INFLUENCE OF FERTILITY ON FAMILY PLANNING DECISIONS AMONG MIDDLEAGED SURVIVORS OF CHILDHOOD CANCER: A QUALITATIVE STUDY

Abstract

Background As the number of childhood cancer survivors increases, there is a need to affront associated issues in adulthood such as anxiety, depression, and infertility. The aim of this qualitative study was to examine how childhood cancer survivors at the end of their fertile period were informed about fertility earlier in life and to investigate how this information influenced family planning decisions during adulthood. Methods The study included childhood cancer survivors in western Sweden ages 37–45 years identified from the Childhood Cancer Registry. Ten women and eight men ultimately participated in the study. Participants had been treated for cancer at a median age of 14 years (range, 2.5–17.5 years) and the median time since diagnosis was 26.0 years (range, 21.0–44.5 years). The study design consisted of a semi-structured interview and thematic analysis. Results A master theme that emerged from interviews was A long and uncertain road, which was divided into three underlying subthemes: Pictures of fertility e.g., from healthcare providers or parents; Experience of fertility e.g., searching as an adult, feeling like everyone else, not for me; and Emotions and fertility e.g., better not to think about it, cancer will affect my child. Women scored consistently lower than men on questionnaires regarding quality of life. Conclusion Most participants felt that they received insufficient information about fertility after cancer. The present study also highlighted a lack of support for cancer survivors into adulthood, which affected their psychological well-being and their inclination to become parents themselves.

Keywords

• childhood cancer survivors
• family planning
• fertility
• thematic analysis