Survival rates for children and adolescents diagnosed with malignancy have been
steadily increasing due to advances in oncology treatments. These treatments
can have a toxic effect on the gonads. Currently, oocyte and sperm
cryopreservation are recognized as well-established and successful strategies
for fertility preservation for pubertal patients, while the use of gonadotropinreleasing
hormone agonists for ovarian protection is controversial. For
prepubertal girls, ovarian tissue cryopreservation is the sole option. However,
the endocrinological and reproductive outcomes after ovarian tissue
transplantation are highly heterogeneous. On the other hand, immature
testicular tissue cryopreservation remains the only alternative for prepubertal
boys, yet it is still experimental. Although there are several published guidelines
for navigating fertility preservation for pediatric and adolescent patients as well as
transgender populations, it is still restricted in clinical practice. This review aims
to discuss the indications and clinical outcomes of fertility preservation. We also
discuss the probably effective and efficient workflow to facilitate
fertility preservation.