Fertility preservation for children treated for cancer (1): scientific advances and research dilemmas

Currently there is uncertainty over the most effective and appropriate strategies for preserving and/or restoring an individual's fertility. This makes it difficult for health care professionals to advise young patients and their guardians. Gamete preservation is an evolving science and young children who are candidates for immature germ cell harvesting, storage, and in vitro maturation will make the greatest technical demands on these procedures. Despite its hopeful promise, gonadal cryopreservation is still experimental and should be subject to appropriate regulation and ethical scrutiny in order to prevent the exploitation of vulnerable individuals by commercially driven technology. A randomised trial of gonadal tissue cryopreservation and ART strategies versus best current practice in children with an intermediate to high risk of future infertility would provide an evidence base for future practice.