# Fertility preservation for children and young people before cancer treatment

Source: https://onco.cc/protocols/paediatric-fertility-preservation/  
OnCo record `paediatric-fertility-preservation` (Protocol). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Some cancer treatments can stop a child having children of their own later. Before treatment, the team should talk with the family about this risk and refer them to a fertility specialist if they want, or are unsure. Teenagers who have started puberty can bank sperm or eggs; for younger girls ovarian tissue can be frozen, and for younger boys testicular tissue freezing is still experimental.

## Summary

Children's Oncology Group endorses the ASCO 2025 guideline update (166 studies, GRADE) for children. Discuss the possibility of infertility as early as possible before treatment (strong, moderate), offer an evaluation of reproductive risk that accounts for the gonadotoxicity of planned and possible future treatment (strong, moderate), and refer anyone interested or uncertain to reproductive specialists as soon as possible (strong, very low), with prompt access to a multidisciplinary fertility preservation team (good practice). Children and adolescents who have started puberty should be offered established methods with their assent and parental consent (strong, moderate): sperm banking for all pubertal and postpubertal males before treatment (strong, high), with testicular sperm extraction if no sample can be produced (strong, high), and embryo or oocyte cryopreservation in females (strong, high). For prepubertal patients the only options are ovarian tissue cryopreservation, an established method that needs no ovarian stimulation or delay (strong, moderate), and testicular tissue cryopreservation, which is experimental and for trials only (strong, very low). Hormonal suppression does not protect male fertility (strong, high); GnRH agonists must not replace established methods (conditional, moderate). Ovarian transposition may be offered before pelvic radiotherapy (strong, moderate). Revisit fertility at follow-up and when plans change (strong, low).

## Fields

- Kind: Protocol
- Last checked: 2026-11-11
- Also known as: oncofertility in children; paediatric fertility preservation; sperm banking teenagers; ovarian tissue freezing children; testicular tissue cryopreservation; fertility counselling before chemotherapy
- Tags: protocol; paediatric; fertility

## Connected records

- collections: [The Oncofertility Consortium](https://onco.cc/collections/oncofertility-consortium/)
- drugs: [Goserelin / leuprolide (ovarian function suppression)](https://onco.cc/drugs/goserelin/), [Leuprolide (leuprorelin) and GnRH agonists](https://onco.cc/drugs/leuprolide/)
- cancers: [Childhood cancers (all types)](https://onco.cc/cancers/childhood-cancers/)
- fronts: [Supportive Care & Survivorship](https://onco.cc/fronts/supportive-care/)
- technologies: [Fertility in boys and young men treated for cancer, including testicular tissue banking](https://onco.cc/technologies/rejuv-paed-fertility-male/), [Fertility in girls and young women treated for cancer, including ovarian tissue freezing](https://onco.cc/technologies/rejuv-paed-fertility-female/), [Oncofertility and fertility preservation](https://onco.cc/technologies/fertility-preservation/)
- companies: [Children's Oncology Group (COG)](https://onco.cc/companies/childrens-oncology-group/)
- institutions: [American Society of Clinical Oncology (ASCO)](https://onco.cc/institutions/asco/)
- terms: [Late effects and survivorship toxicity](https://onco.cc/terms/late-effects/)
- ideas: [Default fertility preservation referral for every patient under 40 before treatment](https://onco.cc/ideas/idea-acc-default-fertility-preservation-referral/)

---
JSON: https://onco.cc/api/v1/entities/paediatric-fertility-preservation.json