Fertility Preservation for Infants, Children and Young Adults

Dr. Hoefgen discussing fertility preservationA diagnosis of cancer and other diseases doesn’t just change life right now. It can also affect the future. The Integrated Care & Fertility Preservation program at St. Louis Children’s Hospital helps even the youngest patients protect their fertility, giving them a better chance of one day having a biological child. 

What Is Fertility Preservation?

Certain treatments for cancer, blood diseases and other conditions may damage reproductive organs and glands. This damage can decrease fertility, the ability to have a biological child. 

Our team performs procedures designed to preserve fertility, development and hormonal health. We may perform these procedures before, during or after treatments such as chemotherapy and bone marrow transplant. People of all ages, from babies to adults, both female and male, can benefit from fertility preservation services. 

The Fertility Preservation Team

We have the area’s only integrated program dedicated to preserving children’s fertility and hormonal health. Our team works across disciplines, hospitals and programs to provide access to specialty medical services and the highest level of care.  

Our specialists are leaders in:

  • Fertility and reproductive medicine
  • Pediatric and adolescent gynecology
  • Hematology (blood disorders) and oncology 
  • Urology 

Why Choose Us?

The fertility preservation program at St. Louis Children’s Hospital offers:

  • Special expertise: Ranked one of the nation’s best hospitals by U.S. News & World Report, we are proud to provide the highest level of specialized care. 
  • Leading treatments: Our team offers the most advanced fertility preservation treatments available. We customize care to deliver the best treatment based on your child’s needs, age and development. 
  • Inclusive care: We’re here for everyone who wants to protect their fertility: 
    • Females and males
    • Babies, children, adolescents, teens and young adults
    • Patients at any stage of treatment 
    • People from every economic and social background 
  • One-on-one support: Our fertility preservation navigators are with you every step of the way, offering guidance and support. These dedicated nurses assist with questions, appointments, paperwork and insurance. We also coordinate care with your child’s medical team to ensure that everyone is on the same page.
  • Compassion in action: Our pediatric and adolescent gynecology team has particular expertise in caring for young female patients. These specially trained professionals put compassion into action to ease fears, manage discomfort and provide care tailored to your child’s age, emotional maturity and level of understanding. 

Who Is a Candidate for Fertility Preservation?

People who are about to begin or have already undergone treatments that affect fertility, development and hormonal health can benefit from fertility preservation. Treatments that can affect fertility include: 

  • Chemotherapy
  • Radiation therapy 
  • Hormone therapy
  • Bone marrow transplants 
  • Stem cell transplants 
  • Certain surgeries, including those for cancer and gender reassignment 

When Should I Discuss Fertility Preservation With My Doctor?

If you or your child recently received a diagnosis, you may feel overwhelmed by the information and decisions before you. Our departments work together to connect you to important care options, including fertility preservation. 

We recommend talking about fertility preservation as soon as possible — but it’s never too late to discuss options. Even if your child has already undergone a procedure such as chemotherapy, there are steps you can take to preserve fertility and development. 

Together, we will discuss: 

  • If and how treatments for cancer, blood diseases and other conditions affect fertility
  • Fertility preservation options
  • Risks, time frames and success rates of fertility preservation procedures
  • Which procedures can be done during or after treatment
  • Possible need for ongoing monitoring, lab tests, hormone replacement and sexual health support

Fertility Preservation for Females

We provide a wide range of options to help girls and women preserve their fertility. The best option for each person depends on their age, diagnosis, treatment plan, puberty status and unique challenges.

Fertility preservation procedures include:

Ovarian tissue freezing (ovarian tissue cryopreservation)

The surgeon removes an ovary or a portion of an ovary through a small incision in the abdomen. The fertility preservation team freezes and stores this tissue until the patient is ready to become pregnant. 

This procedure is the only option for girls who have not entered puberty. Teens and adults who have gone through puberty but need an immediate fertility preservation option are also candidates for this procedure. 

Egg freezing (oocyte cryopreservation)

Special drugs stimulate the ovaries to increase the production of egg cells (called oocytes). The fertility preservation team removes some egg cells, then freezes and stores them until ready for use. 

Teens, young adults and some adolescents are candidates for this procedure. 

Embryo freezing (embryo cryopreservation)

The fertility preservation team combines egg cells with sperm cells from a partner or donor. The team then freezes and stores the resulting embryo to be implanted later. 

Gonadotropin-releasing hormone (GnRH) therapy

Injections of certain hormones can put the body in a pre-puberty or “fake menopause” state. This therapy may offer protection against the fertility-damaging effects of some types of chemotherapy.

Ovarian transposition

A surgeon moves the ovaries away from radiation treatment field, the area that will be exposed to radiation. Most ovarian transpositions are minimally invasive procedures. 

Fertility Preservation for Males

We offer fertility preservation options to help boys and men preserve their fertility. The best option for each person depends on their age, diagnosis, treatment plan, puberty status and unique challenges.

Fertility preservation procedures include: 

Testicular tissue freezing (testicular biopsy cryopreservation)

A surgeon removes a portion of a testicle through a small incision. Our fertility preservation team then freezes and stores this tissue until ready for use. 

This option is the only fertility preservation method for boys who have not entered puberty. 

Sperm banking (semen cryopreservation)

Sperm cells are collected by self-stimulation or, for those who cannot provide a sample, testicular sperm extraction (TSE). During TSE, a provider collects sperm directly from the testes. 

Our fertility preservation team then freezes and stores (or “banks”) the sperm cells for later use. Sperm banking is the most common form of male fertility preservation. 

What to Expect

The first step is a consultation. We meet with you to talk about the diagnosis and how that affects future chances of having a child. We then review the options, process and next steps. Your fertility preservation navigator guides you through every step, offering help and support.

We offer world-class care to children thanks in part to generous gifts from hundreds of people who have joined us in making health care better for all children. This philanthropic support enables us to fulfill our mission to do what's right for kids.

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