Fertility Preservation in Pediatric Oncology: Results of a Single-Center Retrospective Study (2000–2018)

<b>Background/Objectives</b>: With increasing survival rates in pediatric oncology, late effects, such as therapy-induced infertility, are becoming more relevant. This study evaluated the management of fertility preservation in children and adolescents with cancer at the Medical University Innsbruck between 2000 and 2018. <b>Methods</b>: In this retrospective monocentric study, 552 patients (0-17 years) receiving chemotherapy were analyzed. Data was extracted from the Clinical Information System and the cryopreservation database. The assessed main variables included pubertal status, sex hormone levels, and use of fertility preservation methods. <b>Results</b>: Fertility preservation was documented in 6.5% of patients, more frequently in males (8.9%) than females (3.2%). Sperm cryopreservation was performed in twenty-eight males, ovarian tissue cryopreservation in six females, and oocyte cryopreservation in three. Pubertal status at diagnosis was recorded in 4.9% of patients and hormone levels in 29.7%. <b>Conclusions</b>: The findings highlight significant gaps in systematic fertility preservation, particularly in female patients. Consistent assessment of pubertal and hormonal parameters at diagnosis is essential to inform decision-making. Standardized procedures and closer interdisciplinary collaboration are needed to ensure equitable access to fertility preservation and safeguard long-term quality of life.