How treatment for NHL might affect your fertility
Many couples have had healthy babies after one of them has been treated for NHL. Unfortunately, some treatments for NHL, 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 clear about your treatment and its possible effect on fertility.
Sometimes it’s 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 later. Your doctor or nurse will have more information about this.
Robert explains his experience of fertility treatment before he started treatment for Hodgkin lymphoma.
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’s 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 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. Your treatment will need to be delayed for several weeks while the eggs are collected. Your specialist will be able to advise you about any potential risk in delaying treatment.
It’s sometimes possible to store unfertilised eggs so that they can be fertilised and re-implanted when needed. However, this is much less successful than storing fertilised eggs and not widely available. Research is looking at whether it’s possible to remove and store ovarian tissue, and re-implant it after your treatment has finished, but this is still experimental.
If you are infertile, it may be possible to have infertility treatment (IVF) with donor eggs, so that you and your partner can have a child.
Coping with infertility
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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.
Some people find it easier to talk to someone outside their immediate circle. In this case you may find it helpful to talk to your doctor, nurse, social worker or a trained counsellor. We have a list of useful organisations who may be able to help.