Purpose-The knowledge that cancer treatment may impair fertility in pediatric populations is an emerging aspect of quality of life in this population. However, decision making and use of fertility preservation among adolescent cancer patients and their families has not been well studied. This review summarizes the available literature on aspects of decision making and fertility preservation in adolescent cancer patients.Methods-An electronic search was performed to identify peer reviewed studies published between 1999-2009 using key MESH terms and inclusion criteria. Inclusion criteria limited eligible studies to those that focused on adolescent decision-making in cancer treatment or fertility preservation, fertility concerns in pediatric oncology, capacity for decision-making, and health decision making in pediatrics. Studies were excluded that did not meet at least one of these criterion.Results-A total of 29 articles were reviewed and summarized. Three categories of results were seen: a focus on adolescent decision making in oncology, decision making in chronic illness, and decision making in cancer related infertility and preservation. Conclusion-The majority of studies showed adolescents have a strong desire to participate in decisions about their cancer treatment and many have concerns regarding their future fertility although barriers often prevented these discussions. More research is needed to explore the role of teens and parents in decisions about fertility in relation to cancer treatment.© 2011 Society for Adolescent Medicine. Published by Elsevier Inc. All rights reserved. * Corresponding Author: Gwendolyn Quinn, 12902 Magnolia Drive, MRC CANCONT, Tampa FL 33612, 813-745-1359, gwen.quinn@moffitt.org. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Fertility preservation (FP) technologies are available for adolescent cancer patients and in most cases should be pursued prior to treatment. The established (non-experimental) option for males is sperm cryopreservation, and for females the established options are ovarian transposition and embryo cryopreservation. There are experimental options available for both males and females including oocyte, testicular, and ovarian tissue cryopreservation. [8,9] In some cases, the physician may decide an adolescent patient is unable to delay cancer treatment in order to pursue an FP option. NIH Public Access[9] However, the need to consider FP depends on physical and developmental capacity, prognosis, financial circumstances, and religious, cultural, and ethical values.The values and duties of the relevant parties an...

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Visions for the future are a normal developmental process for adolescents and young adults (AYAs) with and without cancer, and these visions often include expectations of sexual and romantic relationships. AYA cancer survivors indicate reproductive health is an issue of great importance and more attention is needed in the health care setting throughout the cancer experience, beginning at diagnosis. Various practice guidelines are predominately focused on fertility; are intended to influence survivorship care plans; and do not encompass the broad scope of reproductive health that includes romantic partnering, friendships, body image, sexuality, sexual identity, fertility, contraception, and more. Although interventions to reduce reproductive health-related sequelae from treatment are best approached as an evolving process, practitioners are not certain of the priorities of these various reproductive health content areas. Strategies incongruent with the reproductive health priorities of AYAs will likely thwart adequate follow-up care and foster feelings of isolation from the treatment team. Research is needed to identify these priorities and ensure discussions of diverse content areas. This review explored various domains of reproductive health and emphasized how understanding the priorities of the AYA cancer cohort will guide future models of care. Cancer 2015;121:2529-36.