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 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 of ovarian late effects include irregular or absent menstrual periods.
These symptoms may be caused by ovarian late effects:
- 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).
Other conditions may cause the same symptoms. 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.
The following methods may be used so that childhood cancer survivors can have children:
- Freezing the eggs or sperm before cancer treatment in patients who have reached puberty.
- Testicular sperm extraction (the removal of a small amount of tissue containing sperm from the testicle).
- Intracytoplasmic sperm injection (an egg is fertilized with one sperm that is injected into the egg outside the body).
- In vitro fertilization (IVF) (eggs and sperm are placed together in a container, giving the sperm the chance to enter an egg).
Children of childhood cancer survivors are not affected by the parent's previous treatment for cancer.