Fertility Preservation in Children and Adolescents during Oncological Treatment—A Review of Healthcare System Factors and Attitudes of Patients and Their Caregivers

SIMPLE SUMMARY: Oncofertility refers to medical interventions aimed at preserving the fertility of cancer patients, particularly those undergoing treatments like chemotherapy and radiation therapy that can harm reproductive cells. This literature review focuses on oncofertility in pediatric and adolescent populations, a relatively niche area with limited research compared to adults. The review examines the methods used, financing, ethical considerations, and the perspectives of patients and their parents. In prepubertal patients, there are fewer fertility preservation options available compared to pubertal individuals. The funding for these procedures varies by country, with only a few governments choosing to provide reimbursement. Oncofertility in pediatric and adolescent patients raises controversies, including decisions, parental beliefs, partner considerations, ethical dilemmas, and healthcare professionals’ knowledge and experience. Given the fertility risks young cancer patients face, healthcare professionals must make every effort to help them fulfill their future reproductive plans and desires for a family. The development of systemic solutions is crucial to advance oncofertility in pediatric and adolescent populations. ABSTRACT: Oncofertility is any therapeutic intervention to safeguard the fertility of cancer patients. Anti-cancer therapies (chemotherapy, radiation therapy, etc.) entail the risk of reproductive disorders through cytotoxic effects on gamete-building cells, especially those not yet fully developed. This literature review analyzes the available data on securing fertility in pediatric and adolescent populations to identify the methods used and describe aspects related to financing, ethics, and the perspective of patients and their parents. Topics related to oncofertility in this age group are relatively niche, with few peer-reviewed articles available and published studies mostly on adults. Compared to pubertal individuals, a limited number of fertility preservation methods are used for prepubertal patients. Funding for the procedures described varies from country to country, but only a few governments choose to reimburse them. Oncofertility of pediatric and adolescent patients raises many controversies related to the decision, parents’ beliefs, having a partner, ethics, as well as the knowledge and experience of healthcare professionals. As the fertility of young cancer patients is at risk, healthcare professionals should make every effort to provide them with an opportunity to fulfill their future reproductive plans and to have a family and offspring. Systemic solutions should form the basis for the development of oncofertility in pediatric and adolescent populations.