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Cancer Health Center

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Late Effects of Treatment for Childhood Cancer (PDQ®): Treatment - Patient Information [NCI] - Reproductive System


Testicular late effects are more likely to occur after treatment for certain childhood cancers.

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Treatment for these and other childhood cancers may cause testicular late effects:

Surgery, radiation and certain chemotherapy drugs increase the risk of late effects that affect the testicles.

The risk of health problems that affect the testicles increases after treatment with one or more of the following:

Late effects that affect the testicles may cause certain health problems.

Late effects of the testicles include the following:

  • Low sperm count: A zero sperm count or a low sperm count may be temporary or permanent. This depends on the radiation dose and schedule, the area of the body treated, and the age when treated.
  • Infertility: The inability to father a child.
  • Retrograde ejaculation: Very little or no semen comes out of the penis during orgasm.

After treatment with chemotherapy or radiation, the body's ability to make sperm may come back over time.


Ovarian late effects are more likely to occur after treatment for certain childhood cancers.

Treatment for these and other childhood cancers may cause ovarian late effects:

  • Hodgkin lymphoma.
  • Cancers treated with total-body irradiation (TBI) before a stem cell transplant.

Radiation to the abdomen and certain chemotherapy drugs increase the risk of ovarian late effects.

The risk of ovarian late effects may be increased after treatment with any of the following:

  • Chemotherapy with alkylating agents, such as cyclophosphamide, mechlorethamine, cisplatin, ifosfamide, lomustine, and especially procarbazine.
  • Radiation therapy to the abdomen or pelvis. In survivors who had radiation to the abdomen, the damage to the ovaries depends on the radiation dose, age at the time of treatment, and whether all or part of the abdomen received radiation.
  • Radiation therapy to the abdomen or pelvis together with alkylating agents.
  • Radiation therapy to the brain and spinal cord.
  • Total-body irradiation (TBI) before a stem cell transplant. In survivors who had TBI, the damage to the ovaries is greatest in survivors who had not reached puberty at the time of treatment.
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