Support Care Cancer. 2025 Dec 27;34(1):57. doi: 10.1007/s00520-025-10284-4.
ABSTRACT
BACKGROUND: With improved survival in pediatric cancers, late effects such as reproductive dysfunction and infertility have emerged as a major concern. Oncofertility services remain underdeveloped in India, particularly in public sector institutions. We aimed to evaluate reproductive function and fertility preservation practices in childhood cancer survivors (CCS) attending a tertiary care center in India.
METHOD: This was a cross-sectional study of CCS enrolled at the Pediatric Cancer Survivor Clinic of AIIMS, New Delhi, between January 2022 and December 2024. Survivors ≥ 8 years of age with prior gonadotoxic therapy were included. Hormonal assays, semen analysis, and ovarian reserve evaluations were conducted. Interventions were offered based as indicated.
FINDING: The cohort included 87 males and 45 females, mostly treated for hemato-lymphoid malignancies. Hypogonadism was identified in 76.3% of males based on low testosterone, and azoospermia in 50% of those tested. Among females, 56.8% of those tested had low anti-Müllerian hormone (AMH) levels, and 62.5% of those tested had reduced antral follicle count. Despite high-risk features, fertility preservation uptake was poor. Only five females received hormone replacement therapy. Cultural barriers and financial constraints were major deterrents.
CONCLUSION: There is a high burden of reproductive dysfunction among Indian CCS, with significant gaps in fertility preservation. Early integration of oncofertility services within oncology care is feasible and essential. Structured, multidisciplinary models and non-governmental organization (NGO) support can help bridge current gaps in LMICs.
PMID:41455091 | DOI:10.1007/s00520-025-10284-4
