A cross-sectional study of the psychosexual impact of cancer-related infertility in women: third-party reproductive assistance

Abstract

Introduction This study empirically assessed emotional and sexual functioning, reproductive concerns, and quality of life (QOL) of cancer-related infertile women in comparison to those without a cancer history and explored awareness of third-party reproduction options in cancer survivors. Methods One hundred twenty-two cancer survivors (Gynecologic and Bone Marrow/Stem Cell Transplant) with cancer-related infertility and 50 non-cancer infertile women completed a self-report survey assessing: reproductive concerns(RCS), mood(CES-D), distress(IES), sexual function(FSFI), menopause(SCL), QOL(SF-12), relationships(ADAS), and exploratory (reproductive options) items. Results Cancer survivors exhibited greater sexual dysfunction and lower physical QOL than non-cancer infertile women (P<0.001). No significant group differences were identified for mood (CES-D), mental health QOL (SF-12), reproductive concerns (RCS), and relationship satisfaction (ADAS). All groups scored in the FSFI range of sexual dysfunction, and with RCS scores above published means. Multivariate comparisons showed comparable depression and distress levels for all groups, but cancer survivors had poorer physical QOL [F(5,146)=4.22, P<0.01]. A significant effect was also found for knowledge of third-party reproductive options on depression and distress levels [F(3,97)=4.62, P<0.01]. Adjusted means demonstrated higher depression and distress scores for women with perceived unmet informational needs. Conclusions Overall, loss of fertility was an emotionally challenging experience for women regardless of its cause. Cancer survivors were found to have lower scores of physical QOL and sexual function than non-cancer infertile women. Unmet informational needs about reproductive options appeared to be associated with negative mood and increased distress in cancer survivors. Implications for Cancer Survivors Targeted interventions to increase knowledge about reproductive options could be of great assistance to women pursuing parenthood in cancer survivorship. Additionally, intervention studies to improve sexual functioning and QOL in women with cancer-related infertility should be a priority of future research.

Cancer patients’ and professional caregivers’ needs, preferences and factors associated with receiving and providing fertility-related information: A mixed-methods systematic review

“…Previous studies indicated that cancer-related infertility has a negative influence on the quality of life in cancer survivors. The psychosocial impact of fertility loss comprised psychosocial concerns, distress and poor sexual functioning (Canada and Schover, 2012;Carter et al, 2010;Howard-Anderson et al, 2012;Wenzel et al, 2005). Moreover, research suggested that most cancer survivors prefer to have a biological child, even if there are concerns about long-term additional barriers associated with limited responsibility and opportunity in fertility information provision.…”

A cross-sectional cohort study of infertile women awaiting oocyte donation: the emotional, sexual, and quality-of-life impact

“…We present data from the participants in one arm of a multigroup comparison study conducted from October 2006 to February 2009 that examined the experience of infertile women with various conditions (i.e., cancer vs. noncancer), which was published in detail elsewhere (26). Study eligibility criteria included no cancer history, 18 to 49 years of age at recruitment, history of infertility and on a wait list for oocyte donation, had not started or completed childbearing, English speaking, and able to provide informed consent.…”

Oncofertility in Canada: cryopreservation and alternative options for future parenthood

“…Donation has the added advantage of preventing the passage of genetic material that may be associated with the patient's cancer (for example, BRCA genes) 8 . Despite pregnancy and live birth rates being comparable or better in donor cycles than in cycles using autologous oocytes (donor oocytes often come from young, healthy women) 95 , accessibility is a limitation 96 . Canada places restrictions on financial compensation to oocyte donors (only reimbursement of expenses incurred by the oocyte donor are allowed) and also prohibits oocyte sharing programs in which the donor receives financial incentives 97 .…”

“…Particularly in the context of the physical morbidities that may linger after cancer, either as a result of the process itself or of the treatment (for example, cardiac toxicity, renal dysfunction, respiratory disease with certain chemotherapies, removal of female reproductive organs), the ability to maintain a pregnancy may not be possible or may be too high a risk even if cryopreserved gametes are available. In a study involving 122 cancer patients, the perceived acceptability of alternative familybuilding options (after pregnancy with autologous oocytes) was highest for adoption (43%, 53 of 122) and second highest for surrogacy (34%, 42 of 122) 96 .…”