Defining the whole of reproductive health in adolescent and young adult cancer populations: fertility is only one piece of the puzzle

SUMMARY Quality of life is an important but distinct issue for adolescent and young adults (AYA) compared with older adults. Reproductive health is a key aspect of health-related quality of life and spans across physiological and psychological domains. While fertility issues have had more attention in the past 5 years, there are other aspects of reproductive health requiring recognition by healthcare practitioners in AYA oncology. These include attention to human papillomavirus and sexually transmitted infection risk, contraception and sexual health in relation to late effects of cancer and treatment. Alkylating agents in chemotherapy, total-body radiation or external-beam radiation in a field that includes the ovaries, testes or endocrine system may cause long-term impairment to reproductive health functioning. We examine reproductive health in relation to National Comprehensive Cancer Network and American Academy of Pediatrics guidelines for AYA cancer survivors in the USA. While fertility preservation ...