Fertility preservation methods in children with the risk of female hypogonadism – possibilities and limitations

Cancer diseases and their treatment, genetic diseases, metabolic and autoimmune disorders, hormonal treatment of transgender people with assigned female sex can lead to early female hypogonadism and ultimately to infertility. Diagnosis of hypothalamic-pituitary-ovarian axis failure is based on hormonal tests (anti-Müllerian hormone, follicle-stimulating hormone, luteinizing hormone, sex hormones) and imaging studies (ultrasound, magnetic resonance imaging), but methods for predicting the loss of gonadal function require further refinement. From the patient’s perspective, it is important to ensure the possibility of preserving material for use in possible future assisted reproduction procedures. Currently, the only technique that works well in prepubertal girls is ovarian tissue cryopreservation (OTC).

The aim of this work is to analyze current methods of preserving fertility in girls and adolescents, their indications, limitations and directions of development.

A review of the literature was done using the following keywords: children, adolescents, fertility preservation and studies published between 2020 and 2025. Included were meta-analyses, clinical trials, and systematic reviews.

The most advanced method for girls remains OTC, with over 200 documented births, including after prepubertal procedures. Gonadal reserve assessment is based on hormonal tests and imaging.

Fertility preservation in children requires an interdisciplinary approach, early diagnosis, and further development of techniques. Establishing standardized procedures and ensuring equal access to care are essential.