Hodgkin's Lymphoma

 Men treated for Hodgkin’s lymphoma may have over 90% risk of long term azoospermia (lack of sperm production) while patients with testicular cancer may have less than 20% risk of long term azoospermia. Also Hodgkin's lymphoma is typically manifested in men ages 20-30 and later at ages over 50.

The disease staging depends on the extent of lymph node involvement and the presence of associated symptoms of fever, night sweats and weight loss. Treatment will include chemotherapy and /or radiotherapy. The treatment has a high cure rate of over 94% of patients who survive after 10 years. Men who are treated with a combination of chemotherapy of six or more courses of mechlorethamine, vincristine, procarbazine, and prednisolone (MOPP) or mechlorethamine, vinblastine, procarbazine and prednisolone (MVPP) may result in azoospermia (lack of sperm) up to 90% of patients.

Other chemotherapy agents which include (ABVD regimen) doxorubicin, bleomycin, vinblastine, and dacarbazine are less toxic to the testis and may have a high recovery of sperm production. Post chemotherapy treatment , sperm production may take up to 5 years to return. Sperm cryopreservation prior to chemotherapy should be offered to post pubertal men. Very low sperm counts can often result in a successful pregnancy using In vitro Fertilization in combination with intracytoplasmic sperm injection.