title: Parenthood in survivors of Hodgkin lymphoma: an EORTC-GELA general population case-control study.
abstract: OBJECTIVE
  We investigated the impact of Hodgkin lymphoma (HL) on parenthood, including factors influencing parenthood probability, by comparing long-term HL survivors with matched general population controls.
  
  
  METHODS
  A Life Situation Questionnaire was sent to 3,604 survivors treated from 1964 to 2004 in successive clinical trials. Responders were matched with controls (1:3 or 4) for sex, country, education, and year of birth (10-year groups). Controls were given an artificial date of start of treatment equal to that of their matched case. The main end point was presence of biologic children after treatment, which was evaluated by using conditional logistic regression analysis. Logistic regression analysis was used to analyze factors influencing spontaneous post-treatment parenthood.
  
  
  RESULTS
  In all, 1,654 French and Dutch survivors were matched with 6,414 controls. Median follow-up was 14 years (range, 5 to 44 years). After treatment, the odds ratio (OR) for having children was 0.77 (95% CI, 0.68 to 0.87; P < .001) for survivors compared with controls. Of 898 survivors who were childless before treatment, 46.7% achieved post-treatment parenthood compared with 49.3% of 3,196 childless controls (OR, 0.87; P = .08). Among 756 survivors with children before treatment, 12.4% became parents after HL treatment compared with 22.2% of 3,218 controls with children before treatment (OR, 0.49; P < .001). Treatment with alkylating agents, second-line therapy, and age older than 35 years at treatment appeared to reduce the chances of spontaneous post-treatment parenthood.
  
  
  CONCLUSIONS
  Survivors of HL had slightly but significantly fewer children after treatment than matched general population controls. The difference concerned only survivors who had children before treatment and appears to have more personal than biologic reasons. The chance of successful post-treatment parenthood was 76%.
authors.affiliation: University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
authors.forename: Marleen A E
authors.initials: MA
authors.lastname: van der Kaaij
authors.forename: Natacha
authors.initials: N
authors.lastname: Heutte
authors.forename: Paul
authors.initials: P
authors.lastname: Meijnders
authors.forename: Edwige
authors.initials: E
authors.lastname: Abeilard-Lemoisson
authors.forename: Michele
authors.initials: M
authors.lastname: Spina
authors.forename: Lotte C
authors.initials: LC
authors.lastname: Moser
authors.forename: Anouk
authors.initials: A
authors.lastname: Allgeier
authors.forename: Bart
authors.initials: B
authors.lastname: Meulemans
authors.forename: Brice
authors.initials: B
authors.lastname: Dubois
authors.forename: Arnold H M
authors.initials: AH
authors.lastname: Simons
authors.forename: Pieternella J
authors.initials: PJ
authors.lastname: Lugtenburg
authors.forename: Berthe M P
authors.initials: BM
authors.lastname: Aleman
authors.forename: Evert M
authors.initials: EM
authors.lastname: Noordijk
authors.forename: Christophe
authors.initials: C
authors.lastname: Fermé
authors.forename: José
authors.initials: J
authors.lastname: Thomas
authors.forename: Aspasia
authors.initials: A
authors.lastname: Stamatoullas
authors.forename: Christophe
authors.initials: C
authors.lastname: Fruchart
authors.forename: Pauline
authors.initials: P
authors.lastname: Brice
authors.forename: Isabelle
authors.initials: I
authors.lastname: Gaillard
authors.forename: Jeanette K
authors.initials: JK
authors.lastname: Doorduijn
authors.forename: Catherine
authors.initials: C
authors.lastname: Sebban
authors.forename: Wilma G J M
authors.initials: WG
authors.lastname: Smit
authors.forename: Serge
authors.initials: S
authors.lastname: Bologna
authors.forename: Judith M
authors.initials: JM
authors.lastname: Roesink
authors.forename: Francisca
authors.initials: F
authors.lastname: Ong
authors.forename: Marc P E
authors.initials: MP
authors.lastname: André
authors.forename: John M M
authors.initials: JM
authors.lastname: Raemaekers
authors.forename: Michel
authors.initials: M
authors.lastname: Henry-Amar
authors.forename: Hanneke C
authors.initials: HC
authors.lastname: Kluin-Nelemans
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005060:Europe / Q000453:epidemiology; D005260:Female; D005298:Fertility; D059247:Fertility Preservation / Q000706:statistics & numerical data*; D006689:Hodgkin Disease / Q000453:epidemiology* / Q000523:psychology* / Q000628:therapy; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic; D011795:Surveys and Questionnaires; D017741:Survivors / Q000706:statistics & numerical data*; D055815:Young Adult