Distress from Post-Treatment Infertility Remains Over Time
A recent study found that premenopausal women who wanted a child but could not conceive after cancer treatment had long-term distress about their infertility.
The study, published in Psycho-Oncology, involved women who had breast and other cancers.
Background and Reason for the Study
Cancer treatment interrupts life plans at any age. Women of childbearing age may postpone becoming pregnant, only to have cancer intervene. The risk that the ovaries will stop working after chemotherapy increases with age. Younger women whose periods come back after treatment may have reduced ovarian function.
It’s possible to try to preserve fertility before treatment, but many doctors don’t discuss these options. And some women opt against these methods because of cost, timing or personal reasons.
This study’s researchers recognized that getting a cancer diagnosis at a young age is distressing in itself. They wanted to measure the long-term impact of cancer-related infertility on quality of life.
The researchers contacted women who had been treated for breast cancer, invasive cervical cancer, Hodgkin disease or non-Hodgkin lymphoma. All the women were under 40 years old at diagnosis. These four cancers commonly affect young women and have treatments that may impair fertility.
Phone interviews were conducted with 240 women who were free of disease. The women were five to 10 years after their treatments. The researchers used standardized questionnaires and scales to measure symptoms and concerns, such as distress and intrusive thoughts about infertility.
Some responses were compared to peers. For others, one sub-group (for example, women who wanted children at diagnosis but remained childless) was compared to another (women with one or more children at diagnosis who could not have another they wanted). Women who completed their families before diagnosis were included.
When cancer interrupts childbearing, women had long-term distress an average of 10 years after treatment. The study found this effect regardless of other demographic or medical factors, such as age, income or recurrence.
Women who wanted children at diagnosis but remained childless were the most distressed. They were significantly more distressed than women who could not become pregnant after treatment but already had one or more children at diagnosis. Women who adopted or became step-parents had elevated distress, but not as much as in those remaining childless.
Distress was only related to infertility and did not reflect general emotional state. Women affected by breast cancer did not have more infertility-related distress than women with the other three cancers, the researchers found.
What This Means for You
Before surgery, chemotherapy or hormonal therapy, talk with your doctors about your fertility. Even if you are unsure whether you want children in the future, consider talking about your options, so you feel informed and confident about your choices.
- How could this treatment affect my ability to become pregnant later?
- What can we do to preserve my fertility? How will these methods affect my treatment?
- What are the chances that I will be able to conceive and carry a pregnancy after this treatment?
If you’ve finished treatment and want to become pregnant, ask about your fertility status and what might be possible to help you. New methods are becoming available, so talk with a reproductive endocrinologist, especially if you have already experienced treatment-related infertility. Learn more in LBBC’s Ask the Expert: Fertility and Pregnancy. Also consider consulting these organizations, which have resources for women with concerns about or who have experienced infertility:
- The American Society for Reproductive Medicine
- The American Fertility Association
- Resolve: The National Infertility Association
AL Canada and LR Schover. The psychosocial impact of interrupted childbearing in long-term female cancer survivors Psycho-Oncology 2012; 21: 134–143.
This article was supported by Cooperative Agreement Number DP11-1111 from The Centers for Disease Control and Prevention. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention.