Fertility Preservation for Kids Is Now an Option in Ontario

When doctors sat down with 12-year-old Chloe Dixon to talk about treating a rare and aggressive soft-tissue cancer, they raised something her family had not thought to ask about. Whether she might want children one day, and what could be done now to keep that door open.

Chloe, who is from Fort Good Hope in the Northwest Territories, was diagnosed last summer with rhabdomyosarcoma and has been treated in Toronto since. As CBC News reports, her care team offered her something young patients have rarely been offered before, and fertility preservation for kids is now a real conversation at the point of diagnosis rather than a regret twenty years later.

What should families know about how treatment affects fertility?

Understanding how treatment affects fertility starts with a fact of biology. A person born with ovaries has a fixed number of eggs at birth, and that number falls naturally over a lifetime. Chemotherapy, radiation and some surgeries can speed that decline sharply, which is what Dr. Kriti Kumar, a pediatric oncologist at SickKids who co-leads the fertility preservation program, explained to CBC.

The practical consequence is that a girl treated at ten can reach menopause in her twenties or thirties, long before she has had any reason to think about it. Adults facing the same treatments can freeze mature eggs first. Children cannot, because the eggs are not mature yet, and for a long time that meant the choice simply disappeared.

What does ovarian tissue freezing actually involve?

The route now open to younger patients is ovarian tissue freezing, known clinically as ovarian tissue cryopreservation. Surgeons remove one ovary, and the tissue is processed, frozen and stored. If the patient later wants to try for a pregnancy, that tissue can be surgically reimplanted, where it re-establishes a blood supply and can resume working.

It is offered through a collaboration between The Hospital for Sick Children and Mount Sinai Fertility in Toronto, first reported by the Toronto Star. Because it needs no hormone stimulation first, it can happen quickly, which matters when treatment cannot wait.

How new are these fertility options for young patients in Canada?

New enough that the story is still being written. The Ontario program launched in late 2023 and has since helped more than 50 patients, about half of them children and teens, while fewer than 20 young patients have had the procedure through the SickKids program specifically. No patient in the province has had tissue reimplanted yet, and surgeons are still training for that step.

That is the honest state of these fertility options for young patients in Canada, and it is why the conversation happens early, soon after diagnosis, with as much time as the family can be given. Access is uneven, since some elements are covered by provincial funding or hospital budgets and others are not, so fertility preservation for kids is not yet a standard offer from coast to coast. Kumar frames the wider shift plainly, which is that as survival rates climb, the job is no longer only to cure children but to hand them a full life afterwards. That thinking is showing up across the field, in treatments like a vaccine built from a patient's own tumour and in the follow-up that comes long after the last appointment. It reaches past the physical too, now that teen mental health in Ontario is tracked with something close to the seriousness once reserved for survival rates. Access remains the harder half, and any family who has waited months for an ultrasound already understands why.

What else do families ask about preserving fertility before treatment?

Who can be offered fertility preservation before treatment starts in Canada?

Eligibility depends on the diagnosis, the planned treatment and the child's clinical stability, and it is assessed by the treating team. The Ontario program has no age restriction, and referrals run through the treating hospital. Ask the oncologist directly, since fertility preservation for kids is not offered everywhere in the country.

How soon after diagnosis does the conversation need to happen?

As early as possible. The procedure works best before chemotherapy or radiation begins, so teams try to raise it within days of diagnosis. Families describe feeling overwhelmed at that moment, which is normal and expected, and the team can walk through the decision more than once.

Is ovarian tissue freezing covered in Ontario?

Some elements of fertility preservation are covered through provincial funding or hospital budgets, and others are not, which creates real differences in access between families and between provinces. Ask the hospital's fertility preservation team for a written breakdown of what is covered before consenting.

What are the questions to ask the care team next?

The takeaway for any family facing a diagnosis is that the questions to ask the care team now include fertility, even when the patient is a child, and the topic feels years too early. Ask whether treatment carries a fertility risk, whether preservation is available locally or by referral, and what it costs.

If you need care of any kind while you sort through it, you can find doctors and specialists near you or read more on the Medimap Health Hub.

This article is general health information and is not medical advice. It cannot diagnose or treat any condition. For personal advice, speak to a doctor, nurse practitioner or pharmacist. In an emergency, call 911.