Fertility may decline at an early age among women who were treated for childhood Hodgkin’s lymphoma, new research presented at a major fertility conference has suggested.
Dutch research, presented at the 39th annual meeting of the European Society of Human Reproduction and Embryology (ESHRE), in Copenhagen, Denmark, found that while these women may have to try for longer to become pregnant, the majority in the study do ultimately became parents.
The study, led by Dr Katja Drechsel from the Princess Máxima Centre for Paediatric Oncology, Utrecht, and Amsterdam UMC location VUmc, included 84 women with an average age of about 30. All had been treated for Hodgkin’s lymphoma, diagnosed at a median age of 13 years.
The study also included 798 women who had not been treated for Hodgkin’s lymphoma.
Participants answered questions about if they had children and how old they were when they became pregnant for the first time. They were tested for three markers of fertility in their blood – anti-Mullerian hormone, follicle stimulating hormone, and inhibin B. In addition, the researchers used ultrasound to carry out an antral follicle count, to estimate the number of egg cells in the women’s ovaries.
In women who had been treated for Hodgkin’s lymphoma, the levels of all three fertility markers were more likely to be abnormal, and had lower antral follicle count, compared to control women.
The Hodgkin’s lymphoma survivors were also almost 2.5-times more likely to spend a year or longer trying before becoming pregnant for the first time. Nevertheless, pregnancy rates and live birth rates were similar between the two groups.
Dr Drechsel said: “Our results suggest that treatment for childhood Hodgkin lymphoma may have an impact on women’s fertility. In particular, they indicate that women’s fertility might decline at a younger age compared to other women.
“However, it’s encouraging to see that the women who have already chosen to start a family have been successful. On average they had their first child at a younger age, which may be because their doctors have spoken to them about the possible effects of their cancer treatment on fertility. We will need to follow this group for longer to see if they face greater difficulties becoming pregnant at older ages.”
Dr Drechsel and her colleagues are to continue monitoring the women’s fertility in the longer term. The team also plan to carry out a larger prospective study that looks at signs of fertility in boys and girls treated according to the current European treatment protocol for Hodgkin’s lymphoma in five European countries.
S Broer, K Drechsel, F Stoutjesdijk, J Twisk, M Van den Berg, E Van Dulmen - den Broeder, G Kaspers, M Veening (2023) “O-083: Ovarian reserve, Reproductive function and Pregnancy outcomes among Female survivors of childhood Hodgkin lymphoma: results from the DCOG LATER-VEVO Later study.” Presentation at the European Society of Human Reproduction and Embryology Annual Meeting 2023, doi: 10.1093/humrep/dead093.097
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