Posted: October 10, 2018

Now that most people with Hodgkin’s Disease, or as it is now called, Hodgin’s Lymphoma — a type of lymphatic cancer —  are cured with chemotherapy, with or without radiation,  investigators are taking another look at preservation of fertility.  The conventional wisdom has been that men who are treated go through a period of decreased sperm production, but that this usually recovers.  With women, the story has been more complicated and harder to evaluate, at least in part because there is no equivalent to sperm count that can easily be measured.  Since a greater percentage of women put off child bearing, often with associated difficulties in fertility, this issue is possibly even more complex.

A recrent study published in Lancet Oncology (a spinoff journal of the very old Lancet) addresses this concern.  Click here for the article. The authors looked at surrogate markers of fertility (blood tests looking at ovarina function rather than actual pregnancy).  The authors looked at women treated with standard chemotherapy and also intensive chemo, reserved for women at the highest risk of dying of the disease.  Here is what they found.

Most women had a brief fall in ovarian function regardless of chemo.  Women younger than 35 recovered promptly after standard chemo, but onlysome of those treated with intensive chemo recovered.  Women over 35 had a much more difficult time recovering ovarian function regardless of chemo.  No attempt was made to stimulate ovarian function with hormone shots.

Dr. Stark comments: there is no free lunch in cancer therapy.  Women over 35 who get HD and wish to have children should consider egg (oocyte) preservation for later use.