- •Childhood cancer survivors are living longer.
- •High cumulative doses of alkylating agents and/or radiation increase the risk of premature ovarian insufficiency.
- •Ovarian function monitoring after therapy is dependent on pubertal status.
- •A risk of premature ovarian insufficiency should prompt referral to a reproductive endocrinology specialist.
Most children diagnosed with cancer survive for many years after treatment. However, the fertility potential of these patients may suffer due to their oncologic therapies. Certain chemotherapies and radiation are more likely to be detrimental to gonadal function, and put patients at risk of acute or premature ovarian failure. Prepubertal cancer patients will need different follow-up and testing from their post-pubertal counterparts. This review will present evidence to help patients, family members and physicians determine who is most at risk of ovarian insufficiency and how to monitor childhood cancer survivors. It will discuss the impact of age at diagnosis and cancer therapies on reproductive outcomes, and guide caregivers and patients on monitoring gonadal function after therapy.
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Published online: January 23, 2019
Accepted: January 22, 2019
Received in revised form: January 14, 2019
Received: December 11, 2018
© 2019 Elsevier B.V. All rights reserved.