Finding a partner and having a family is an important aspiration in people’s lives. Nevertheless, for many cancer survivors, this goal is unattainable due to the impact on their fertility from their cancer therapy. Others may be worried that their cancer history may have an impact on the health of their future children. In my 10 years working with survivors of pediatric cancer, the inability to have children is the most devastating of all late effects of treatment. Very few of my survivors worry about the long term effects on their heart or kidneys, even when they are already experiencing organ dysfunction. But most of them worry about their ability to have children, even those who did not have any therapy that would impair their fertility.