How do you feel about fertility and parenthood? The voices of young female cancer survivors

Abstract

Purpose Young adult cancer survivors are often unaware of their fertility status and uninformed regarding their fertility and fertility preservation options. This qualitative research study explores the fertility and parenthood concerns of reproductive-age female cancer survivors and how they make parenthood decisions. Methods Population- and clinic-based recruitment methods were used to identify a diverse group of survivors between the ages of 18 and 34 years. Our final sample size included 22 participants who attended one of seven focus groups. We used cross-case, inductive analysis to identify themes. Results The following main themes were identified: (1) A hopeful but worried approach to fertility and parenthood, (2) Frustration with a lack of choice or control over fertility, (3) Young survivors want information about their fertility, (4) Young survivors want better continuity of care in survivorship, (5) Cancer diagnosis and related fertility problems introduce relationship challenges, and (6) Decisions about parenthood are complicated. Conclusions The diverse group of young cancer survivors in this study identified several common needs and concerns regarding fertility and parenthood. This study illustrates that young survivors could benefit from improved information regarding their fertility and parenthood options throughout survivorship, better coordination of medical care, and support navigating many emotional and practical issues that arise when considering their reproductive and parenthood options.

Gonadal Function and Fertility in Survivors After Hodgkin Lymphoma Treatment Within the German Hodgkin Study Group HD13 to HD15 Trials

“…Among these sequelae, infertility and hypogonadism are of particular importance for patients and survivors and demand specialized medical care. [4][5][6][7][8] Health care professionals need comprehensive information on treatment-related gonadal toxicity. At diagnosis, physicians should inform the patient thoroughly and consider protective methods to preserve fertility in time.…”

“…Unfortunately, these issues are still not routinely addressed by most physicians. 5,9 It is known that the rate of treatment-induced infertilityincreaseswithmoreaggressivechemotherapy. [10][11][12][13][14] However, there still are many open questions about the probability of amenorrhea, reduced ovarian reserve, and infertility after distinct chemotherapies and the impact of age at treatment onset, as well as about the chance of recovery and the risk of suffering from symptoms of hypogonadism.…”

Pediatric and Teen Ovarian Tissue Removed for Cryopreservation Contains Follicles Irrespective of Age, Disease Diagnosis, Treatment History, and Specimen Processing Methods

“…5,6 Preservation and restoration of fertility are key aspects for enhancing quality of life in this population, and studies have found that 60% of survivors desire to rear biological children and >65% of childhood or young adult cancer survivors have used or want information about infertility and options for having children. [7][8][9][10][11] Thus, major emphasis has been placed on research in the area of childhood cancer survivors, directed not only at providing a cure for their cancer, but at a treatment approach that will allow for the best possible quality of life into adulthood. In addition, the American Society of Clinical Oncology (ASCO), the American Association of Pediatrics, the American Society for Reproductive Medicine (ASRM), and the Association of Pediatric Hematology/Oncology Nurses (APHON) have issued practice guidelines or recommendations that all patients and their parents, as part of education and informed consent before cancer therapy, should be made aware of potential effects on their reproductive function and referred to appropriate reproductive specialists.…”

Fertility preservation in young cancer patients as a springboard to address the needs of this unique population

“…3 The thought of the possibility or actual prior experience of treatment-related infertility can lead to psychological stress. 4,5 Patients prefer maintaining their fertility and future reproductive function at the time of cancer diagnosis. 6 Fertility concerns may also affect the decision to pursue treatment.…”