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What is fertility?

  • Fertility is the ability to produce biological children.
  • Infertility is the loss of the ability to produce biological children.
  • Subfertility is when fertility is reduced, but not lost entirely.

Is my child at risk for infertility?

  • Children who need medical or surgical treatment for their disease may have injury to eggs, sperm, or other parts of the reproductive system because of treatment.
  • Not all children who have surgery or need medical treatment will have injury to their eggs, sperm, or reproductive system.
  • In some cases, this damage is temporary, and the reproductive system may heal over time. If so, the ability to produce children may return.
  • In some cases, the damage to the reproductive system is permanent.

Children who have the following medical conditions may be at risk for infertility or subfertility:

  • Endocrine – Some endocrine diagnoses and treatments can impact future fertility. Diagnosis such as hypopituitarism, ovarian failure, and testicular failure may require treatment with estrogen or testosterone. Fertility can be impacted due to the disease, or in some cases, the treatment. In these cases, there may an opportunity to help preserve your child’s fertility. If your child is seeing a pediatric endocrinologist, please ask if your child’s diagnosis may impact their fertility.
  • Gender Diversity – Medications used to help stop the development of puberty or to help with gender affirming physical development may impact fertility. The exact impact is currently poorly understood. It is important to understand how gender-affirming hormone therapy may impact fertility. If your child is undergoing gender-affirming treatment, you may consider discussing fertility preservation options with one of our experts.
  • Genetics and Metabolism – Some genetic conditions and inborn errors of metabolism may result in future fertility impairments including sterility. Please discuss your child’s diagnosis with your physician to determine if fertility is at risk.
  • Hematology/Oncology –
    • Oncology: Cancer and cancer treatment, including chemotherapy, radiation therapy, and some surgeries, may affect your child’s fertility. The specific types of chemotherapy, the location of radiation therapy, and the type of surgery are all important in determining the risk of infertility. Please ask your child’s oncologist about these risks and about options for fertility preservation prior to starting cancer treatment.
    • Sickle Cell Disease (SSD): SSD can result in infertility. If your child has SSD, talk with your hematologist about how this disease can impact fertility and if your child is at risk. Please ask your doctor if your child should be referred to a  specialist or contact us directly.
  • Urology – Some urology diagnoses such as ambiguous genitalia or testicular cancer, may affect your child’s ability to have children and may require fertility preservation. If your child is being seen for a urology condition, please ask your pediatric urologist if your child is at risk of infertility.
  • Rheumatology – Patients with chronic rheumatic or autoimmune diseases may be at risk of infertility. Sometimes the disease can impact fertility, and sometimes the medications used to treat autoimmune conditions can impact fertility. Please ask the pediatric rheumatologist about your child’s risk of fertility problems.
  • Nephrology (Kidney) – Kidney disease can impact multiple organ systems. Medications needed to treat some kidney diseases can affect future fertility. Please ask your pediatric nephrologist if your child’s disease or treatment may impact their ability to have children in the future.
  • Gynecology – Some gynecological conditions, such as ovarian torsion or failure, may impact your child’s ability to have children. If your child is being evaluated by gynecology be sure to ask if your child is at risk of fertility problems.

 

The Livestrong Fertility website includes many helpful resources, including a fertility risk calculator.