Background. Survival from cancer continues to improve. Antimitotic therapy can induce failure of spermatogenesis
and oogenesis, gonadal disturbances and infertility. Recent advances in reproductive medicine have opened
opportunities for the preservation of reproductive potential of patients with cancer. The aim of our study was to
analyse by a multidisciplinary team the contemporary state of art and proposal of the Czech model of fertility
preservation starting in childhood and continuing through the whole reproductive period.
Methods. This paper highlights the problems associated with gonadal failure as a consequence of therapy for
malignancy in childhood, adolescence and adulthood. Analysis of these problems served as a principle for the
management strategy for fertility preservation.
Conclusions. Patients undergoing treatment for malignancy are at the high risk of gonadal damage and infertility.
Therefore, alternative treatmentswith less gonadal toxicity and different treatment protocolswere evaluated. Fertility
can be preserved with the freezing and banking of spermatozoa, embryos, and oocytes obtained prior to the cancer
treatment. In female patients (starting in puberty) pharmacological preservation of gonads with gonadoliberin
analogues is also possible. Chance for the future fertility preservation for children offers freezing and thawing of
primordial follicles and spermatozoa obtained during the gonadal biopsies. Long-term follow-up study by a multidisciplinary
medical team is necessary.
cancer, chemotherapy, radiotherapy, fertility preservation.