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Abstract: Female childhood cancer survivors are at much higher risk of premature menopause (a.k.a. primary ovarian insufficiency - POI), which causes infertility and the accompanied wide range of post-menopausal symptoms. To counsel survivors, accurate risk estimates at different ages are needed. In this talk, I will discuss our recently completed study where we used data from 7891 participants in the childhood cancer survivors study to develop and 1349 survivors in the St Jude Life study (SJLIFE) to externally validate prediction algorithms based on age-specific logistic regression and XGBoost, as well as the added contributions of relevant polygenic risk scores (PRSs). Given cancer diagnosis and treatment information, these POI risk prediction algorithms perform excellently (AUROCs ranging from 0.91-0.96 in SJLIFE) and can inform decisions regarding fertility preservation interventions among female childhood cancer survivors.