Expert consensus
A fertility preservation consultation should be initiated prior to therapy. Post-menarchal girls receiving any alkylating agent or pelvic radiation should be offered the option of oocyte harvest if it can be accomplished without inappropriate delay in therapy initiation.
Girls who will receive pelvic radiation may be offered ovarian transposition.
Ovarian tissue cryopreservation (OTC) is an additional, experimental fertility preservation option available to both pre- and post-menarchal girls receiving alkylating agent therapy and/or pelvic radiation. The risk for infertility and premature menopause is proportional to the dose of alkylating agent, as quantified by the cyclophosphamide equivalent dose (CED), but different cooperative study groups and local institutions employ various thresholds for offering this intervention.
Oocyte harvest and cryopreservation in the late teenage years, after therapy completion, is another option.