Many couples go on to have normal healthy babies after one or other partner has been treated for lymphoma.

However, some treatments for lymphoma, and sometimes the disease itself can cause infertility. This infertility may be temporary or permanent. Your doctor will talk to you about this in more detail before you start treatment. If you have a partner, you may find it helpful if you see the doctor together so that you can both talk about your fears and worries.

For women

Chemotherapy

Some of the drugs used to treat non-Hodgkin’s lymphoma can affect the ovaries. This means that your periods may stop during or for a few months after treatment. You may get hot flushes, a dry vagina or other symptoms of the menopause. If it is temporary your periods may return to normal after a few months. This happens in about a third of women who have short-term infertility brought on by chemotherapy. In general the younger you are, the more likely it is that regular periods will return and you will still be able to have children.

The nearer a women is to her menopause the more likely it is that chemotherapy will stop her periods permanently. Most of the effects of the menopause can be prevented or reversed by replacing the hormones the ovaries normally produce. However, it will not be possible to restore your fertility. Your doctor may prescribe hormone replacement therapy (HRT) for you. This treatment can be given in different ways. For example: in tablet form or through an implant device inserted under the skin, or by slow release patch worn on the arm or the leg. Often a simple lubricant such as KY gel, which can be bought from most chemists, can help to ease any discomfort during intercourse. Talk to your doctor if this is an ongoing problem for you.

As periods usually stop during treatment you may not know if you are fertile or not. If you are having sex and are still young enough to have children you must use some reliable method of contraception throughout your treatment and for some time afterwards. This is because there is a risk of miscarriage or birth defects in children conceived during or just after treatment.

Many doctors believe it is better not to get pregnant for two years after your chemotherapy ends. This gives you a chance to recover from the effects of treatment and by this time likelihood of the disease coming back is much less. When you have finished treatment there are blood tests that can be done to show if you are fertile or not. Talk to your doctor or nurse if you need more information. He or she will answer your questions in more detail.

Radiotherapy

Most radiotherapy treatment has no effect on your ability to have children. If the lower part of your body is being treated special shields can be used to protect the ovaries. However, many specialists recommend that women wait for two years after radiotherapy before trying to get pregnant, to give the body a chance to get over the effects of the cancer and its treatment. If you are still young enough to have children you should use a reliable method of contraception throughout your treatment and for some time afterwards. This is because there is a risk of miscarriage or birth defects in children conceived during or just after treatment.

For Men

For some men, the lymphoma itself can cause infertility. Sperm tests carried out before treatment starts will show if this is the case. Some types of treatment can also cause infertility. It may be temporary or permanent.

The prospect of infertility can be a difficult issue to come to terms with. If you are young you may not have considered the thought of having children. You may also want to get started on treatment straight away. At times like this whether you will be able to have children may not be a priority.

However, as many lymphomas can be completely cured, it is most important that you give yourself some time to think about the future. It may help to talk to a member of your family or a close friend about your concerns. Ask your doctor or nurse for advice on what you should do.

If the tests show that your sperm count is satisfactory it may be possible to store sperm, before treatment begins, for use at a later date. To do this you will be asked to give several sperm samples. There will be a couple of days break between each sample to make sure good samples are obtained. The sperm will be frozen and stored until required.

You may worry that the process of banking sperm may cause a delay in starting treatment. This is seldom the case as it can be done while tests and procedures are being carried out and the results of tests awaited. If you want to find out more about sperm banking talk to your doctor or nurse. He or she will give you more information. Call the Cancer Helpline Freefone 1800 200 700. You can talk to a nurse who will tell you what services are available.

Chemotherapy

Chemotherapy may cause infertility. It may be temporary or permanent. Even though doctors know that some chemotherapy drugs may cause infertility it is very difficult to say if and when this will happen. You may be on treatment 2-3 months before your sperm count is reduced. If you are having sex and your partner is still young enough to have children you must use some reliable method of contraception throughout your treatment and for some time afterwards. There is a risk of miscarriage or birth defects in children conceived during or just after treatment. Many doctors believe it is better for your partner not to get pregnant for two years after your chemotherapy ends. This gives you a chance to recover from the effects of treatment and by this time the likelihood of the disease coming back is much less.

Radiotherapy

Most radiotherapy treatment has no effect on your ability to have children. However, sperm production may be reduced if the testes are near the area being treated. Nowadays it is possible to avoid giving radiotherapy to the testes in most treatments. Special shields can also be used to protect the testes during treatment.

If your partner is still young enough to have children you must use a reliable method of contraception throughout your treatment and for some times afterwards. This is because there is a risk of miscarriage or birth defects in children conceived during or just after treatment. Many specialists recommend that you wait for two years after radiotherapy before trying to start a family or have more children. This time gives your body a chance to get over the effects of the cancer and its treatment.