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The effects of children's cancer therapy on female reproductive function depend on many factors, including the person's age at the time of cancer therapy, the specific type and location of the cancer, and the treatment that was given. It is important to understand how the ovaries and female reproductive organs function and how they may be affected by therapy given to treat cancer during childhood.
Chemotherapy of the "alkylator" type (such as cyclophosphamide, nitrogen mustard, and busulfan) is most likely to affect ovarian function. The total dose of alkylators used during cancer treatment is important in determining the likelihood of ovarian damage. With higher total doses, the likelihood of damage to the ovaries increases. If treatment for children's cancer included a combination of both radiation and alkylating chemotherapy, the risk of ovarian failure may be increased.
If a woman does NOT have monthly menstrual periods, or if she has monthly menstrual periods ONLY with the use of supplemental hormones, or if she had to take hormones in order to enter or progress through puberty, she is likely to be infertile.
Women who had surgical removal of both ovaries will be infertile.
Females who have had any cancer treatments that may affect ovarian function should have a yearly check-up that includes careful evaluation of menstrual history, hormonal status, and progression through puberty. Blood may be tested for hormone levels (FSH, LH, and estradiol). If any problems are detected, a referral to an endocrinologist (hormone specialist) and/or other specialists may be recommended. For women with ovarian failure, a bone density test (special type of X-ray) to check for thinning of the bones (osteoporosis) may also be recommended.