University students plan to have children at ages when female fertility is decreased without being sufficiently aware of the age-related decline in fertility. This increases the risk of involuntary infertility in this group, which is alarming in view of the great importance they put on parenthood.

Delaying childbearing based on incorrect perceptions of female fertility could lead to involuntary childlessness. Education regarding fertility issues is necessary to help men and women make informed reproductive decisions that are based on accurate information rather than incorrect perceptions.

Our results show marked sex differences regarding the receipt of fertility-related information and use of FP. There is an urgent need to develop fertility-related information adapted to female patients with cancer to improve their opportunities to participate in informed decisions regarding their treatment and future reproductive ability.

STUDY QUESTIONWhat do adolescent and young adult survivors of childhood cancer think about the risk of being infertile?SUMMARY ANSWERThe potential infertility, as well as the experience of having had cancer, affects well-being, intimate relationships and the desire to have children in the future.WHAT IS KNOWN ALREADYMany childhood cancer survivors want to have children and worry about possible infertility.STUDY DESIGN, SIZE, DURATIONFor this qualitative study with a cross-sectional design, data were collected through 39 online focus group discussions during 2013.PARTICIPANTS/MATERIALS, SETTING, METHODSCancer survivors previously treated for selected diagnoses were identified from The Swedish Childhood Cancer Register (16–24 years old at inclusion, ≥5 years after diagnosis) and approached regarding study participation. Online focus group discussions of mixed sex (n = 133) were performed on a chat platform in real time. Texts from the group discussions were analysed using qualitative content analysis.MAIN RESULTS AND THE ROLE OF CHANCEThe analysis resulted in the main category Is it possible to have a baby? including five generic categories: Risk of infertility affects well-being, Dealing with possible infertility, Disclosure of possible infertility is a challenge, Issues related to heredity and Parenthood may be affected. The risk of infertility was described as having a negative impact on well-being and intimate relationships. Furthermore, the participants described hesitation about becoming a parent due to perceived or anticipated physical and psychological consequences of having had cancer.LIMITATIONS, REASONS FOR CAUTIONGiven the sensitive topic of the study, the response rate (36%) is considered acceptable. The sample included participants who varied with regard to received fertility-related information, current fertility status and concerns related to the risk of being infertile.WIDER IMPLICATIONS OF THE FINDINGSThe results may be transferred to similar contexts with other groups of patients of childbearing age and a risk of impaired fertility due to disease. The findings imply that achieving parenthood, whether or not with biological children, is an area that needs to be addressed by health care services.STUDY FUNDING/COMPETING INTEREST(S)The study was financially supported by The Cancer Research Foundations of Radiumhemmet, The Swedish Childhood Cancer Foundation and the Doctoral School in Health Care Science, Karolinska Institutet. The authors report no conflicts of interest.

Sexual dysfunction and reproductive concerns are common in young women with breast cancer. Current endocrine treatment, previous chemotherapy, a negative body image, and a wish for children in the future predict higher level of problems.

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.

Independent outdoor activities seem to contribute to the well-being and feelings of self-worth among persons with early-stage dementia who want to be and are able to be outdoors. If a person with dementia, despite cognitive limitations, wants and is able to engage in outdoor activities, it is important for relatives and health-care staff to encourage and facilitate this, for example, by discussing adaptation strategies to deal with orientation problems.

Background: The aim was to investigate HRQoL and psychosocial function among patients with carcinoid tumours, longitudinally and prospectively, and to compare HRQoL among patients with carcinoid tumours to that of the Swedish general population. The aim was also to investigate the prevalence of distress during the first year after diagnosis.