Fertility in Hodgkin lymphoma survivors

Hodgkin lymphoma has high cure rates. Seventy per cent of patients are below age forty. Fertility can be an issue for survivors. In male patients infertility occurs more often and recovery takes longer after alkylating chemotherapy. 32 months after treatment FSH was elevated in 60% of patients treated with alkylating chemotherapy, versus 3-8% of patients treated with non-alkylating chemotherapy.

20% of females treated for Hodgkin lymphoma suffered premature ovarian failure versus 0.9% in the general population. One cycle of alkylating chemotherapy increases the risk by 50%. Every year of age extra at treatment start increases risk by 23%.

Hodgkin lymphoma survivors have children slightly less often than the general population. This small difference is only significant in women and in those who already had children before treatment.

Semen quality before treatment start is almost always sufficient for cryopreservation. Semen quality is poor in 7% of patients, with 3% azoospermia. Only in those patients cryopreservation is impossible.
Presence of cryopreserved semen doubled odds of post-treatment fatherhood. One in five children of male survivors after Hodgkin lymphoma were born using cryopreserved semen.