随着年轻和青少年霍奇金淋巴瘤（HL）幸存者数量的增加，人们对抗癌治疗的（长期）不良影响的认识正在增加。由于对生活质量的影响，受损生殖能力的风险值得极大关注。目前没有关于儿童 HL 治疗后生育能力的综述。本文旨在综述现有文献，总结男女儿童，青少年和年轻成人 HL 幸存者生殖功能的不同方面。在女性方面，评估了抗Müllerian激素（AMH）、卵泡数量、早发卵巢功能不全（POI）、急性卵巢功能衰竭、月经周期、FSH 和妊娠 /分娩。在男性方面，包括精液分析、血清FSH、抑素B、LH、睾酮以及妊娠 / 分娩报告。研究之间存在显著的异质性和缺乏对照组；因此，无法进行 Meta 分析。结果以描述方式呈现，对研究的质量没有进行单独评估。筛选后，包括了 75篇报道儿童或青少年HL 幸存者生殖标志物的文章。41篇论文报道了 5057 名女性 HL 幸存者。POI 的发生率为 6-34%（中位数为 9%；七项研究）。经常出现卵巢储备能力减弱或卵巢功能受损的症状（低 AMH 55-59%；中位数57%；两项研究，高 FSH 17-100%；中位数53%；七项研究）。大多数幸存者月经周期规律。51项研究评估了1903名男性HL幸存者的生育能力。治疗后无精子症高度普遍（33-100%；中位数75%；29项研究）。长期随访数据有限，但有治疗后最多 12年精液恢复的报告。FSH水平经常升高，抑素 B 降低（高 FSH 0-100% ；中位数51.5%；26项研究，低抑素B 19-50%；中位数45%；三项研究）。LH和睾酮水平受影响较少（高 LH 0-57%；中位数17%；21项研究和低睾酮 0-43%；中位数6%；15项研究）。在两性中，受损的生育能力与累积化疗药物和盆腔放射治疗的剂量有关。治疗前存在异常标志物表示疾病本身也可能对生殖功能产生负面影响（女性：AMH < p10 9%；一项研究和男性：无精子症 0-50%；中位数10%；六项研究）。关于幸存期间获得妊娠的机会的报告是令人放心的，尽管这些研究存在局限性，其结果仍然难以评估。最终，卵巢储备减少并不排除活着的机会，有异常标志物的男性仍然可能怀孕。该综述证实了HL治疗对生殖功能的负面影响，因此应向年轻的HL幸存者提供与未来生殖生活相关的咨询，应考虑保护生育能力。目前的证据水平不充分，需要进行更多关于HL和（目前的）治疗方案对生殖功能影响的试验。在本综述中，我们提出了可评估的生殖标志物和（重复）测量的时间建议。© 作者（们）2023年。由牛津大学出版社代表欧洲人类生殖和胚胎学协会出版。

Owing to a growing number of young and adolescent Hodgkin lymphoma (HL) survivors, awareness of (long-term) adverse effects of anticancer treatment increases. The risk of impaired reproductive ability is of great concern given its impact on quality of life. There is currently no review available on fertility after childhood HL treatment.The aim of this narrative review was to summarize existing literature on different aspects of reproductive function in male and female childhood, adolescent, and young adult HL survivors.PubMed and EMBASE were searched for articles evaluating fertility in both male and female HL survivors aged <25 years at diagnosis. In females, anti-Müllerian hormone (AMH), antral follicle count, premature ovarian insufficiency (POI), acute ovarian failure, menstrual cycle, FSH, and pregnancy/live births were evaluated. In males, semen-analysis, serum FSH, inhibin B, LH, testosterone, and reports on pregnancy/live births were included. There was profound heterogeneity among studies and a lack of control groups; therefore, no meta-analyses could be performed. Results were presented descriptively and the quality of studies was not assessed individually.After screening, 75 articles reporting on reproductive markers in childhood or adolescent HL survivors were included. Forty-one papers reported on 5057 female HL survivors. The incidence of POI was 6-34% (median 9%; seven studies). Signs of diminished ovarian reserve or impaired ovarian function were frequently seen (low AMH 55-59%; median 57%; two studies. elevated FSH 17-100%; median 53%; seven studies). Most survivors had regular menstrual cycles. Fifty-one studies assessed fertility in 1903 male HL survivors. Post-treatment azoospermia was highly prevalent (33-100%; median 75%; 29 studies). Long-term follow-up data were limited, but reports on recovery of semen up to 12 years post-treatment exist. FSH levels were often elevated with low inhibin B (elevated FSH 0-100%; median 51.5%; 26 studies. low inhibin B 19-50%; median 45%; three studies). LH and testosterone levels were less evidently affected (elevated LH 0-57%, median 17%; 21 studies and low testosterone 0-43%; median 6%; 15 studies). In both sexes, impaired reproductive ability was associated with a higher dose of cumulative chemotherapeutic agents and pelvic radiotherapy. The presence of abnormal markers before treatment indicated that the disease itself may also negatively affect reproductive function (Females: AMH