Delivery after bone marrow transplantation with total lymphoid irradiation for severe aplastic anemia

A 28-year old woman delivered a normal child at 85 months after bone marrow transplantation (BMT) for severe aplastic anemia (SAA). BMT was done after conditioning with cyclophosphamide (CY: 50 mg/kg/day for 4 days), anti-lymphocyte globulin (ALG: 50 mg/kg/day for 3 days) and total lymphoid irradiation (TLI: 5 Gy in a single fraction). Ovarian shielding was not done during irradiation. Six months after BMT, she gained normal menstruation spontaneously. Serum gonadotrophin levels were within the normal range, with an LH level of 34.6 mIU/ml (normal: 1-36 mIU/ml) and an FSH level of 13.4 mIU/ml (normal: 1-30 mIU/ml), at 38 months after BMT. She became pregnant 8 years after BMT and delivered a female child, who is now 3 years old and shows normal development.