question @ fertility/remission for 40 year old female with NHL

Hello from Houston, texas. I am in remission from non-hodgkins b cell MALT lymphoma cancer.
Would like your opinion of chances/likelihood of pregnancy and pending hysterectomy.
I will be 41 in September, white female. Medical issues: diagnosed with Non-hodgkins b cell lymphoma in 2006. Radiation in 2006 on chest area - successful. Cancer found in stomach: ritoximum chemo in 2007, didn't work. 6 rounds of full R-CHOP in 2008 - successful and in remission as of 11/08. Laparoscopy surgery for endometriosis in 1989 and 1997. currently have two 1.5cm cysts on ovaries. severe cramping 24/7 for over two years. Active Sjogren's Syndrome. Positive antibody for Lupus and Rheumatoid but not active. Severe gastroparesis, Celiac Disease, Fibromyalgia. Off birth control since 1994 but did take it while doing chemo last year (did not help cramps). Zero pregnancies and never been pregnant. In the 1990's I took fertility pills but never any injections.
My GYN is recommending a full hysterectomy and I am in agreement, but there is that small part of me that still wants to have a baby. With my infertility history, my age, my chemo (which included the drug Cyclophosphamide), and other medical issues... what do you think are the chances of me getting pregnant and successfully carrying full term? Is there a chance of passing all my medical problems onto the fetus? My GYN does not recommend pregnancy for me. She said it would be too high risk. My husband is also afraid of complications from a pregnancy hurting me more. I am curious to know what your thoughts are on this. I want to make sure I'm making the right decision with the full hysterectomy.
Thank you for your time.

kbmuhl:
I'll do the best I can here to address your question.

"With my infertility history, my age, my chemo (which included the drug Cyclophosphamide), and other medical issues... what do you think are the chances of me getting pregnant and successfully carrying full term?"

You're clearly aware of the longterm infertility dangers of cyclophosphamide from your R-CHOP regimen. The same or similar is true of the vincristine (Oncovin) from the regimen.

The fact that you've had laprascopy twice for endometriosis suggests that endometriosis is a recurring problem for you, although your last treatment was 11 years ago. Although no one knows what causes endometriosis, it is linked to high estrogen levels. Since you're almost 41, a possible presumption is that your levels have come down since 1997 to the point where endometriosis is no longer a problem or threat to your fertility.

The size of those ovarian cysts—at 1.5 cm (15 mm)—is problematic as well, since most research suggests that ovarian cysts larger than 10 mm are associated with lower fertility rates. They don't eliminate fertility in-and-of themselves, but do make it harder, even if you were doing IVF.

"Is there a chance of passing all my medical problems onto the fetus?"

The chances of passing ALL of your medical problems onto your fetus are very slim. Some of them are greater than others. For instance:

--Lupus and rheumatoid arthritis, even if they aren't active, are connective tissue disorders that could have led to you developing Sjogren's Syndrome. Whether or not Sjogren's is hereditary, according to this PDF, "the specific risk that children or siblings will get [Sjogren's or Lupus] remains very low (<10%)."

--There are certain genes associated with an increased risk of celiac disease.

-- B-cell mucosa-associated lymphoid tissue (MALT) lymphoma is likely no different than any other lymphoma in terms of heredity, meaning that no one knows for certain. It's possible that you could pass on a compromised immune system, which might make lymphomas more likely, but there are plenty of other risk factors, too many in fact to know for certain. Keep in mind that Sjogren's is an autoimmune disorder (affecting the immune system) which, who knows, may exacerbate the problem.

Everything I've written so far I've culled from reliable sources. What I'll say now is strictly personal. I'm not a woman, I don't know what the psychological implications of a full hysterectomy are or may be, but my goodness, your entire medical history plus the recommendation of your GYN—it all adds up to what we might call a preponderance of the evidence, you know? I mean, on paper, in theory, your answer is obvious—for the sake of your own health, you should probably follow your doc's advice and have the full hysterectomy. But that surgical procedure carries with it some difficult implications—for instance, no longer being capable of childbirth might affect your personal perceptions of yourself as a woman.

Ultimately, I would recommend you checking out Hyster Sisters, as big and comprehensive a hysterectomy support site on the web as I can think of.