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


The risk may also be greater in survivors who were age 13 to 20 years at the time of treatment.

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

Ovarian late effects include the following:

  • Early menopause, especially in women who had their ovaries removed or were treated with both an alkylating agent and radiation therapy to the abdomen.
  • Changes in menstrual periods.
  • Infertility (inability to conceive a child).
  • Puberty does not begin.

Possible signs and symptoms of ovarian late effects include irregular or absent menstrual periods and hot flashes.

These and other signs and symptoms may be caused by ovarian late effects or by other conditions:

  • Irregular or no menstrual periods.
  • Hot flashes.
  • Night sweats.
  • Trouble sleeping.
  • Mood changes.
  • Lowered sex drive.
  • Vaginal dryness.
  • Inability to conceive a child.
  • Sex traits, such as developing arm, pubic, and leg hair or having the breasts enlarge, do not occur at puberty.
  • Heart disease.
  • Osteoporosis (weak or thin bones that can break easily).

Talk to your child's doctor if your child has any of these problems.

Fertility and reproduction

Treatment for cancer may cause infertility in childhood cancer survivors.

The risk of infertility increases after treatment with the following:

  • In boys, treatment with radiation therapy to the testicles.
  • In girls, treatment with radiation therapy to the pelvis, including the ovaries and uterus.
  • Radiation therapy to brain and spinal cord or lower back.
  • Total-body irradiation (TBI) before a stem cell transplant.
  • Chemotherapy with alkylating agents, such as cyclophosphamide and procarbazine.
  • Surgery, such as the removal of a testicle or an ovary or lymph nodes in the abdomen.

Childhood cancer survivors may have late effects that affect pregnancy.

Late effects on pregnancy include increased risk of the following:

  • High blood pressure.
  • Miscarriage or stillbirth.
  • Low birth-weight babies.
  • Early labor and/or delivery.
  • Delivery by Cesarean section.
  • The fetus is not in the right position for birth (for example, the foot or buttock is in position to come out before the head).

There are methods that may be used to help childhood cancer survivors have children.

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