Survivors of cancer in childhood have a higher risk of infertility in later life. This is the conclusion reached by Magdalena Balcerek and her co-authors in a study published in Deutsches Arzteblatt International (Dtsch Arztebl Int 2012; 109[7] 126-31).

In a nationwide German survey on infertility after treatment for cancer in childhood and adolescence, the authors collected data from former pediatric oncology patients. Of the 2754 participants, 1476 had been treated for leukemia and 1278 for solid tumors. Altogether, 210 of these former patients had opted to have their fertility tested.

Infertility was suspected in 30% of them. In one subgroup 23% of the responders stated that they and their partner had failed to conceive a child despite at least 24 months of unprotected intercourse, thus fulfilling the World Health Organization's definition of infertility.

In a second investigation, the Berlin hormone testing and sperm analysis study, 201 survivors of childhood cancer consented to fertility testing. Infertility was suspected in a quarter of them.

On the basis of these findings, the authors conclude that patients and/or their parents should be informed about possible fertility-preserving measures before commencement of treatment.