Phd ceremony Ms. M.A.E. van der Kaaij: Fertility in Hodgkin lymphoma survivors

Hodgkin lymphoma has high cure rates. Seventy per cent of patients are younger than forty and (in)fertility can be an issue for these 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 the patients who were treated with alkylating chemotherapy, versus 3-8% of patients treated with non-alkylating chemotherapy.Twenty percent of the 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 the beginning of the treatment increases the 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 prior to treatment is almost always sufficient for cryopreservation. Semen quality is poor in 7% of patients, with 3% azoospermia. Only in those patients cryopreservation is impossible. Our studies indicated that the presence of cryopreserved semen doubled the odds of post-treatment fatherhood. One in five children of male survivors after Hodgkin lymphoma were born using cryopreserved semen.