Skip to main content
Top
Published in: Supportive Care in Cancer 10/2014

Open Access 01-10-2014 | Original Article

Desire for children, difficulties achieving a pregnancy, and infertility distress 3 to 7 years after cancer diagnosis

Authors: Gabriela M. Armuand, Lena Wettergren, Kenny A. Rodriguez-Wallberg, Claudia Lampic

Published in: Supportive Care in Cancer | Issue 10/2014

Login to get access

Abstract

Purpose

The 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.

Methods

Cancer 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).

Results

Most 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.

Conclusions

Health 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.
Literature
1.
2.
go back to reference Siegel R, DeSantis C, Virgo K, Stein K, Mariotto A, Smith T, Cooper D, Gansler T, Lerro C, Fedewa S, Lin C, Leach C, Cannady RS, Cho H, Scoppa S, Hachey M, Kirch R, Jemal A, Ward E (2012) Cancer treatment and survivorship statistics, 2012. CA Cancer J Clin 62(4):220–241. doi:10.3322/caac.21149 PubMedCrossRef Siegel R, DeSantis C, Virgo K, Stein K, Mariotto A, Smith T, Cooper D, Gansler T, Lerro C, Fedewa S, Lin C, Leach C, Cannady RS, Cho H, Scoppa S, Hachey M, Kirch R, Jemal A, Ward E (2012) Cancer treatment and survivorship statistics, 2012. CA Cancer J Clin 62(4):220–241. doi:10.​3322/​caac.​21149 PubMedCrossRef
7.
go back to reference Armuand GM, Rodriguez-Wallberg KA, Wettergren L, Ahlgren J, Enblad G, Hoglund M, Lampic C (2012) Sex differences in fertility-related information received by young adult cancer survivors. J Clin Oncol 30(17):2147–2153. doi:10.1200/JCO.2011.40.6470 PubMedCrossRef Armuand GM, Rodriguez-Wallberg KA, Wettergren L, Ahlgren J, Enblad G, Hoglund M, Lampic C (2012) Sex differences in fertility-related information received by young adult cancer survivors. J Clin Oncol 30(17):2147–2153. doi:10.​1200/​JCO.​2011.​40.​6470 PubMedCrossRef
8.
go back to reference Letourneau JM, Ebbel EE, Katz PP, Katz A, Ai WZ, Chien AJ, Melisko ME, Cedars MI, Rosen MP (2012) Pretreatment fertility counseling and fertility preservation improve quality of life in reproductive age women with cancer. Cancer 118(6):1710–1717. doi:10.1002/cncr.26459 PubMedCrossRefPubMedCentral Letourneau JM, Ebbel EE, Katz PP, Katz A, Ai WZ, Chien AJ, Melisko ME, Cedars MI, Rosen MP (2012) Pretreatment fertility counseling and fertility preservation improve quality of life in reproductive age women with cancer. Cancer 118(6):1710–1717. doi:10.​1002/​cncr.​26459 PubMedCrossRefPubMedCentral
9.
go back to reference Yee S, Buckett W, Campbell S, Yanofsky R, Barr RD (2012) A national study of the provision of oncofertility services to female patients in Canada. J Obstet Gynaecol Can 34(9):849–858PubMed Yee S, Buckett W, Campbell S, Yanofsky R, Barr RD (2012) A national study of the provision of oncofertility services to female patients in Canada. J Obstet Gynaecol Can 34(9):849–858PubMed
10.
go back to reference Garvelink MM, Ter Kuile MM, Fischer MJ, Louwe LA, Hilders CG, Kroep JR, Stiggelbout AM (2013) Development of a Decision Aid about fertility preservation for women with breast cancer in the Netherlands. J Psychosom Obstet Gynaecol 34(4):170–178. doi:10.3109/0167482X.2013.851663 PubMedCrossRef Garvelink MM, Ter Kuile MM, Fischer MJ, Louwe LA, Hilders CG, Kroep JR, Stiggelbout AM (2013) Development of a Decision Aid about fertility preservation for women with breast cancer in the Netherlands. J Psychosom Obstet Gynaecol 34(4):170–178. doi:10.​3109/​0167482X.​2013.​851663 PubMedCrossRef
11.
go back to reference Peate M, Meiser B, Cheah BC, Saunders C, Butow P, Thewes B, Hart R, Phillips KA, Hickey M, Friedlander M (2012) Making hard choices easier: a prospective, multicentre study to assess the efficacy of a fertility-related decision aid in young women with early-stage breast cancer. Br J Cancer 106(6):1053–1061. doi:10.1038/bjc.2012.61 PubMedCrossRefPubMedCentral Peate M, Meiser B, Cheah BC, Saunders C, Butow P, Thewes B, Hart R, Phillips KA, Hickey M, Friedlander M (2012) Making hard choices easier: a prospective, multicentre study to assess the efficacy of a fertility-related decision aid in young women with early-stage breast cancer. Br J Cancer 106(6):1053–1061. doi:10.​1038/​bjc.​2012.​61 PubMedCrossRefPubMedCentral
12.
go back to reference Lee SJ, Schover LR, Partridge AH, Patrizio P, Wallace WH, Hagerty K, Beck LN, Brennan LV, Oktay K (2006) American Society of Clinical Oncology recommendations on fertility preservation in cancer patients. J Clin Oncol 24(18):2917–2931. doi:10.1200/JCO.2006.06.5888 PubMedCrossRef Lee SJ, Schover LR, Partridge AH, Patrizio P, Wallace WH, Hagerty K, Beck LN, Brennan LV, Oktay K (2006) American Society of Clinical Oncology recommendations on fertility preservation in cancer patients. J Clin Oncol 24(18):2917–2931. doi:10.​1200/​JCO.​2006.​06.​5888 PubMedCrossRef
15.
go back to reference Carter J, Lewin S, Abu-Rustum N, Sonoda Y (2007) Reproductive issues in the gynecologic cancer patient. Oncology (Williston Park) 21(5):598–606, discussion 606-599 Carter J, Lewin S, Abu-Rustum N, Sonoda Y (2007) Reproductive issues in the gynecologic cancer patient. Oncology (Williston Park) 21(5):598–606, discussion 606-599
16.
17.
go back to reference Wenzel L, Dogan-Ates A, Habbal R, Berkowitz R, Goldstein DP, Bernstein M, Kluhsman BC, Osann K, Newlands E, Seckl MJ, Hancock B, Cella D (2005) Defining and measuring reproductive concerns of female cancer survivors. J Natl Cancer Inst Monogr 34:94–98. doi:10.1093/jncimonographs/lgi017 PubMedCrossRef Wenzel L, Dogan-Ates A, Habbal R, Berkowitz R, Goldstein DP, Bernstein M, Kluhsman BC, Osann K, Newlands E, Seckl MJ, Hancock B, Cella D (2005) Defining and measuring reproductive concerns of female cancer survivors. J Natl Cancer Inst Monogr 34:94–98. doi:10.​1093/​jncimonographs/​lgi017 PubMedCrossRef
21.
24.
go back to reference Sullivan M, Karlsson J, Ware JE Jr (1995) The Swedish SF-36 Health Survey–I. Evaluation of data quality, scaling assumptions, reliability and construct validity across general populations in Sweden. Soc Sci Med 41(10):1349–1358PubMedCrossRef Sullivan M, Karlsson J, Ware JE Jr (1995) The Swedish SF-36 Health Survey–I. Evaluation of data quality, scaling assumptions, reliability and construct validity across general populations in Sweden. Soc Sci Med 41(10):1349–1358PubMedCrossRef
25.
go back to reference Ware JE Jr, Sherbourne CD (1992) The MOS 36-item short-form health survey (SF-36) I. Conceptual framework and item selection. Med Care 30(6):473–483PubMedCrossRef Ware JE Jr, Sherbourne CD (1992) The MOS 36-item short-form health survey (SF-36) I. Conceptual framework and item selection. Med Care 30(6):473–483PubMedCrossRef
26.
go back to reference Ware JE Jr, Kosinski M, Bayliss MS, McHorney CA, Rogers WH, Raczek A (1995) Comparison of methods for the scoring and statistical analysis of SF-36 health profile and summary measures: summary of results from the Medical Outcomes Study. Med Care 33(4 Suppl):AS264–279PubMed Ware JE Jr, Kosinski M, Bayliss MS, McHorney CA, Rogers WH, Raczek A (1995) Comparison of methods for the scoring and statistical analysis of SF-36 health profile and summary measures: summary of results from the Medical Outcomes Study. Med Care 33(4 Suppl):AS264–279PubMed
28.
go back to reference Newton CR, Sherrard W, Glavac I (1999) The Fertility Problem Inventory: measuring perceived infertility-related stress. Fertil Steril 72(1):54–62PubMedCrossRef Newton CR, Sherrard W, Glavac I (1999) The Fertility Problem Inventory: measuring perceived infertility-related stress. Fertil Steril 72(1):54–62PubMedCrossRef
29.
30.
31.
go back to reference Lampic C, Svanberg AS, Karlstrom P, Tyden T (2006) Fertility awareness, intentions concerning childbearing, and attitudes towards parenthood among female and male academics. Hum Reprod 21(2):558–564. doi:10.1093/humrep/dei367 PubMedCrossRef Lampic C, Svanberg AS, Karlstrom P, Tyden T (2006) Fertility awareness, intentions concerning childbearing, and attitudes towards parenthood among female and male academics. Hum Reprod 21(2):558–564. doi:10.​1093/​humrep/​dei367 PubMedCrossRef
32.
go back to reference Senkus E, Gomez H, Dirix L, Jerusalem G, Murray E, Van Tienhoven G, Westenberg AH, Bottomley A, Rapion J, Bogaerts J, Di Leo A, Neskovic-Konstantinovic Z (2013) Attitudes of young patients with breast cancer toward fertility loss related to adjuvant systemic therapies. EORTC study 10002 BIG 3-98. Psychooncology. doi:10.1002/pon.3384 Senkus E, Gomez H, Dirix L, Jerusalem G, Murray E, Van Tienhoven G, Westenberg AH, Bottomley A, Rapion J, Bogaerts J, Di Leo A, Neskovic-Konstantinovic Z (2013) Attitudes of young patients with breast cancer toward fertility loss related to adjuvant systemic therapies. EORTC study 10002 BIG 3-98. Psychooncology. doi:10.​1002/​pon.​3384
33.
go back to reference Peate M, Meiser B, Friedlander M, Zorbas H, Rovelli S, Sansom-Daly U, Sangster J, Hadzi-Pavlovic D, Hickey M (2011) It's now or never: fertility-related knowledge, decision-making preferences, and treatment intentions in young women with breast cancer—an Australian fertility decision aid collaborative group study. J Clin Oncol 29(13):1670–1677. doi:10.1200/JCO.2010.31.2462 PubMedCrossRef Peate M, Meiser B, Friedlander M, Zorbas H, Rovelli S, Sansom-Daly U, Sangster J, Hadzi-Pavlovic D, Hickey M (2011) It's now or never: fertility-related knowledge, decision-making preferences, and treatment intentions in young women with breast cancer—an Australian fertility decision aid collaborative group study. J Clin Oncol 29(13):1670–1677. doi:10.​1200/​JCO.​2010.​31.​2462 PubMedCrossRef
35.
go back to reference Peterson BD, Newton CR, Rosen KH (2003) Examining congruence between partners’ perceived infertility-related stress and its relationship to marital adjustment and depression in infertile couples. Fam Process 42(1):59–70PubMedCrossRef Peterson BD, Newton CR, Rosen KH (2003) Examining congruence between partners’ perceived infertility-related stress and its relationship to marital adjustment and depression in infertile couples. Fam Process 42(1):59–70PubMedCrossRef
36.
go back to reference Carter J, Raviv L, Applegarth L, Ford JS, Josephs L, Grill E, Sklar C, Sonoda Y, Baser RE, Barakat RR (2010) A cross-sectional study of the psychosexual impact of cancer-related infertility in women: third-party reproductive assistance. J Cancer Surviv 4(3):236–246. doi:10.1007/s11764-010-0121-2 PubMedCrossRefPubMedCentral Carter J, Raviv L, Applegarth L, Ford JS, Josephs L, Grill E, Sklar C, Sonoda Y, Baser RE, Barakat RR (2010) A cross-sectional study of the psychosexual impact of cancer-related infertility in women: third-party reproductive assistance. J Cancer Surviv 4(3):236–246. doi:10.​1007/​s11764-010-0121-2 PubMedCrossRefPubMedCentral
37.
go back to reference Hudson N, Culley L, Rapport F, Johnson M, Bharadwaj A (2009) “Public” perceptions of gamete donation: a research review. Public Underst Sci 18(1):61–77PubMedCrossRef Hudson N, Culley L, Rapport F, Johnson M, Bharadwaj A (2009) “Public” perceptions of gamete donation: a research review. Public Underst Sci 18(1):61–77PubMedCrossRef
39.
40.
go back to reference Tyden T, Svanberg AS, Karlstrom PO, Lihoff L, Lampic C (2006) Female university students’ attitudes to future motherhood and their understanding about fertility. Eur J Contracept Reprod Health Care 11(3):181–189. doi:10.1080/13625180600557803 PubMedCrossRef Tyden T, Svanberg AS, Karlstrom PO, Lihoff L, Lampic C (2006) Female university students’ attitudes to future motherhood and their understanding about fertility. Eur J Contracept Reprod Health Care 11(3):181–189. doi:10.​1080/​1362518060055780​3 PubMedCrossRef
41.
go back to reference Ahearn EP (1997) The use of visual analog scales in mood disorders: a critical review. J Psychiatr Res 31(5):569–579PubMedCrossRef Ahearn EP (1997) The use of visual analog scales in mood disorders: a critical review. J Psychiatr Res 31(5):569–579PubMedCrossRef
42.
go back to reference Wewers ME, Lowe NK (1990) A critical review of visual analogue scales in the measurement of clinical phenomena. Res Nurs Health 13(4):227–236PubMedCrossRef Wewers ME, Lowe NK (1990) A critical review of visual analogue scales in the measurement of clinical phenomena. Res Nurs Health 13(4):227–236PubMedCrossRef
Metadata
Title
Desire for children, difficulties achieving a pregnancy, and infertility distress 3 to 7 years after cancer diagnosis
Authors
Gabriela M. Armuand
Lena Wettergren
Kenny A. Rodriguez-Wallberg
Claudia Lampic
Publication date
01-10-2014
Publisher
Springer Berlin Heidelberg
Published in
Supportive Care in Cancer / Issue 10/2014
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-014-2279-z

Other articles of this Issue 10/2014

Supportive Care in Cancer 10/2014 Go to the issue
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine