Sobota A & Ozakinci G (2013) Poster abstract: A Systematic Review of Fertility and Parenthood Issues in Female Cancer Survivors. 15th World Congress of Psycho‐Oncology, Rotterdam Psycho-Oncology, 22 (s3), pp. 339-339. https://onlinelibrary.wiley.com/toc/10991611/2013/22/s3
BACKGROUND: Progress in cancer treatment led to the signiﬁcant increase in survival rates. Younger cancer survivors are faced with many issues such as potential impact of diagnosis and treatment on childbearing. Parenthood is important for social identity, especially for women and the inability to fulﬁl the desire of having a child can
have detrimental effects on psychological well-being. The purpose of this systematic review was to evaluate fertility and parenthood issues encountered by female cancer survivors.
METHOD: Thirteen medical and social science databases were searched for relevant articles using speciﬁc key-words related to cancer, fertility, and psychological outcomes. The established inclusion criteria for the papers were based on three factors: the targeted population (reproductive age women diagnosed with any type of cancer and not pregnant at diagnosis), the reported outcomes (short- and long-term psychological outcomes) and the study design (experimental and observational studies). Of a total number of 8040 identiﬁed articles, 36 met all the eligibility criteria and were included in the review.
RESULTS: Cancer-related infertility was found to provoke stress reactions as well as affect survivors’ quality of life and sexual functioning. Both fertility counselling by specialists and written or online educational materials aimed at increasing knowledge about cancer-related effects on fertility shown to improve psychological outcomes in female cancer survivors. Reproductive decisions in those patients who did not lose their fertility subsequently to cancer were inﬂuenced by multiple fears related to dis-ease course and offspring’s health. However, despite those fears, having a child was a desired goal for many women, giving them a sense of normalcy and hope for recovery. CONCLUSIONS: The existing evidence suggests that in addition to cancer itself, fertility issues can affect psychological outcomes in female cancer survivors, particularly if having children was an important life goal and cancer interrupted those plans. Counselling and education seem to be beneﬁcial in terms of psychological adjustment to the situation. Nonetheless, psychological impact of cancer-related infertility is yet an under-studied area and several limitations to the research exist including small patient samples, retrospective design and predominance of breast cancer survivors across the studies which limit the generalizability of the ﬁndings to other cancer sites.
RESEARCH IMPLICATIONS: There is a gap in our under-standing of the complex associations among cancer, childbearing, and psychological well-being in cancer survivors. We need to identify factors contributing to adverse psychological functioning. Longitudinal studies examining the trajectory of adjustment to infertility and cancer as well as the development of effective interventions are strongly recommended.
CLINICAL IMPLICATIONS: Cancer-related infertility can be prevented using fertility sparing treatment methods or artiﬁcial reproductive technologies. In cases where fertility impairment is unavoidable, provision of reliable information and counselling should be offered to patients. The identiﬁcation of risk factors leading to worse psychological functioning could guide clinicians through the process of selecting patients most in need for support.
Psycho-Oncology: Volume 22, Issue s3