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Both Hodgkin lymphoma and non-Hodgkin lymphoma, which are cancers of the body's white blood cells, often affect young people who are still in their reproductive years. For men, treatment for these cancers can harm or halt sperm production. Although most men regain their fertility within two years of treatment, the researchers cautioned that men should be counseled about the possibility of this significant side effect before treatment begins.
"While many men can look forward to their fertility returning after treatment is over, not all will be so fortunate," Dr. Rebecca Sokol, president of the American Society for Reproductive Medicine, said in a society news release. "It is imperative that prior to the initiation of therapy, counseling and sperm preservation be made available to all lymphoma patients and their partners who may want to have children in the future."
In conducting the study, the researchers monitored the sperm of lymphoma patients undergoing various treatments to determine how each therapy affected the men's fertility. Specifically, they examined the sperm of 57 Hodgkin lymphoma patients and 18 non-Hodgkin lymphoma patients who used a sperm bank before starting their cancer treatment.
The researchers analyzed the men's sperm before treatment began as well as at three months, six months, 12 months and 24 months after treatment ended. The patients' sperm were compared to the sperm of 257 healthy, fertile men.
Even before treatment, the sperm of the men with lymphoma were more damaged than that of their healthy peers. These levels of damage improved between three and six months after treatment, but were still worse than the men in the control group.
Depending on their diagnosis, the men received combination chemotherapy, with or without radiation. Following treatment, their sperm density, total count, motility and vitality dropped. The lowest levels occurred three and six months after treatment.
The study, published recently in the journal Fertility and Sterility, revealed that alkylating chemotherapy was more often associated with a total halt in sperm production or a longer period of time for sperm production to resume. Alkylating chemotherapy damages DNA as it attacks cancer cells, to keep the cells from reproducing.
For all the men who received non-alkylating chemotherapy, with or without radiation, sperm production recovered between 12 to 24 months after treatment ended.
Two years after treatment ended, the researchers noted that sperm production had not recovered for 7 percent of the men in the study.
-- Mary Elizabeth Dallas
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