News | Study: Women Treated for Hodgkin Lymphoma in Childhood May Experience Earlier Fertility Decline
At the 39th Annual Meeting of the European Society of Human Reproduction and Embryology (ESHRE), Dr. Katja Drechsel of the Princess Máxima Center for Pediatric Oncology in Utrecht and Amsterdam UMC presented research showing that women treated for Hodgkin lymphoma in childhood may face reduced fertility. Their fertility may begin declining at a younger age, and they may take longer to conceive.
Study details and findings
The study included 84 women with an average age of about 30 who had been treated for Hodgkin lymphoma at an average age of 13, along with 798 healthy women who had not received such treatment. Questionnaires, blood tests, and ultrasound scans were used to compare reproductive history and fertility markers.
Fertility markers: Treated women were more likely to have abnormal levels of three blood markers—anti-Müllerian hormone, follicle-stimulating hormone, and inhibin B—and had significantly fewer ovarian follicles.
Time to pregnancy: Hodgkin lymphoma survivors were 2.5 times as likely as controls to try for one year or longer before their first pregnancy.
Reproductive outcomes: Despite some reduced fertility, pregnancy and live birth rates were similar between the groups. Treated women had their first child at an average age of 27, respectively 2 and 3 years younger than controls and the general population of Dutch women.
Expert perspective
Dr. Drechsel said: “Hodgkin lymphoma is a cancer that affects children and adolescents. Although treatment advances have greatly improved survival, chemotherapy and radiotherapy can have long-term effects, including reduced fertility. Our study shows that women treated for Hodgkin lymphoma in childhood may experience fertility decline earlier than other women. Encouragingly, most who chose to have children still became pregnant and had their first child earlier, perhaps because doctors had informed them in advance about the potential effect of treatment on fertility.”
Dr. Drechsel emphasized that many participants received treatment used in the 1970s and 1980s, while modern therapies may have less effect on fertility. Her team plans long-term follow-up and a larger prospective study across five European countries to assess the fertility effects of current treatments.
Further significance
ESHRE Chair Professor Carlos Calhaz-Jorge of Centro Hospitalar Universitário Lisboa Norte in Portugal commented: “This study offers some reassurance to women treated for Hodgkin lymphoma in childhood. Although they face a potential risk of reduced fertility, most who tried to conceive became pregnant. However, these women are generally young, and some have not yet considered having children. Longer follow-up is needed to assess the full long-term effects of treatment.”
He also noted that female childhood cancer survivors should understand how treatment may affect fertility so they can plan earlier or consider fertility preservation such as egg freezing.
News | Study: Women Treated for Hodgkin Lymphoma in Childhood May Experience Earlier Fertility Decline
News | Study: Women Treated for Hodgkin Lymphoma in Childhood May Experience Earlier Fertility Decline
At the 39th Annual Meeting of the European Society of Human Reproduction and Embryology (ESHRE), Dr. Katja Drechsel of the Princess Máxima Center for Pediatric Oncology in Utrecht and Amsterdam UMC presented research showing that women treated for Hodgkin lymphoma in childhood may face reduced fertility. Their fertility may begin declining at a younger age, and they may take longer to conceive.
Study details and findings
The study included 84 women with an average age of about 30 who had been treated for Hodgkin lymphoma at an average age of 13, along with 798 healthy women who had not received such treatment. Questionnaires, blood tests, and ultrasound scans were used to compare reproductive history and fertility markers.
Fertility markers: Treated women were more likely to have abnormal levels of three blood markers—anti-Müllerian hormone, follicle-stimulating hormone, and inhibin B—and had significantly fewer ovarian follicles.
Time to pregnancy: Hodgkin lymphoma survivors were 2.5 times as likely as controls to try for one year or longer before their first pregnancy.
Reproductive outcomes: Despite some reduced fertility, pregnancy and live birth rates were similar between the groups. Treated women had their first child at an average age of 27, respectively 2 and 3 years younger than controls and the general population of Dutch women.
Expert perspective
Dr. Drechsel said: “Hodgkin lymphoma is a cancer that affects children and adolescents. Although treatment advances have greatly improved survival, chemotherapy and radiotherapy can have long-term effects, including reduced fertility. Our study shows that women treated for Hodgkin lymphoma in childhood may experience fertility decline earlier than other women. Encouragingly, most who chose to have children still became pregnant and had their first child earlier, perhaps because doctors had informed them in advance about the potential effect of treatment on fertility.”
Dr. Drechsel emphasized that many participants received treatment used in the 1970s and 1980s, while modern therapies may have less effect on fertility. Her team plans long-term follow-up and a larger prospective study across five European countries to assess the fertility effects of current treatments.
Further significance
ESHRE Chair Professor Carlos Calhaz-Jorge of Centro Hospitalar Universitário Lisboa Norte in Portugal commented: “This study offers some reassurance to women treated for Hodgkin lymphoma in childhood. Although they face a potential risk of reduced fertility, most who tried to conceive became pregnant. However, these women are generally young, and some have not yet considered having children. Longer follow-up is needed to assess the full long-term effects of treatment.”
He also noted that female childhood cancer survivors should understand how treatment may affect fertility so they can plan earlier or consider fertility preservation such as egg freezing.
Source:
Collected online