Loss, uncertainty, or acceptance: subjective experience of changes to fertility after breast cancer

Abstract

This qualitative study examines the subjective experience of infertility in a large sample of Australian women with breast cancer. Participants were 1830 women, average age 54, who responded to an email invitation to complete an online survey on sexual well-being and fertility concerns after breast cancer. 24.6% (n = 452) reported that cancer had affected their fertility; 21.3% (n = 391) did not know their fertility status. In thematic analysis of open-ended responses provided by 381 women about changes to fertility status, reactions to infertility, and experiences of information and interventions to assist fertility, five themes were identified: 'Negative responses to infertility and early menopause'; 'Sexual changes associated with menopause and infertility'; 'Uncertainty and anxiety about fertility status'; 'Information and fertility preservation'; 'Acceptance of the end of fertility'. These findings confirm previous reports that infertility and premature menopause are a significant cause of anxiety for many women with breast cancer. However, some women closer to natural menopause, or who had completed their families, reported acceptance of changed fertility status. Accounts of deficits in information provision and fertility counselling suggest an urgent need for accessible and comprehensive information about fertility and cancer to be developed and evaluated, as well as education and training of health professionals in addressing fertility concerns following cancer.

Threatened fertility: A longitudinal study exploring experiences of fertility and having children after cancer treatment

“…A study among 484 male and female cancer survivors showed that parental status and age were associated with a change in the desire to have children (Armuand, Wettergren, Rodriguez-Wallberg, & Lampic, 2014). Qualitative research has provided valuable insight into male and female survivors' experiences of compromised fertility (Perz, Ussher, & Gilbert, 2014;Wong et al, 2017) and the complexity involved in the decision to have children following cancer (Hsieh et al, 2017). Qualitative research has provided valuable insight into male and female survivors' experiences of compromised fertility (Perz, Ussher, & Gilbert, 2014;Wong et al, 2017) and the complexity involved in the decision to have children following cancer (Hsieh et al, 2017).…”

Communication Difficulties and the Experience of Loneliness in Patients With Cancer Dealing With Fertility Issues: A Qualitative Study

“…Previous studies have found that impaired fertility from cancer treatment has a negative impact on quality of life for cancer survivors. The psychological impact of cancer-related infertility is comprised of emotional distress, reproductive concerns, loss of identity, depression, and grief (Carter et al, 2005(Carter et al, , 2010Gorman, Bailey, Pierce, & Su, 2012;Perz, Ussher, & Gilbert, 2014). Infertility can also place strain on couples' relationships (Penrose, Beatty, Mattiske, & Koczwara, 2013;Perz et al, 2014).…”

“…The psychological impact of cancer-related infertility is comprised of emotional distress, reproductive concerns, loss of identity, depression, and grief (Carter et al, 2005(Carter et al, , 2010Gorman, Bailey, Pierce, & Su, 2012;Perz, Ussher, & Gilbert, 2014). Infertility can also place strain on couples' relationships (Penrose, Beatty, Mattiske, & Koczwara, 2013;Perz et al, 2014). Single cancer survivors with the potential for fertility problems may experience difficulties in starting new relationships because of past rejection or the fear of being rejected by a potential partner (Zebrack, Casillas, Nohr, Adams, & Zeltzer, 2004).…”

Portuguese oncologists’ practices regarding female fertility preservation: Which barriers most relate to these practices?

“…Peate et al, 2011;Perz et al, 2014), these results highlight the need to implement strategies that help to generalise the FP discussion and referral practices. Peate et al, 2011;Perz et al, 2014), these results highlight the need to implement strategies that help to generalise the FP discussion and referral practices.…”

“…In Portugal, despite the availability of male FP since the 1990s in several clinical institutions, female FP techniques are only offered since 2010; both male and female FP options are funded by the Portuguese National Healthcare System. Cancer-related infertility has been shown to have a negative impact on the individual adaptation of female cancer survivors (Carter et al, 2010;Loscalzo & Clark, 2007;Perz, Ussher, & Gilbert, 2014), so this topic deserves further attention. Cancer-related infertility has been shown to have a negative impact on the individual adaptation of female cancer survivors (Carter et al, 2010;Loscalzo & Clark, 2007;Perz, Ussher, & Gilbert, 2014), so this topic deserves further attention.…”