Many young adult female cancer survivors do not receive adequate information about their fertility as part of their survivorship care after completing treatment, despite having concerns about their ability to bear children in the future, finds a new study published early online in CANCER.
The findings point to the need for better resources to support survivors in making informed decisions about their reproductive options after treatment is completed.
‘Delayed fertility-related decisions may cause cancer survivors to miss their narrowed window of opportunity to preserve their fertility’
Many young female cancer survivors are at risk for early menopause because of their cancer treatment, meaning that they will have a shorter reproductive timeline. If they wish to have children but are not yet ready to start a family, they may be able to undergo fertility preservation with egg or embryo freezing after treatment.
To better understand young adult female cancer survivors' informational needs, their concerns about fertility, and how they view the decision to undergo fertility preservation after treatment, a team led by Catherine Benedict, PhD, of Northwell Health, and Joanne Kelvin, RN, MSN, AOCN, and Bridgette Thom, MS, of Memorial Sloan Kettering, asked survivors to complete a web-based, anonymous survey.
Of 346 participants who were an average age of 30 years old and had completed treatment an average of 5 years earlier, the investigators focused on a subgroup of 179 women with uncertain fertility status who had not previously undergone/attempted fertility preservation, either before or after their cancer treatment, and who either wanted future children or were unsure.
Across fertility topics, 43 percent to 62 percent reported unmet information needs, and two-thirds of women were worried about their ability to have future children. Having unmet information needs and greater reproductive concerns made it more difficult for women to think about the decision to undergo fertility preservation in the future. Also, two-thirds of women wanted more advice about the decision to preserve their fertility and one-third wanted more support in making the decision.
These findings establish the need for support services to help young female cancer survivors make decisions about fertility preservation and family-building as part of survivorship care. The literature has largely focused on the clinical and support needs of women making fertility decisions before their treatment begins, but most patients do not preserve their fertility before treatment for a number of reasons, despite wanting children in the future.
"The potential loss of fertility has been described in the literature as being almost as painful, if not more so, than the cancer diagnosis itself," said Dr. Benedict. "Failure to provide information and address concerns with respect to fertility-related decisions may have lasting consequences for young women who hope to move on from their cancer experience to achieve important life goals such as having children. For women at risk for early menopause, delaying fertility-related decisions may cause them to miss their narrowed window of opportunity to preserve their fertility, if desired."