Reproductive intentions in childless female adolescent and young adult cancer survivors

Abstract

Objective: To examine the association between prior cancer treatments, medical comorbidities, and voluntary childlessness in reproductive-aged women who are survivors of cancers diagnosed as adolescents and young adults (AYA survivors).

Reproductive Problems in Adolescent and Young Adult Gynecology Cancer Survivors: A Systematic Review

“…The results of this study are contrary to of those a study conducted by Young et al (2019), which showed that more than half (74.8%) of survivors did not want to give birth after a cancer diagnosis and 98.5% did not want to adopt (Young et al, 2019). Survivors aged 36-40 years are three times more likely to be voluntarily childless than those aged 25-35 years (Lam et al, 2020). Not wanting to become pregnant can be caused by a possibly poor pregnancy outcome.…”

“…Age, sexual identity, history of pregnancy, cancer treatment were not significantly related to voluntarily childless (OR=0.60; 95% CI 0.35-1.02). Adolescent and young adult cancer survivors ages 36-40 years were three times more voluntarily childless than those aged 25-35 years (OR=2.97; 95% CI 1.71-5.18) (Lam et al, 2020). The results of a study by Mattsson et al (2020) showed that 59.6% of ovarian cancer survivors and 60% of uterine cancer survivors did not have children before being diagnosed with cancer.…”

“…There was no significant association between the stress experienced by adolescent and young adult survivors and decreased ovarian function in 311 survivors who had completed cancer treatment for >2 years. The Desire to Have Children In two studies, 73.2% of adolescent and young adult cancer survivors wanted to have children in the future (Lam et al, 2020) and 82.9% stated that having children was important to them (Urech et al, 2018). A study by Young et al (2019) found that more than half (74.8%) of the survivors did not want to give birth after a cancer diagnosis.…”

Family size and duration of fertility in female cancer survivors: a population-based analysis

“…The wide range of reasons that may influence women’s choice to have a pregnancy or achieve a certain family size after cancer may be more important than biologic reproductive function for several survivors ( 24 , 47 ). A recent survey indicated that 21% of young women cancer survivors (mean age, 31.8 years) were voluntarily childless ( 25 ), and this was independent of diagnosis and medical comorbidities. Others, however, have found a similar desire to have children among cancer survivors compared with their siblings ( 23 ).…”

“…There are additionally several other factors that influence the likelihood of pregnancy after cancer, including effects on rates of cohabitation/marriage, sexuality, and the impact of other long-term health consequences (generally termed “late effects”) of cancer treatment ( 18 , 19 , 20 , 21 , 22 , 23 ). Concerns regarding health status and disease recurrence may also be significant in decisions regarding family building after treatment ( 24 ); others may be voluntarily childless ( 25 ). Thus, there is a complex interplay of biologic, psychologic and social factors that determine postcancer fertility ( 26 ).…”