The ovarian response to stimulation in patients with lymphoma (Hodgkin and non-Hodgkin); a retrospective age-matched control study

Fertility preservation has become a critical element in the management of patients with hematologic malignancies. Although fertility in lymphoma survivors has been investigated in numerous studies, the overall quality of evidence remains low. The present investigation was designed to assess ovarian response in patients with lymphoma before oncologic therapy, comparing them with healthy controls and evaluating differences between Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL) subgroups. This is a retrospective, age-matched controlled study. All patients diagnosed with HL or NHL who underwent oocyte or embryo cryopreservation between October 2015 and March 2024 were included. The control cohort comprised healthy women who underwent ovarian stimulation during the same period. The primary outcome was total oocytes retrieved. Based on anti-Müllerian hormone values, the study's statistical power is 80%. A total of 65 patients with lymphoma were enrolled. The control cohort Likewise comprised 65 age-matched individuals. The primary outcome was total oocytes retrieved. The secondary outcome was total number of mature oocytes. The gonadotropin dose and duration of ovarian stimulation were significantly greater in the lymphoma group (P = 0.001). No significant differences were observed in the total oocytes retrieved. The number of metaphase two oocytes and the proportion of mature oocytes to total retrieved oocytes were significantly higher in the lymphoma group (P = 0.013 and P = 0.026, respectively). No significant intergroup differences were observed in the numbers of 2PN, embryos obtained, fertilization rates, or embryo quality. HL and NHL patients exhibit a favorable ovarian response to stimulation prior to gonadotoxic therapy. It is therefore recommended that comprehensive counseling be provided to ensure these patients can maximize their use of fertility preservation services prior to gonadotoxic treatment.