在过去的二十年中，癌症治疗的进步显着提高了生存率，特别是儿童癌症。尽管如此，由于许多癌症治疗方案具有性腺毒性，许多治疗方法仍存在降低未来生育潜力的巨大风险，这证明了针对儿童和成年癌症患者的生育力保存计划的合理性。为了确保提供生育力保存和治疗后不孕的实际机会之间的平衡，制定了指导方针。然而，鉴于许多癌症治疗计划的多方面方法不断发展，评估治疗后不孕的实际风险仍然具有挑战性。这篇综述讨论了过去 20 年癌症治疗的演变，并试图评估其对治疗后生育能力的影响。总体而言，癌症治疗方案已从广泛杀死快速分裂细胞转向更具针对性的治疗，总体上减少了附带损害。尽管在降低总体毒性方面已经取得了进展，但不幸的是，这并不会自动转化为降低性腺毒性。因此，当前的生育力保存计划仍然是癌症护理的重要组成部分。版权所有 © 2024 作者。由爱思唯尔有限公司出版。保留所有权利。

Over the past two decades, advances in cancer therapy have significantly improved survival rates, particularly in childhood cancers. Still, many treatments pose a substantial risk for diminishing future fertility potential due to the gonadotoxic nature of many cancer regimens, justifying fertility preservation programs for both childhood and adult cancer patients. To assure a balance between offering fertility preservation and actual chance of infertility post-treatment, guidelines are in place. However, assessing the actual risk of infertility after treatment remains challenging, given the multi-faceted approach of many cancer treatment plans, which are continuously evolving. This review discusses the evolution of cancer therapy over the past 20 years and attempts to assess their impact on fertility after treatment. Overall, cancer regimens have shifted from broadly killing fast dividing cells to more targeting therapies, reducing collateral damage in general. Although progress has been made to reduce overall toxicity, unfortunately this does not automatically translate to reduced gonadotoxicity. Therefore, current fertility preservation programs continue to be an important part of cancer care.Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.