Fertility preservation in pediatric healthcare: a review

Lin Chen; Zirui Dong; Xiaoyan Chen

doi:10.3389/fendo.2023.1147898

Fertility preservation in pediatric healthcare: a review

Front Endocrinol (Lausanne). 2023 May 3:14:1147898. doi: 10.3389/fendo.2023.1147898. eCollection 2023.

Authors

Lin Chen¹, Zirui Dong^{2

3}, Xiaoyan Chen^{4

5}

Affiliations

¹ Reproductive Medical Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
² Department of Obstetrics and Gynecology, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China.
³ Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, China.
⁴ Maternal-Fetal Medicine Institute, Shenzhen Baoan Women's and Children's Hospital, Shenzhen University, Shenzhen, China.
⁵ The Fertility Preservation Research Center, Department of Obstetrics and Gynecology, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China.

Abstract

Survival rates for children and adolescents diagnosed with malignancy have been steadily increasing due to advances in oncology treatments. These treatments can have a toxic effect on the gonads. Currently, oocyte and sperm cryopreservation are recognized as well-established and successful strategies for fertility preservation for pubertal patients, while the use of gonadotropin-releasing hormone agonists for ovarian protection is controversial. For prepubertal girls, ovarian tissue cryopreservation is the sole option. However, the endocrinological and reproductive outcomes after ovarian tissue transplantation are highly heterogeneous. On the other hand, immature testicular tissue cryopreservation remains the only alternative for prepubertal boys, yet it is still experimental. Although there are several published guidelines for navigating fertility preservation for pediatric and adolescent patients as well as transgender populations, it is still restricted in clinical practice. This review aims to discuss the indications and clinical outcomes of fertility preservation. We also discuss the probably effective and efficient workflow to facilitate fertility preservation.

Keywords: fertility preservation; oocyte cryopreservation; ovarian tissue cryopreservation; pediatric; testicular tissue cryopreservation.

Publication types

Research Support, Non-U.S. Gov't
Review

MeSH terms

Adolescent
Child
Cryopreservation
Delivery of Health Care
Female
Fertility Preservation*
Humans
Male
Oocytes
Ovary
Semen
Testis

Grants and funding

This study was supported by Shenzhen Key Medical Discipline Construction Fund (Grant No. SZXK028), Shenzhen Science and Technology Program (Grant No. JCYJ20210324141403009, RCYX20210609104608036) and Natural Science Funding of China (Grant No. 82201851).