Infertility After Lymphoma and Leukemia Treatment

Do you have a lot of questions about infertility after cancer treatment? The possibility of becoming infertile is a distressing issue for people suffering from cancer. Many people with lymphoma or leukemia are young and wish to preserve their fertility. Check out these answers and take notes so you can talk to your healthcare provider. Becoming a parent after cancer has worked for many people, but planning ahead can help.


What Kinds of Treatment Can Cause Infertility?

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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.

But that doesn't mean there aren't options! Only that planning ahead can be important.


Do All Patients Taking Treatment Develop Infertility?

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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, and combination chemotherapy is more likely to cause infertility than single medications.

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 peripheral blood stem cell transplants involve intense chemotherapy and are very likely to cause infertility.


Is It Possible to Calculate an Individual's Risk of Becoming Infertile?

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Permanent infertility is not common after the treatment, and it only occurs in a 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.

Your consulting oncologist can give you a fair idea of how toxic the planned treatment might be for your reproductive cells, but the other factors may be difficult to measure.


Can a Person Regain Fertility After a Period of Time?

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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. Healthcare providers can determine sperm counts and viability in men and ovulation in women.


Can the Treatment Plan Be Changed to Preserve Fertility?

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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.


Can Steps Be Taken in Advance to Preserve Reproductive Cells?

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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. Women can also freeze their eggs.

Freezing embryos is an option for some, though this can be a problem for those who aren't ready to take that step. 

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  • American Society of Clinical Oncology. Cancer.Net. Having a Baby After Cancer: Fertility Assistance and Other Options.

By Indranil Mallick, MD
 Indranil Mallick, MD, DNB, is a radiation oncologist with a special interest in lymphoma.