Desire for children, difficulties achieving a pregnancy, and infertility distress 3 to 7 years after cancer diagnosis

Abstract

PurposeThe aim was to investigate desire for children, difficulties achieving a pregnancy, and infertility distress among survivors 3 to 7 years after cancer treatment in reproductive age.MethodsCancer survivors were identified in national population-based cancer registries. Eligible subjects presented with selected cancer diagnoses between 2003 and 2007 between the ages of 18 to 45. A postal questionnaire including study-specific questions, the Short-Form 36 Health Survey and the Fertility Problem Inventory, was sent to 810 survivors, and 484 participated (60 % response).ResultsMost survivors who had a pretreatment desire for children still wanted children 3–7 years after treatment, and this group was characterized by young age and being childless at diagnosis. In addition, a substantial group of survivors (n = 55, 17 %) that did not have a pretreatment desire for children had changed their mind about wanting children after treatment. About a third of the survivors with a desire to have children had experienced difficulties achieving a pregnancy after the cancer treatment, and an unfulfilled desire to have children was associated with worse mental health. Survivors presently facing difficulties achieving a pregnancy reported moderate levels of infertility distress and expressed low interest in using gamete donation.ConclusionsHealth professionals in cancer care need to be aware that patients’ plans for future children may change, particularly if they are young and childless. All patients of reproductive age should be provided with adequate information about the impact of cancer treatment on future fertility and fertility preservation.

Oncologists and hematologists’ perceptions of fertility-related communication – a nationwide survey

“…One of the reasons for conducting the present study was the previous results from our research group [2,3,25], showing that female patients receive less information about the treatment-related impact on fertility and FP than males. We therefore inquired separately about the fertility discussions with female and male patients, and conducted all analyses separately for the two groups.…”

“…Although it is rational for most cancer patients to prioritize survival over fertility, having children remains an important life goal after being treated for cancer [2,3]. Moreover, treatment-induced infertility is associated with emotional distress [2] and depression [4]. The American Society of Clinical Oncology recommends the early provision of information on the risks to fertility associated with cancer treatment and on fertility preservation (FP) to all patients of reproductive age [5].…”

“…One is broaching the topic of the cancer treatment's impact on future fertility, since this treatment in many cases is known to be gonadotoxic [1]. Although it is rational for most cancer patients to prioritize survival over fertility, having children remains an important life goal after being treated for cancer [2,3]. Moreover, treatment-induced infertility is associated with emotional distress [2] and depression [4].…”

Pediatric and Teen Ovarian Tissue Removed for Cryopreservation Contains Follicles Irrespective of Age, Disease Diagnosis, Treatment History, and Specimen Processing Methods

“…3,4 Indeed, the CCSS reported that 6.3% of childhood survivors experience acute ovarian failure immediately after treatment, and 8% experience premature ovarian failure at some point after the end of treatment. 5,6 Preservation and restoration of fertility are key aspects for enhancing quality of life in this population, and studies have found that 60% of survivors desire to rear biological children and >65% of childhood or young adult cancer survivors have used or want information about infertility and options for having children. [7][8][9][10][11] Thus, major emphasis has been placed on research in the area of childhood cancer survivors, directed not only at providing a cure for their cancer, but at a treatment approach that will allow for the best possible quality of life into adulthood.…”

Innovative fertility preservation strategies and programs for young adults with cancer

“…One-third of the young adult cancer survivors surveyed in this study had already experienced problems conceiving, and fertility problems were associated with moderate distress. 19 Cancer patients' attitudes toward infertility and FP Infertility may be unanticipated and may come as a shock to cancer survivors, particularly those who have been inadequately counseled about fertility. 20,21 Beyond the loss of ability to have children, infertility may be perceived as a loss of masculinity or femininity.…”