Journal Article
. 1999 Aug; 86(4):697-709.
doi: 10.1002/(sici)1097-0142(19990815)86:4<697::aid-cncr20>;2-j.

Having children after cancer. A pilot survey of survivors' attitudes and experiences

L R Schover 1 L A Rybicki  B A Martin  K A Bringelsen  
  • PMID: 10440699
  •     135 citations


Background: Although the prevalence of infertility after cancer treatment and the health of the offspring of survivors have been studied, little information has been available about survivors' attitudes, emotions, and choices with regard to having children.

Methods: A questionnaire was received by 283 patients from the Cleveland Clinic Foundation tumor registry who were diagnosed before age 35 years, were age 18 years or older at the time of the survey, and were free of disease. The SF-36, a measure of health-related quality of life, was included, as well as questions about demographic and medical background, reproductive and fertility history, and a variety of concerns about having children after cancer.

Results: The response rate to the survey was 47%, yielding a sample of 43 men and 89 women who had had cancer at various sites. Their mean age at diagnosis was 26 years and the mean time since diagnosis was 5 years. Before cancer, 35% had at least 1 child, compared with 46% currently. Of those currently childless, 76% want children in the future. Although about half of the entire sample view themselves as having impaired fertility, only 6% have undergone infertility treatment. Nineteen percent have significant anxiety that their cancer treatment could impact negatively on their children's future health. Of women, 18% fear that a pregnancy could trigger a cancer recurrence. Only 57% received information from their health care providers about infertility after cancer. Other reproductive concerns were discussed less often. Only 24% of childless men banked sperm before treatment. SF-36 scores were very similar to normative data for healthy Americans of similar age. About 80% of the sample viewed themselves positively as actual or potential parents. Feeling healthy enough to be a good parent after cancer was the strongest predictor (P < 0.001) of emotional well-being as measured by the Mental Component Score of the SF-36.

Conclusions: The great majority of younger cancer survivors see their cancer experience as potentially making them better parents. Those who are childless want to have children in the future. Many, however, are left with significant anxieties and insufficient information about reproductive issues.

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Cancer survivors of gynecologic malignancies are at risk for decreased opportunity for fertility preservation.
Wael H Salem, Joe M Letourneau, +3 authors, Mitchell P Rosen.
Contracept Reprod Med, 2017 Dec 05; 2. PMID: 29201417    Free PMC article.
Knowledge and Perceptions about Cancer Treatment-associated Infertility among Young Patients at a Tertiary Care Hospital in Pakistan
Asif Husain Osmani, Ghulam Haider, +3 authors, Dur e Fatima.
Asian Pac J Cancer Prev, 2017 Dec 30; 18(12). PMID: 29286217    Free PMC article.
Tissue Engineering to Improve Immature Testicular Tissue and Cell Transplantation Outcomes: One Step Closer to Fertility Restoration for Prepubertal Boys Exposed to Gonadotoxic Treatments.
Federico Del Vento, Maxime Vermeulen, +4 authors, Christine Wyns.
Int J Mol Sci, 2018 Jan 19; 19(1). PMID: 29346308    Free PMC article.
Childbearing across borders: Fertility and parenthood attitudes and decisions among breast cancer survivors in USA and Portugal.
Vânia Gonçalves, Janella Hudson, +6 authors, Gwendolyn P Quinn.
Breast, 2018 Apr 21; 40. PMID: 29674220    Free PMC article.
Fertility Preservation for Patients with Malignant Disease. Guideline of the DGGG, DGU and DGRM (S2k-Level, AWMF Registry No. 015/082, November 2017) - Recommendations and Statements for Girls and Women.
Ralf Dittrich, Sabine Kliesch, +54 authors, Laura Lotz.
Geburtshilfe Frauenheilkd, 2018 Jul 03; 78(6). PMID: 29962516    Free PMC article.
Preserving fertility in an unconscious patient with Goodpasture syndrome-medicolegal and ethical aspects.
Doreen Stark, Ruth Stiller, +3 authors, Matthias Peter Hilty.
J Intensive Care, 2018 Aug 01; 6. PMID: 30062013    Free PMC article.
Current standing and future directions in pediatric oncofertility: a narrative review.
Glen A Lau, Anthony J Schaeffer.
Transl Androl Urol, 2018 Aug 31; 7(Suppl 3). PMID: 30159233    Free PMC article.

;. PMID: 30241266
Knowledge, attitude, intention, and religion aspect toward fertility preservation among obstetrics and gynecology residents in Indonesia: A cross-sectional study.
Achmad Kemal Harzif, Mila Maidarti, +3 authors, Budi Wiweko.
Int J Reprod Biomed, 2020 Feb 12; 18(1). PMID: 32043071    Free PMC article.
Patterns of Referral for Fertility Preservation Among Female Adolescents and Young Adults with Breast Cancer: A Population-Based Study.
Ann Korkidakis, Katherine Lajkosz, +2 authors, Maria P Velez.
J Adolesc Young Adult Oncol, 2019 Jan 25; 8(2). PMID: 30676852    Free PMC article.
Perceived infertility and contraceptive use in the female, reproductive-age cancer survivor.
Tracy N Hadnott, Shaylyn S Stark, +4 authors, H Irene Su.
Fertil Steril, 2019 Apr 02; 111(4). PMID: 30929732    Free PMC article.
Oncofertility in adult and pediatric populations: options and barriers.
Joshua A Halpern, Arighno Das, Cory A Faw, Robert E Brannigan.
Transl Androl Urol, 2020 Apr 08; 9(Suppl 2). PMID: 32257863    Free PMC article.
Is Fertility Preservation Feasible and Safe With Neoadjuvant Therapy for Breast Cancer?
Avner Hershlag, Christine Mullin, Sara L Bristow.
JCO Glob Oncol, 2020 Apr 08; 6. PMID: 32259161    Free PMC article.
Outcomes of Pregnancy after Breast Cancer in Korean Women: A Large Cohort Study.
Moo Hyun Lee, Young Ae Kim, +5 authors, Eun Sook Lee.
Cancer Res Treat, 2019 Sep 04; 52(2). PMID: 31476846    Free PMC article.
Attitudes toward fertility and fertility preservation in women with glioma.
Rachel K Stiner, Jennifer L Clarke, +8 authors, Mitchell P Rosen.
Neurooncol Pract, 2019 Aug 07; 6(3). PMID: 31386027    Free PMC article.
Post-transplant outcome of ovarian tissue cryopreserved after chemotherapy in hematologic malignancies.
Catherine Poirot, Anne Fortin, +20 authors, Nicolas Boissel.
Haematologica, 2019 Feb 16; 104(8). PMID: 30765476    Free PMC article.
Pregnancy, time to pregnancy and obstetric outcomes among female childhood cancer survivors: results of the DCOG LATER-VEVO study.
M van Dijk, F E van Leeuwen, +14 authors, M H van den Berg.
J Cancer Res Clin Oncol, 2020 Mar 30; 146(6). PMID: 32221745    Free PMC article.
Fertility preservation and fulfillment of parenthood after treatment of hematological malignancies: results from the 'Aftercare in Blood Cancer Survivors' (ABC) study.
Christine Schmitz, Julia Baum, +5 authors, Ulrich Dührsen.
Int J Clin Oncol, 2020 Mar 07; 25(6). PMID: 32140954    Free PMC article.
Fertility and risk factors for elevated infertility concern in 10-year hematopoietic cell transplant survivors and case-matched controls.
Camille Hammond, Janet R Abrams, Karen L Syrjala.
J Clin Oncol, 2007 Jul 25; 25(23). PMID: 17646668    Free PMC article.
Trends of socioeconomic disparities in referral patterns for fertility preservation consultation.
Linnea R Goodman, Ursula Balthazar, Jayeon Kim, Jennifer E Mersereau.
Hum Reprod, 2012 May 04; 27(7). PMID: 22552688    Free PMC article.
Investigation of Each Society for Fertility Preservation in Asia.
Achmad Kemal Harzif, Victor Prana Andika Santawi, Mila Maidarti, Budi Wiweko.
Front Endocrinol (Lausanne), 2019 Mar 30; 10. PMID: 30923515    Free PMC article.
Fertility preservation for young adults, adolescents, and children with cancer.
Kenny A Rodriguez-Wallberg, Amandine Anastacio, +3 authors, Birgit Borgström.
Ups J Med Sci, 2020 May 02; 125(2). PMID: 32356507    Free PMC article.
Quality of life among female childhood cancer survivors with and without premature ovarian insufficiency.
Hjelmér Ida, Gustafsson Kylberg Alicia, +6 authors, Nenonen Hannah.
J Cancer Surviv, 2021 Jan 21;. PMID: 33469826
Fertility Preservation and Long-Term Monitoring of Gonadotoxicity in Girls, Adolescents and Young Adults Undergoing Cancer Treatment.
Kaja Michalczyk, Aneta Cymbaluk-Płoska.
Cancers (Basel), 2021 Jan 13; 13(2). PMID: 33429908    Free PMC article.