Optimizing Options for Future Third-Party Reproduction Among Youth Newly Diagnosed With Cancer: Considerations for Pediatric Fertility Preservation Counseling

Abstract

Children with cancer are at-risk for infertility, yet most desire biological parenthood. Fertility preservation is available for pre- and postpubertal patients, with tissues typically banked for autologous use. Some survivors require third-party reproduction (TPR) but do not complete the Food and Drug Administration (FDA)-required donor eligibility steps when banking their reproductive materials. This article reviews medical and nonmedical factors associated with TPR, FDA regulatory requirements, risks of non-compliance, and recommendations for facilitation in the pediatric oncology setting. Challenges, opportunities, and clinical decision trees for discussing TPR during pediatric fertility consultations are presented, emphasizing collaboration with adult reproductive clinics to support survivors’ long-term reproductive goals.