Children who had only chemotherapy during the conditioning regimen usually have normal sexual development, though not always. Those who had total body irradiation, however, are particularly at risk for delayed puberty. (The incidence is lower if the radiation was given in several smaller doses.) All children treated by transplantation should be followed closely by a pediatric endocrinologist, who can prescribe hormones (testosterone for boys, estrogen and progesterone for girls) to assist in normal pubertal development. Girls are more likely to need hormonal replacement; boys usually produce testosterone but not sperm.
Children who receive total body radiation usually (but not always) become sterile; that is, after growing up, girls will not be able to become pregnant, nor will boys be able to father children. Ability to have a normal sex life is not affected. Some children treated only with chemotherapy have remained fertile, and to date all offspring have been healthy. Teenaged boys may want to bank sperm prior to beginning their conditioning regimen. The banking of eggs is more experimental and takes a much longer time to accomplish; therefore, it is performed infrequently.
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