The survival rate for children and adolescents with cancer has improved dramatically in recent years,so that increasing numbers of successfully treated children and adolescents are growing up into adults.One estimate is that they represented 1 in 900 people aged 15-44 in the United States in 2000.Among the many concerns of these young people as they grow up is their fertility.Survivors of childhood and adolescent cancer are subfertile. A large study (the five centre study) of survivors treated between 1945 and 1975 showed an adjusted relative fertility in survivors of 0.85 (95% confidence interval 0.78 to 0.92) compared with that of their siblings.4 The adjusted relative fertility of male survivors (0.76, 0.68 to 0.86) was slightly lower than that of female survivors (0.93, 0.83 to 1.04). The most dramatic declines in relative fertility rates were in male survivors who had been treated with alkylating agents, with or without infradiaphragmatic irradiation.
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