The perceived impact of infertility on romantic relationships and singlehood among adult survivors of childhood cancer

Abstract

Objective To examine whether adult survivors of childhood cancer perceive a direct impact of potential/confirmed infertility on their romantic relationships/singlehood. Methods Open‐ended qualitative phone interviews were conducted with 57 adult survivors of childhood cancer and analyzed through thematic content analysis until saturation was reached (N = 30). Results Interviews revealed three major themes: (1) impact on survivors, (2) impact on partners/romantic relationships, and (3) alternative routes to parenthood. An overarching theme related to (4) timing also emerged. In describing the impact on themselves, survivors shared subthemes of (1.1) becoming aware of infertility as potential late effect of childhood cancer treatment and (1.2) their emotional reactions (ie, worries/concerns, distress, guilt, no emotional reaction). The impact on partners/romantic relationships also included subthemes: (2.1) partner communication, (2.2) partner reactions, and (2.3) the journey of active family planning. Conclusions The perceived impact of potential/confirmed infertility on romantic relationships of adult survivors of childhood cancer varied across individuals and time. Its presence or absence depends on life circumstances (eg, marital status, life goals), and if present, negative effects were typically resolved over time by having a pregnancy. Other survivors found joy and comfort in step‐children, considering adoption, or embracing a life without children. While more research is needed, findings indicate that discussions about infertility and fertility testing should be tailored to individual survivors and their needs, which may change over time. Timely referrals to reproductive specialists or adoption agencies are recommended for those who want children and have difficulties conceiving.

The impact of cancer‐related fertility concerns on current and future couple relationships: People with cancer and partner perspectives

“…The findings of this study highlight that cancer‐related fertility concerns and decision‐making or participation in fertility treatments are a significant source of tension and distress for couples and a source of anxiety about impact on future relationships. These findings are consistent with previous research amongst infertile couples without cancer (Luk & Loke, 2015), and childhood cancer survivors (Lehmann et al, 2019).…”

“…Feelings of inadequacy associated with not being able to ‘provide’ a child within a couple relationship may also have an impact on psychosexual well‐being, as reported previously (Lehmann et al, 2018). What is unique to PWC is the grief related to a sudden loss of fertility following cancer treatment (Ussher, Parton, et al, 2018) or an uncertain fertility status (Lehmann et al, 2019), which may be a further source of distress in the couple relationship. Tailored ongoing psychosexual counselling and sexuality psychoeducation programmes may help to improve sexual relationships for couples with cancer‐related psychosexual or fertility concerns (Luk & Loke, 2016).…”

“…There is some evidence that PWC with fertility concerns fear abandonment or rejection by current or future partners (Dryden et al, 2014), have reduced sexual satisfaction (Canada & Schover, 2012), or experience relationship difficulties or relationship breakdown (Lehmann et al, 2018). However, much of the existing research concentrates on adults who have experienced childhood cancer (Lehmann et al, 2018; Thompson et al, 2013) and focuses on PWC (Gorman et al, 2012; Lehmann et al, 2019), meaning the experience of partners is less understood. Previous research on cancer‐related fertility concerns has also been criticised for being small scale, focusing on cancers of the reproductive organs, recently diagnosed young women, and patients recruited from a single clinical site (Barlevy et al, 2016; Bibby et al, 2017).…”

“…However, much of the existing research concentrates on adults who have experienced childhood cancer (Lehmann et al, 2018;Thompson et al, 2013) and focuses on PWC (Gorman et al, 2012;Lehmann et al, 2019), meaning the experience of partners is less understood. Previous research on cancer-related fertility concerns has also been criticised for being small scale, focusing on cancers of the reproductive organs, recently diagnosed young women, and patients recruited from a single clinical site (Barlevy et al, 2016;Bibby et al, 2017).…”

Attitudes and Perceptions of Parenthood Among Young Adult Survivors of Childhood Cancer

“…24,25 For example, concerns about an offspring's well-being and health risks (e.g., cancer predispositions, birth defects) have been expressed despite mounting evidence contradicting such concerns. 4,21,23,25,26 In addition, survivors may worry about their own health, strength, ability to carry a pregnancy, 23 or the demands of caring for a child. 24,26 Potential relapse or early death are additional worries and possible reasons survivors may refrain from having children.…”