Journal Article
. 2012 Jan; 21(2):134-43.
doi: 10.1002/pon.1875.

The psychosocial impact of interrupted childbearing in long-term female cancer survivors

Andrea L Canada 1 Leslie R Schover  
  • PMID: 22271533
  •     65 References
  •     76 citations


Objective: To understand the influence of cancer-related infertility on women's long-term distress and quality of life. Women diagnosed at age 40 or less with invasive cervical cancer, breast cancer, Hodgkin disease, or non-Hodgkin lymphoma were interviewed an average of 10 years later. We predicted that women whose desire for a child at diagnosis remained unfulfilled would be significantly more distressed.

Methods: Participants completed a semi-structured phone interview, including the SF-12® , Brief Symptom Inventory-18, Impact of Events Scale (IES), Reproductive Concerns Scale (RCS), brief measures of marital satisfaction or comfort with dating, sexual satisfaction, and menopause symptoms.

Results: Of 455 women contacted by phone, 240 (53%) participated. Seventy-seven women had wanted a child at diagnosis but did not conceive subsequently (38 remaining childless and 39 with secondary infertility). Even controlling for other psychosocial and health factors, this group had higher distress about infertility (RCS) (p<0.001), had more intrusive thoughts about infertility, and used more avoidance strategies when reminded of infertility (IES) (p<0.001). Childless women were the most distressed. Women with adopted or stepchildren were intermediate, and those with at least one biological child were least distressed. Infertility-related distress did not differ significantly by cancer site.

Conclusions: Even at long-term follow-up, distress about interrupted childbearing persists, particularly in childless women. Social parenthood buffers distress somewhat, but not completely. Not only is it important to offer fertility preservation before cancer treatment, but interventions should be developed for survivors to alleviate unresolved grief about cancer-related infertility.

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Reprod Health, 2018 Jan 07; 15(1). PMID: 29304873    Free PMC article.
Young Adult Female Cancer Survivors' Concerns About Future Children's Health and Genetic Risk.
Nirupa Jaya Raghunathan, Catherine Benedict, +2 authors, Joanne Frankel Kelvin.
J Adolesc Young Adult Oncol, 2018 Jan 25; 7(1). PMID: 29364765    Free PMC article.
Fertility information needs and concerns post-treatment contribute to lowered quality of life among young adult female cancer survivors.
Catherine Benedict, Bridgette Thom, +3 authors, Joanne F Kelvin.
Support Care Cancer, 2018 Feb 02; 26(7). PMID: 29387996    Free PMC article.
Fertility Management for the Hemato-Oncologist.
Parathan Karunakaran, Pankaj Malhotra, Deepesh Lad.
Indian J Hematol Blood Transfus, 2018 Feb 06; 34(1). PMID: 29398794    Free PMC article.
Pathways: patient-centred decision counselling for women at risk of cancer-related infertility: a protocol for a comparative effectiveness cluster randomised trial.
Terri Lynn Woodard, Aubri S Hoffman, +6 authors, Robert J Volk.
BMJ Open, 2018 Feb 23; 8(2). PMID: 29467138    Free PMC article.
Threat of biographical disruption: the gendered construction and experience of infertility following cancer for women and men.
Jane M Ussher, Janette Perz, Australian Cancer and Fertility Study Team (ACFST).
BMC Cancer, 2018 Mar 07; 18(1). PMID: 29506492    Free PMC article.
The intersection of financial toxicity and family building in young adult cancer survivors.
Bridgette Thom, Catherine Benedict, Danielle N Friedman, Joanne F Kelvin.
Cancer, 2018 Jun 21; 124(16). PMID: 29924381    Free PMC article.
Influence of Negative Emotional Expressions on the Outcomes of Shared Decision Making During Oncofertility Consultations in Japan.
Tomoe Koizumi, Kazuko Nara, +4 authors, Yoshiharu Morimoto.
J Adolesc Young Adult Oncol, 2018 Jul 24; 7(4). PMID: 30036103    Free PMC article.
Long-Term Oncologic Outcomes of Uterine-Preserving Surgery in Young Women With Stage Ib1 Cervical Cancer.
Jill H Tseng, Alessia Aloisi, +4 authors, Mario M Leitao.
Int J Gynecol Cancer, 2018 Jul 24; 28(7). PMID: 30036225    Free PMC article.
Determinants of fertility issues experienced by young women diagnosed with breast or gynaecological cancer - a quantitative, cross-cultural study.
Aleksandra Sobota, Gozde Ozakinci.
BMC Cancer, 2018 Sep 08; 18(1). PMID: 30189847    Free PMC article.
Ovarian survival after pelvic radiation: transposition until the age of 35 years.
Ellen J Hoekman, Dan Knoester, +3 authors, Carina G J M Hilders.
Arch Gynecol Obstet, 2018 Sep 16; 298(5). PMID: 30218184    Free PMC article.
We are different: Young adult survivors' experience of breast cancer.
Ashley Henneghan, Carolyn Phillips, Anne Courtney.
Breast J, 2018 Sep 29; 24(6). PMID: 30264438    Free PMC article.
Effects of controlled ovarian stimulation on toxicity of TAC chemotherapy in early breast cancer patients.
Stefanie de Groot, Leoni A Louwé, +5 authors, Judith R Kroep.
Cancer Manag Res, 2018 Oct 13; 10. PMID: 30310313    Free PMC article.
Factors Affecting Fertility Decision-Making Among Transgender Adolescents and Young Adults.
Diane Chen, Moira A Kyweluk, +4 authors, Teresa K Woodruff.
LGBT Health, 2019 Apr 16; 6(3). PMID: 30985275    Free PMC article.
Supportive oncofertility care, psychological health and reproductive concerns: a qualitative study.
Y Wang, Shanna Logan, +11 authors, A Anazodo.
Support Care Cancer, 2019 Jun 04; 28(2). PMID: 31154532
A comparison of heterosexual and LGBTQ cancer survivors' outlooks on relationships, family building, possible infertility, and patient-doctor fertility risk communication.
Andrea M Russell, Kathleen M Galvin, Maya M Harper, Marla L Clayman.
J Cancer Surviv, 2016 Feb 19; 10(5). PMID: 26887847
Fertility counseling before cancer treatment and subsequent reproductive concerns among female adolescent and young adult cancer survivors.
Katie Young, Ksenya Shliakhtsitsava, +6 authors, H Irene Su.
Cancer, 2018 Nov 30; 125(6). PMID: 30489638    Free PMC article.
Applying behavioral theory to understand fertility consultation uptake after cancer.
Jessica R Gorman, Julia H Drizin, Jennifer E Mersereau, H Irene Su.
Psychooncology, 2019 Feb 15; 28(4). PMID: 30761655    Free PMC article.
Epigallocatechin-3-gallate inhibits doxorubicin-induced inflammation on human ovarian tissue.
R Fabbri, M Macciocca, +6 authors, R Seracchioli.
Biosci Rep, 2019 Apr 19; 39(5). PMID: 30996116    Free PMC article.
Level of Knowledge and Needs on Fertility Preservation in Reproductive-Aged Male Patients with Cancer.
Hanfeng Zhang, Guorong Wang, +5 authors, Jian Zhang.
J Cancer Educ, 2019 Jan 09; 35(2). PMID: 30618008    Free PMC article.
Sexual dysfunction and reproductive concerns in young women with breast cancer: Type, prevalence, and predictors of problems.
Lisa Ljungman, Johan Ahlgren, +5 authors, Claudia Lampic.
Psychooncology, 2018 Sep 12; 27(12). PMID: 30203884    Free PMC article.
First Italian birth after cryopreserved ovarian tissue transplantation in a patient affected by non-Hodgkin's lymphoma.
Raffaella Fabbri, Maria Macciocca, +5 authors, Renato Seracchioli.
Int J Hematol Oncol, 2019 Jan 18; 7(4). PMID: 30651967    Free PMC article.
Factors associated with treatment delay in women with primary breast cancer who were referred to reproductive specialists.
Atsuko Kitano, Chikako Shimizu, +4 authors, Sachiko Ohde.
ESMO Open, 2019 Apr 10; 4(2). PMID: 30962960    Free PMC article.
Talking but not always understanding: couple communication about infertility concerns after cancer.
Alexandra Hawkey, Jane M Ussher, Janette Perz, Chloe Parton.
BMC Public Health, 2021 Jan 21; 21(1). PMID: 33468106    Free PMC article.
Fertility counseling information adequacy as a moderator of regret among adolescent and young adult breast cancer survivors.
Angela G Campbell, Marianne Hillemeier.
Support Care Cancer, 2020 Sep 28; 29(5). PMID: 32980927    Free PMC article.
Development and validation of a guideline on sexual and reproductive health of breast cancer survivors in Iran: a mixed methods study protocol.
Solmaz Roshandel, Minoor Lamyian, +2 authors, Eesa Mohammadi.
Health Res Policy Syst, 2021 Jun 02; 19(1). PMID: 34059055    Free PMC article.