Table 4.

Suggested best practice model: plausible fertility preservation, protection, and restoration strategies for children with cancer

Cancer patients	Before anticancer therapy (fertility preservation)	During anticancer therapy (fertility protection)	After anticancer therapy and later after puberty (fertility restoration)
Childhood cancer (♀ & ♂) Leukemias, central nervous system cancers, lymphomas and sarcomas	- Freezing of gonadal tissue - In vitro maturation and vitrification of gametes (promising in research but not yet clinically proven in children) - Oophoropexy in case of female pelvic radiation - Artificial gonads technology (promising in research but not yet clinically proven)	- Gonadal shielding - Fractionation of chemo- and radiotherapy - GnRH analogs in case of peripubertal child (widely debated) - Neoadjuvant cytoprotective pharmacotherapy (promising in research but not yet clinically proven)	- IVF/ICSI of frozen in-vitro-matured gametes - Autotransplantation of frozen gonadal tissue (should be utilized with caution in leukemia) - Stem cells (promising in research but not yet clinically proven)