How treatment for Hodgkin lymphoma might affect your fertility

Many couples have had healthy babies after one of them has been treated for Hodgkin lymphoma.

Unfortunately, however, some treatments for Hodgkin lymphoma, and sometimes the lymphoma itself, can cause infertility. Your doctor or specialist nurse will talk to you about this before you start your treatment. If you have a partner, you may find it helpful to see the doctor together so that you can both discuss any fears or worries that you may have.

Some precautions can be taken to reduce the risk of infertility. If men have radiotherapy| to the abdominal area, a lead shield may be able to protect the testes. In women it is sometimes possible to move the ovaries out of the treatment area by an operation before radiotherapy begins.

Some combinations of chemotherapy| drugs do not cause infertility. With some drugs, however, the risk of either temporary or permanent infertility is high.

As your doctor knows the exact type of treatment you are having, they are the best person to answer your questions about fertility. Make a list of any questions you have so you can be sure you are clear about your treatment.

Men

Sometimes it is possible for men to store sperm before starting treatment. Parents of teenage boys should also be aware of this so that, if possible, sperm can be stored for use in later years.

Women

Most women find that their menstrual periods stop or become irregular during treatment. The periods may return to normal once the treatment is over, so it is very important to continue to use contraception during and after your treatment. The nearer a woman is to her natural menopause, the more likely it is that chemotherapy will stop her periods permanently. Women whose periods stop can be given hormone replacement therapy (HRT). This does not restore fertility, but it prevents the possible development of menopausal symptoms. Menopausal symptoms can include hot flushes, dry skin, low sex drive, and dryness of the vagina which can make sex uncomfortable.

It may be possible to store fertilised eggs (embryos), with the chance of re-implanting them later. This could be worth considering if you and your partner want a child, and you are going to have chemotherapy which is likely to affect your fertility. For this to be possible, the lymphoma needs to be at a stage where the treatment can be delayed for several weeks while the eggs are collected and fertilised. Research is going on into storing unfertilised eggs or ovarian tissue, which contains immature eggs, hoping at some time in the future to be able to help women conceive. However, this research is still at an early, experimental stage and is not widely available.

Coping with infertility

If chemotherapy has made you infertile, it can be very difficult to come to terms with the fact that you can no longer have children. You may feel that you have lost a part of your identity. Talking about your feelings with your partner, family or a close friend can help to clarify your thoughts and give the people close to you the opportunity to understand how you are feeling.

If it would be easier for you to talk to someone outside your immediate circle, you may find it helpful to talk to your doctor, nurse, social worker or a trained counsellor.