- Din, H. N. et al. Perceived and Objective Fertility Risk Among Female Survivors of Adolescent and Young Adult Cancer. JAMA Network Open 6, e2337245 (2023).
Concerns about the loss of fertility after cancer cause considerable psychological stress. Misconceptions can also lead to unplanned pregnancies or misguided decisions regarding family planning.
Until now, there has been little data on the question of whether those affected realistically assess their own situation. A US retrospective study examined young women who had survived cancer between the ages of 15 and 39.1 Of the 785 respondents, almost two thirds (62%) considered their risk of infertility to be significantly increased. However, according to the study authors, patients' perceptions and objective risks were often far appart from one another.
The concern is, in principle, justified: Cancer survivors in adolescence or young adulthood are more likely to suffer from infertility and have fewer live births than, for example, their siblings without cancer or survivors of paediatric cancer. Nevertheless, many cancer survivors in this age group are perfectly capable of having children.
Both medium to highly gonadotoxic tumour therapies and absent or irregular menstruation were associated with an excessively increased subjective expectation of infertility. Conversely, women who had already given birth to several children tended to underestimate their risk of infertility after tumour treatment.
Infertility risk counselling based on objective biomarkers and previous tumour therapies is needed to close the gap between perceived and real risks.
Repeated counselling on the risk of infertility is necessary for young cancer survivors so that they can correctly classify their actual risk. The authors conclude that appropriate counselling could reduce the psychological burden on those affected and make family planning decisions easier.