1. What kinds of treatment can cause infertility?
Treatments for lymphoma include chemotherapy, radiotherapy and bone marrow or stem cell transplants. Each of these treatments can kill the sperms and eggs that are responsible for an individual's fertility. This can prevent the individual from being able to have children in the future.
2. Do all patients taking treatment develop infertility?
The chances of developing infertility depend on a number of treatment related factors:
Infertility after chemotherapy depends on the combination of drugs being used. Some drugs are more likely to cause infertility than others.
Radiation causes infertility if it is delivered to the pelvic or groin area. Radiation at other sites like the neck or chest does not cause infertility.
Bone marrow or stem cell transplant involves intense chemotherapy and is very likely to cause infertility.
3. Is it possible to calculate an individual's risk of becoming infertile?
Permanent infertility is not common after treatment, and it only occurs in the minority of patients.
The risk of infertility is a complex issue, depending on an individual's age, the previous fertility status, the exact treatment planned, and some yet unknown factors.
The consulting oncologist can give a fair idea of how toxic the planned treatment might be for an individual's reproductive cells, but the other factors may be difficult to measure.
4. Can a person regain fertility after a period of time?
A period of infertility immediately after treatment is quite common. Over time, however, the body's reproductive cells can recover themselves in some individuals.
It is possible and not uncommon for many patients to become able to produce children some years after lymphoma treatment. It is possible to get tested for this. Doctors can determine sperm counts and viability in men and ovulation in women.
5. Can the treatment plan be changed to preserve fertility?
The treatment plan for a particular stage of disease is determined by the highest chance of disease control and prolonging life.
To change the treatment plan in order to preserve fertility may compromise on treatment outcome, because the most appropriate combination of drugs or radiation may have to be omitted or replaced.
This is a step that cannot be taken lightly. You should discuss this very seriously with your oncologist before coming to a final decision.
6. Can steps be taken in advance to preserve reproductive cells?
Men can preserve their sperm and have it stored for future use. This is called 'sperm banking.' Stored sperm can be used later for artificial insemination procedures, which are routine and widely available. Most hospitals will offer men the option of sperm banking before cancer treatments.
Egg preservation for women may also be considered.