Childhood Hodgkin lymphoma survivors take longer to conceive in 20s

Pregnancy and live birth rates were comparable between women who had received treatment for a form of cancer known as childhood Hodgkin lymphoma, and women who had not.

No differences were seen in the birth weight or time of birth for babies born to women who had Hodgekin lymphoma, though they were younger on average when they had children compared to those who did not have cancer, researchers found. Presenting research at the European Society of Human Reproduction and Embryology (ESHRE) 39th Annual Meeting 2023, researchers from the Netherlands reported cancer survivors were, however, almost two and half times more likely to spend a year or longer trying before becoming pregnant for the first time.

Dr Katja Drechsel from the Princess Máxima Centre for Paediatric Oncology, Utrecht, and Amsterdam UMC location VUmc (the Netherlands) told the conference: '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.

Childhood Hodgkin lymphoma is now a highly curable form of cancer with survival rates over 90 percent. However, treatments including chemotherapy and radiation are associated with increased risk of reduced ovarian function and reserve.

Researchers followed 84 female childhood Hodgkin lymphoma survivors treated between 1963 and 2002, and compared them to 798 controls including siblings and women from the general population. Fertility markers were worse in cancer survivors, but they had comparable pregnancy rates and had their first pregnancy at an average age of 27, compared to 29 for women who had not had cancer.

Professor Richard Anderson member of ESHRE executive committee, and chair of clinical reproductive science at the MRC Centre for Reproductive Heath, University of Edinburgh, who was not involved in the research told BioNews: 'This is valuable information about fertility after treatment for Hodgkin lymphoma, one of the commonest cancers in young women. Very positively, it seems that the lymphoma patients were as likely to have a baby as women not treated for cancer, but importantly they took longer to fall pregnant despite being younger.

'We recently found that even when women are able to become pregnant after cancer, they have fewer children. This raises important questions about the effects of cancer treatments on women's fertility, and how this can be improved.'