian dysfunction caused by chemotherapy and radiotherapy have gradually been elucidated to support the development of fertility-preserving agents. However, many questions remain to be answered to increase the effectiveness and ensure the safety of fertility preservation.

In fact, most common and effective cancer treatments stop the growth of rapidly dividing cells, including germ cells in the testes and ovaries, and may result in temporary or permanent disruption of the reproductive system.

Chemotherapy, radiotherapy and surgery can affect the child’s reproductive system in the future. However, the risk of infertility depends on the type of cancer, the dose of chemotherapy drugs, the amount of radiation in the radiotherapy and the surgical procedure.

Of course, infertility after cancer treatment is often not permanent. Men can achieve optimal fertility after treatment, even with low sperm production, due to the type of sperm cells in the testicles, but women have a limited egg reserve and may lose their fertility forever if the ovaries are severely damaged during treatment.

If we leave aside cancers that affect the female reproductive system, such as ovarian and uterine cancer, cancer treatments such as surgery, radiotherapy and chemotherapy often cause irreversible damage to the ovaries and reproductive organs. Cancer treatment with factors such as high-dose alkylating and pelvic radiation, which reduce ovarian reserve, brain radiation that affects the hypothalamic-pituitary-gonadal axis, and surgical removal of the reproductive system,

reduce the likelihood of having biological children.

However, it is often difficult to determine which patients will become infertile following cancer treatment. As a result, fertility preservation in children with cancer should be included in the program for more detailed counseling.

Given the remarkable successes in the treatment and fertility preservation in children and adolescents with cancer and to increase the quality of life of these people, it is essential to pay attention to the issue of fertility preservation. When a child is diagnosed with malignancy and is struggling with cancer, parents are so involved in the recovery and treatment process that thinking about fertility is very far from the mind.

 However, with the increasing chances of recovery in children with cancer, the day will come when a child with cancer today will be a father or mother in the future. This increase in life expectancy in cancer patients of reproductive age has increased the focus on long-term quality of life, including preserving the ability to biologically conceive in children. Of course, no one can predict with complete certainty whether a child with cancer will be sterile or fertile in the future.

Although the prediction of future fertility preservation in children with cancer is still in the research stage and has not reached a clear and clear conclusion, it is clear that anticancer drugs usually cause damage and damage to ovarian function, as a result of which immature eggs produced remain and are not able to mature by the body.

 That is, despite advances in cancer treatment, female children may survive cancer, but the negative impact of the necessary chemotherapy and radiation regimens on the future fertility of patients can remain. The treatment regimen includes alkylating agents and radiation therapy to the gonads or pituitary gland, as well as the whole body, especially to the gonads.

These long-term effects of gonadotoxic agents and drugs include ovarian failure, puberty arrest and subsequent infertility. Therefore, to preserve fertility in female children with cancer

Cancer should begin preventive measures before chemotherapy and radiation therapy begin. Assessing the potential severity of these harms and the appropriateness of fertility preservation methods before starting cancer treatment in each child patient is crucial to limit this delayed effect of treatment and should be considered the standard of care before starting gonadotoxic therapy.

Guidelines have been published by cancer and fertility support societies, according to which young and adolescent patients and parents or caregivers of children of patients treated with a gonadotoxic regimen should be systematically informed of the risk of infertility and the options for preserving their fertility, followed by a procedure for preserving fertility (e.g., freezing of sperm or eggs) for children who have reached puberty, with the consent of the patient, the consent of the parents or caregiver.

Correct information on this matter to patients or their parents about the fact that premature ovarian failure occurs with a risk percentage varying from low to high (20 to 80%) according to the treatment regimen and dose of drugs and the age of the patient can be effective in their attitude and demand for fertility preservation.

In studies conducted in this regard, many young female patients They stated that fertility was one of their concerns at the time of diagnosis and many wanted children after treatment.