How can I get a measure of my child's fertility, and when should I do this?

Before assuming that your child has lost fertility due to cancer treatment or that they must now pursue alternative reproductive methods, it is important that they find out their actual fertility status. Talk to your child’s doctor about the right time to measure your child’s fertility following cancer treatment.

GIRLS

There are certain ways to assess the impact of cancer treatment upon a young woman’s fertility. Following cancer treatment, girls should undergo a yearly exam to monitor the onset and timing of puberty, including the menstrual cycle and sexual function (as age appropriate). The most common sign of fertility is the occurrence of a normal menstrual cycle once treatment is completed. Although having a period is a good sign, it does not guarantee that fertility has returned to normal. The ovarian reserve is an important measure of a woman’s ability to become pregnant.

The ovarian reserve refers to the ability of the ovaries to respond to hormones and to the quality and number of eggs in the ovary at any given time in a woman’s life. While there are no precise tests to measure the ovarian reserve, young women can undergo blood tests to measure hormone levels in the bloodstream. These tests can provide more clues about the impact of cancer treatment on your daughter’s fertility status and ovarian reserve.

The most common hormone measured is FSH (follicle-stimulating hormone), but levels of other hormones like inhibin B and AMH may also provide useful information about the ovarian reserve.

BOYS

For boys who have completed cancer treatment, there is a wide variation in the length of time it takes to begin or resume sperm production. Boys should undergo yearly examinations to assess the onset of puberty and sexual function (as age appropriate), and some children may have hormone levels measured. These hormones can reveal how well the testicles are functioning to produce sperm.

Analysis of sperm should be performed for evaluation of fertility as part of family planning. A fertility specialist can test for sperm levels, motility, appearance, and shape, as well as measuring hormone levels (testosterone and FSH).