Sex, fertility and non-Hodgkin lymphoma

Non-Hodgkin lymphoma (NHL) and its treatment does not always affect your sex life. But you will probably go through times when you don't feel like sex, because you are too tired or have side effects.

Some chemotherapy drugs for NHL can cause ​infertility​. This does not happen with all chemotherapy drugs for NHL. Your doctor will talk to you about this before you start your treatment.

How chemotherapy can affect fertility

Some chemotherapy drugs for NHL can cause ​infertility​ . 

This does not happen with all chemotherapy drugs for NHL. Your doctor will try to use drugs that do not cause infertility. But the first priority is to treat your lymphoma effectively. 

If you become infertile you will not be able to have children naturally after your treatment. Having a ​stem cell transplant​ will almost certainly mean you will be infertile.

Some drugs are likely to cause infertility but do not always do so. Some people may be made infertile at a lower dose of a particular drug than other people. Some drugs cause temporary infertility. So your fertility may come back from six months to a year after your treatment has finished.

With some chemotherapy treatment, your doctor can't be certain whether you will be infertile or not. This will depend on:

• the drugs you have

• the total dose of each drug

• your age if you are a woman

Your doctor or nurse will tell you whether your chemotherapy is likely to make you infertile. And they can answer your questions before you start your treatment. If you have a partner, you may want to see the doctor together. You can then both ask questions and discuss any fears or worries.

Sperm banking for men

It may be possible for you to have sperm frozen and stored before you start your treatment. This is called sperm banking. Sperm banking means you might be able to have children in the future. You can use the frozen sperm to make your partner pregnant.

Teenage boys can also have sperm frozen. Their sperm can be stored for use in later years.

Sometimes men who have lymphoma have fewer sperm in their semen. It is not then possible to store the sperm. But there are newer techniques to help men with low sperm counts.  It's important to discuss sperm banking with your doctor before you start treatment.

Read more about men's fertility and chemotherapy

Freezing embryos or eggs for women

The closer you are to menopause, the more likely it is that chemotherapy will make you infertile. Your periods might stop or become irregular during your chemotherapy. This does not necessarily mean you will be infertile. Your periods might go back to normal six months to a year after treatment has finished.

You might be able to have children in the future if you have embryos or eggs frozen. This is more complicated than sperm banking is for men. You have to take hormones to stimulate your ovaries to make many more eggs than usual. This takes a couple of weeks at least, depending on where you are in your menstrual cycle.

Depending on your situation, you can have the eggs fertilised and stored as embryos. It is now also possible to have just your eggs frozen (if they cannot be fertilised first). The embryos or eggs are kept in storage until the time when you want to try to have children. 

Talk to your lymphoma specialist as early as possible if you think you would like to do this. You have to do it before you start this treatment. It takes a few weeks, so it could delay your chemotherapy.

With some types of faster growing lymphoma, this might not be possible. Your doctor might feel you need to start treatment straight away.

Read more about chemotherapy and women’s fertility