Recent advances in cancer therapy have given many patients hope and have lead to survival rates of approximately 70% treatments such as radiation, chemotherapy and surgery may have life altering implication. For women and men of reproductive age, cancer therapies can often lead to ovarian damage and premature menopause both of which can have significant impact on current and future fertility.Thanks to significant advances in reproductive medicine, there are technologies now available that can help to preserve fertility prior to undergoing cancer treatment. The decision to preserve fertility in the face of cancer is difficult. Decisions regarding the timing of cancer treatment and disposition of the eggs or embryos, should the patient not regain the health needed to carry a pregnancy, are never easy and require the support of family and friends and the expertise of a wide range of health care specialistsFertility PRESERVATION options in male patients: Sperm cryoPRESERVATION. Sperm cryoPRESERVATION is effective, and oncologists should discuss sperm banking with appropriate patients, it is strongly recommended that sperm are collected prior to initiation of treatment because the quality of the sample and sperm DNA integrity may be compromised even after a single treatment session. Although planned chemotherapy may limit thenumber of ejaculates, intracytoplasmic sperm injection allows the successful freezing and future use of a very limited amount of sperm.Hormonal gonadoprotection Hormonal therapy in men is not successful in preserving fertility when highly sterilizing chemotherapy is administered.Other consideration Men should be advised of a potentially higher risk of genetic damage in sperm stored after initiation of therapy. Testicular tissue or spermatogonial cryoPRESERVATION and transplantation or testis xenografting have not yet been tested successfully in humans. Of note, such approaches are also the only methods of fertility PRESERVATION potentially available to prepubertal boys.Fertility PRESERVATION options in female patients: Embryo cryoPRESERVATION. Embryo cryoPRESERVATION is considered an established fertility PRESERVATION method because it has routinely been used for storing surplus embryos after in vitro fertilization. Approximately 2 weeks of ovarian stimulation with daily injections of follicle stimulating hormone is required as must be started whiten the first 3 days of menstrual cycle. CryoPRESERVATION of unfertilized oocytes CryoPRESERVATION of unfertilized oocytes is an option particularly for patients without a partner of those with religious or ethical objections to embryo freezing. Ovarian stimulation is required as described in the preceding section. Oocyte cryoPRESERVATION should be performed only in centers with the necessary expertise.Ovarian tissue cryoPRESERVATION ovarian tissue cryoPRESERVATION and transplantation procedures should be performed only in centers with the necessary expertise under scientific approved protocols that include follow-up for recurrent cancer. A concern with reimplanting ovarian tissue is the potential for reintroducing cancer cells, although in fewer than 20 procedures reported thus far, there are no reports of cancer recurrence.Ovarian suppression currently, there is insufficient evidence regarding the safety and effectiveness of gonadotropin releasing hormone analogs and other means of ovarian suppression on fertility PRESERVATION. Women interested in this technique are encouraged to participate in clinical trials.Ovarian transposition Ovarian transposition (oophoropexy) can be offered when pelvic radiation is administered as cancer treatment because of the risk of remigration of the ovaries, this procedure should be performed as close to the radiation treatment as possible.Conservative gynecologic surgery It has been suggested that radical trachellectomy be restricted to stage IA2-IB disease with diameter less than 2 cm and invasion less than 10 mm. in the treatment of other gynecologic malignancies, interventions to spare fertility have generally centered on doing less-radical surgery and/or lower-dose chemotherapy with the intent of sparing the reproductive organs as much as possible.Other considerations Of special concern in breast and gynecologic malignancies is the possibility that fertility PRESERVATION interventions and/or subsequent pregnancy may increase the risk of cancer recurrence. Although several studies have not shown a decrement in survival or an increase in risk of breast cancer recurrence with pregnancy, the studies are all limited by significant biases, and concerns remain for some women and their physicians. Fertility PRESERVATION methods are still applied relatively infrequently in the cancer population, limiting greater knowledge about success and effects of different potential interventions. Other than risk of tumor recurrence, less attention is paid to the potential negative effects (physical and psychological) of fertility PRESERVATION attempts. Despite the facts that considered before, and other uncertainties in this despite the facts that considered before, and other uncertainties in this regard, cancer patients should be informed of options for fertility PRESERVATION and future reproduction prior to cancer treatment and this is not fully possible except by cooperation of cancer specialists, fertility specialist and the patients.