Fertility and parenthood issues in young female cancer patients - a systematic review

Abstract

Purpose: For young women who were diagnosed with cancer prior to having children, reproductive potential might affect quality of life (QoL). This systematic review looks at fertility issues in young female cancer patients, focusing on their influence on psychological well-being, specific fertility-related interventions and reproductive decisions. Methods: Thirteen medical and social science databases were searched for relevant articles up to December 2012, according to PRISMA guidelines. Twenty-six articles meeting the eligibility criteria were included in the review, along with 5 additional papers that missed the inclusion criteria narrowly. Narrative synthesis was used to analyse the studies. Results: Depression, anxiety, and QoL seemed to be related to the perceptions of reproductive issues rather than to the fertility status based on the type of treatment received. Fertility-related interventions improved patients’ QoL, decisional regret, and decisional conflict. Finally, cancer influenced women’s reproductive decisions. Pursuing pregnancy was affected mainly by worries about child’s and mother’s health. Decisions about treatment were influenced by the wish to preserve fertility. The generalisability of these results might be undermined by small sample sizes and homogeneity of participants within and across the studies. Inferences about causality of associations are problematic due to predominantly cross-sectional design. Implications for cancer survivors: The existing literature gives preliminary insight into the importance of fertility for young women diagnosed with cancer. However, more research is needed in order to offer patients comprehensive care.