One of the side effects for the first line chemotherapy treatment used to treat Hodgkin's Lymphoma today - ABVD - is as follows:
"Fertility: Your ability to conceive or father a child may be affected by this treatment. It is important to discuss this with your doctor before starting treatment. However, ABVD is less likely to affect fertility than some other chemotherapy treatments for Hodgkin lymphoma." [Cancerbackup.org.uk]
The standard advice given to men is prior to the chemotherapy to place a 'deposit' at a sperm bank. With modern technology sperm can be stored for decades and brought back later on and used to concieve. I was advised that while ABVD is less likely to decrease fertility this option is recommended and does not cost anything - and is fairly straight forward. Its like an insurance policy i was told - i decided to take the insurance.
The whole experience was strange - within an hour or so i was also presented with some numbers based on an analysis of my sample, along with pages and pages of consent forms. Here's a taster of the sort of question i had to answer:
"In the event of your death do you consent to allowing your wife / partner to utilise your sperm for conceiving a child?"
This whole thing occurs in the period of time where you know you have cancer - and you know you have months of treatment coming up - but you've not started yet. You are already pretty messed up emotionally - and then you have questions like that!
Also - then came the numbers... i was not prepared for a conversation about sperm counts! I had hoped the sample would be taken and frozen and that was that - but no - they had to check it was a good sample and check other things.
So before i even started any chemotherapy i was told that the counts in the sample were a little low. They were apparently not something to worry about - but i should come back for another couple of visits. To have your fertility brought in to question before chemotherapy had even started - knowing the ordeal that was ahead - was not nice.
What made it worse was my complete lack of preparation for any feedback on this subject on the given day - i had just been told i needed to come back in a few hours to get some forms!
Chemotherapy
Then comes the chemo! Chemo works by attacking cells that are dividing rapidly - this is why it can affect the production of sperm. Stronger regimes of chemo can have stronger effects and some forms can lead to the patient becoming completely sterlie. Pretty heavy stuff to take in at 25 - but i knew my chances with ABVD were far better and things 'should' be ok.
Theory Vs Practice
Well, I had 4 cycles of ABVD - my wife had 3 cycles of ABVD [fertility needs both sides working!] - and many couples with no chemo-drugs involved have issues with having children.
So. There's the theory. The practice? We got married in October 2008 and in January 2009 we found out we're expecting our first child. Wow. Looks like fertility was not an issue at all - in fact if we were in a system where drugs were commercially sold to patients and 'marketed' then i think my case could be used as part of an ad for ABVD - something like 'this couple BOTH had and are expecting their first child' etc etc.
Advice
So if you are stressing about this prior to treatment my advice is to concentrate on other areas. The advice to bank sperm before treatment starts is still good advice - but dont lose sleep over having children post-chemo - it can happen without any issues.
