Fertility and Pregnancy Outcome after Treatment for Cancer in Childhood or Adolescence.

Successful therapy for children and adolescents with cancer includes the use of ionizing irradiation and/or chemotherapeutic agents. These may produce DNA damage, resulting in cell death, or the damage may be sublethal. These effects may be expressed in the gonads as sterilization or germ cell DNA damage. Sterilization may be acute, or identified by the occurrence of premature menopause. DNA damage may be identified by an increased risk for chromosomal syndromes, single gene defects or major congenital malformations in the offspring. Management of pediatric and adolescent cancer patients must include recognition of the potential for germ cell injury, counseling of patients regarding strategies for germ cell preservation, and long-term follow-up of the offspring of pediatric and adolescent cancer survivors to determine their increased risk, if any, for adverse pregnancy outcome, genetic disease and cancer.