Unfortunately, some types of chemotherapy for non-Hodgkin lymphoma can cause infertility. Your doctor will talk to you about this in more detail before you start your treatment. If you have a partner, you may find it helpful to see the doctor together so you can both discuss any fears or worries. Some drugs do not cause infertility and these are being used more often than those that do. Unfortunately, the intensive chemotherapy and radiotherapy necessary before a stem cell transplant may be more likely to make you permanently infertile.

If your chemotherapy does make you infertile, it may not do so straight away. Because of this you may still be able to get pregnant, or father a child. You will normally be advised to avoid pregnancy during your chemotherapy treatment and for up to a year afterwards. To prevent this, you should use reliable contraception, such as a condom. It is important to remember that there are many couples who have had healthy babies following chemotherapy treatment – there is no increase in the risk of birth defects in children of people who have had treatment for cancer.

As your doctor knows the exact type of treatment you are having, they are the best person to answer your questions about fertility. Make a list of any questions you may have so you can be sure you are clear about your treatment.

If chemotherapy does make you infertile, it can be very difficult to come to terms with the fact that you can't have children. You may feel that you have lost a part of your identity. Talking about your feelings with your partner, family or a close friend can help to clarify your thoughts and give the people close to you the chance to understand how you are feeling.

If it would be easier for you to talk to someone outside your immediate circle, you may find it helpful to talk to your nurse, social worker, our nurses or a trained counsellor. Our cancer information and support service can tell you more about counselling and let you know about services in your area. 

Some people can preserve their fertility by storing sperm or fertilised (and in some situations, unfertilised) eggs. These procedures have to be done before you start treatment, but the eggs and sperm can be stored until you need them. It is important to bear in mind that some of the methods of collecting eggs or sperm can take quite a while. You may have to weigh up the benefits of having fertility preservation against the drawback of delaying your treatment.

Men

If men have radiotherapy to the abdominal area, a lead shield may be used to protect the testes. If there is a risk of infertility it is usually possible for men to have sperm stored before starting treatment. Parents of teenage boys should also be aware of this so that, where possible, sperm can be stored for use in later years.

If you are infertile and would like to have a child, it may also be possible for your partner to become pregnant using donated sperm.

Women

If women are to have radiotherapy to the abdomen it is sometimes possible to surgically move the ovaries out of the treatment area before the treatment starts.

It may be possible to store fertilised eggs with the chance of re-implanting them later. This may be worth considering if you and your partner want a child, and you are going to have chemotherapy that may make you infertile. Your treatment will need to be delayed for several weeks while the eggs are collected. Your specialist will be able to advise you about any potential risk in delaying treatment.

It is sometimes possible to store unfertilised eggs so that they can be fertilised and re-implanted when needed. However, this is much less successful than storing fertilised eggs and not widely available. Research is looking at whether it is possible to remove and store ovarian tissue, and re-implant it after your treatment has finished, but this is still experimental. If you are infertile, it may be possible to have infertility treatment (IVF) with donor eggs, so that you and your partner can have a child.

Our booklet, Relationships, Sex and Fertility: A Guide for Young People, gives information about ways of preserving fertility. You can order a copy of this publication.