Fertility preservation options in prepubertal females: feasibility, safety and outcomes

Fertility preservation is a developing area of reproductive biology and successes in adult populations has led to an emerging interest in prepubertal populations. Advances in treatment strategies for many disease processes including childhood cancer means that many patients now survive their initial diagnosis. Ovarian insufficiency is a recognized side-effect of chemotherapy and as such advances in reproductive technologies are now possible to attempt to overcome the so called late effects. Questions regarding the outcomes and safety of these treatments still exist. A review of the available literature with regard to fertility preservation options in prepubertal females was undertaken with consideration given to the need for options, availability of options, safety of available techniques and current outcomes. The new discipline of onco-fertility is rapidly advancing. Work to facilitate accurate and robust identification of those in need of fertility preservation and the optimization of strategies for fertility restoration are ongoing. With time it is hoped that the techniques used to freeze-store ovarian tissue and to conduct auto-transplantation will undergo refinement and so advance from the research arena into mainstream clinical practice. Further research is likely to be fruitful and will offer significant hope to those at risk of premature ovarian insufficiency whether from underlying genetic causes or as a result of ablative therapies. It is important that research advancements are disseminated widely as this will help to inform clinical practitioners, nurses and counsellors of strategies and to ensure that appropriate treatments are offered to patients who are at risk of fertility loss.