Abstract
Fertility patients frequently report living in a binary world, one divided between the fertile and the infertile. However, adolescent and young adult (AYA) cancer survivors who later learn they will have difficulty conceiving or bearing children have similar reactions to their diagnosis, but with some marked differences, as the injustices of their reality are much more complex. They frequently feel betrayed because the very treatments used to save their lives may be the ones that have caused them to be unable to have biogenetic children of their own, unable to fulfill their need for generativity and their longing for a return to normalcy [1]. In 1999, it was predicted that by the time this book is published [2012] one in every 250 young adults would be a survivor of cancer [2]. Although the ability to have biogenetically related offspring has been the topic of countless articles and books published in the area of reproductive health and medicine, less than half of adolescent and young adult cancer survivors can recall their oncologist or other members of their medical team discussing fertility related issues, including fertility preservation, prior to commencement of treatment [3–10]. Of those who did remember their physicians providing facts, advice, details, or statistics about fertility, many believed the information they received was inadequate and presented in an untimely manor [8–13].
Keywords
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
Having cancer has been quite scary and physically exhausting. I felt sick and was worried that I would die. After the treatment put me into remission, I was nervous that I might never have a child. At the same time, I was also concerned I would pass my bad genes to my children and they eventually would get cancer too.
Since finding out that as a result of my cancer treatment I am sterile, many of my friends walk on eggshells when they are around me. I can see by their sideway glances that they are trying to be sensitive and considerate when speaking about their pregnancies and their children. I feel it is my job to reassure them that these are not forbidden topics.
I am quite fortunate. As soon as my oncologist informed me that my cancer treatment would cause infertility, my middle sister told me that when I wanted to become pregnant and have a child, she would like to donate her eggs to me. The reproductive endocrinologist with whom we consulted told us that quite often sisters donate eggs to sisters. Luckily, my middle sister Rita is 23 years old, and is eligible to help me out.
Not to be outdone by Rita, my youngest sister Melody offered to act as our gestational carrier, should I be unable to carry a baby to term. My husband and I will have to wait until Melody first has her own child to see whether she still wishes to be pregnant with our child. However, two of my closest friends who already have children have also volunteered to carry our child.
I am choosing not to disclose to my friends that Rita will act as my egg donor because I believe that the information about my child’s conception should belong to my child and that Jake and I have the obligation to be the first ones to explain the facts about his or her conception. Only after I disclose to my child, do I intend to tell others. Of course, everyone will already know that Melody acted as our gestational surrogate because I won’t ever be pregnant. My doctor told me that if one of my friends acts as our gestational carrier, I will have to tell her that we used Rita’s eggs to conceive.
However, this experience also has been very humbling. I do not think I would have been the type of sister or friend who would have gone through controlled ovarian hyperstimulation or pregnancy for anyone other than me. This has caused me to take a good, hard look at myself and my life. I hope I become a better person as a result of having gone through cancer treatment.
Joanna, Adult Cancer Patient
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Eiser C, Penn A, Katz E, Barr R (eds) (2009) Psychosocial issues and quality of life. Elsevier Seminars in Oncology 36:375–380
Ries LAG, Smith MA, Gurney JG, Linet M, Tamra T, Young J et al (1999) Cancer incidence and survival among children and adolescents: United States SEER Program 1975–1995. Bethesda, MD: National Cancer Institute SEER Program NIH Pub no. 994649
Algier L, Kav S (2008) Nurses’ approach to sexuality-related issues in patients receiving cancer treatments. Turk J Cancer 38(3):135–141
Deming S (2007) OncoLog 51. http://www2.mdanderson.org/depts/oncolog/articles/06/1-Jan-06-1.html
Forman EJ, Anders CK, Behera MA (2010) A nationwide survey of oncologists regarding treatment-related infertility and fertility preservation in female cancer patients. Fertil Steril 94:1652–1661
Jones BL (2008) Promoting healthy development among survivors of adolescent cancer. Fam Commun Health 31:S61–S70
Lee SJ, Schover LR, Partridge AH, Patrizio P, Wallace WH, Hagerty K et al (2006) American Society of Clinical Oncology recommendations on fertility preservation in cancer patients. J Clin Oncol 24(18):2917–2931
Mancini J, Rey D, Préau M, Malavolti L, Moatti JP (2008) Infertility induced by cancer treatment: inappropriate or no information provided to majority of French survivors of cancer. Fertil Steril 90(5):1616–1625
Nieman CL, Kazer R, Brannigan RE, Zoloth LS, Chase-Lansdale PL, Kinahan K et al (2006) Cancer survivors and infertility: a review of a new problem and novel answers. J Support Oncol 4(4):171–178
de Ziegler D, Streuli I, Vasilopoulos I, Decanter C, This P, Chapron C (2010) Cancer and fecundity issues mandate a multidisciplinary approach. Fertil Steril 93(3):691–696
Jukkala AM, Azuero A, McNees P, Bates GW, Meneses K (2010) Self-assessed knowledge of treatment and fertility preservation in young women with breast cancer. Fertil Steril 94(6):2396–2398
Meseguer M, Molina N, García-Velasco JA, Remohí J, Pellicer A, Garrido N (2006) Sperm cryopreservation in oncological patients: a 14-year follow-up study. Fertil Steril 85(3):640–645
Schover LR (1999) Psychosocial aspects of infertility and decisions about reproduction in young cancer survivors: a review. Med Pediatr Oncol 33(1):53–59
Zebrack BJ, Mills J, Weitzman TS (2007) Health and supportive care needs of young adult cancer patients and survivors. J Cancer Survivorship 1(2):137–145
Schover LR (2005) Motivation for parenthood after cancer: a review. JNCI Monogr 2005(34):2–5
Soliman H, Agresta SV (2008) Current issues in adolescent and young adult cancer survivorship. Cancer Control 15(1):55–62
Clinton-McHarg T, Carey M, Sanson-Fisher R, Shakeshaft A, Rainbird K (2010) Measuring the psychosocial health of adolescent and young adult (AYA) cancer survivors: a critical review. Cancer 8:25–38
Odo R, Potter C (2009) Understanding the needs of young adult cancer survivors: a clinical perspective. Oncology (Williston Park, NY) 23(11 Suppl Nurse Ed) 33:23–27
Maier DB, Covington SN, Maier LU (2006) Patients with medically complicating conditions. Cambridge University Press, New York, NY
Noll RB, Kupst MJ (2007) Commentary: the psychological impact of pediatric cancer hardiness, the exception or the rule? J Pediatr Psychol 32(9):1089–1098
Rourke MT, Hobbie WL, Schwartz L, Kazak AE (2007) Posttrauamatic stress disorder (PTSD) in young adult survivors of childhood cancer. Pediatr Blood Cancer 49(2):177–182
Eggert J, Theobald H, Engfeldt P (2004) Effects of alcohol consumption on female fertility during an 18-year period. Fertil Steril 81(2):379–383
Gaur DS, Talekar MS, Pathak VP (2010) Alcohol intake and cigarette smoking: Impact of two major lifestyle factors on male fertility. Indian J Pathol Microbiol 53(1):35–40
Jensen TK, Hjollund NKI, Henriksen TB, Scheike T, Kolstad H, Giwercman A et al (1998) Does moderate alcohol consumption affect fertility? Follow up study among couples planning first pregnancy. BMJ 317(7157):505–510
Silva PD, Cool J, Olson K (1999) Impact of lifestyle choices on female infertility. J Reprod Med 44(3):288
Jones L (2008) Surviving childhood cancer – growing up too fast. J Reprod Med 44:288–296
Zebrack BJ, Zeltzer LK (2003) Quality of life issues and cancer survivorship. Curr Probl Cancer 27(4):198–211
Nielsen AF, Pedersen B, Lauritsen JG (1995) Psychosocial aspects of donor insemination Attitudes and opinions of Danish and Swedish donor insemination patients to psychosocial information being supplied to offspring and relatives. Acta Obstet Gynecol Scand 74(1):45–50
Merz JF, Fischhoff B (1990) Informed consent does not mean rational consent. J Legal Med 11:321–350
Bryan C (2008) Provider and policy response to reverse the consequences of low health literacy. J Healthcare Manag/Am Coll Healthc Exec 53(4):230–241
Peters E, Hibbard J, Slovic P, Dieckmann N (2007) Numeracy skill and the communication, comprehension, and use of risk-benefit information. Health Aff 26(3):741–748
Paterick TJ, Carson GV, Allen MC et al (2008) Medical informed consent: general considerations for physicians. Mayo Clin Proc 83:272–273
Education USDo (2003) National assessment of adult literacy. Institute of Education Sciences. http://nces.ed.gov/naal/newsarchives.asp
Lundgren RE, McMakin AH (2009) Risk communication: a handbook for communicating environmental, safety, and health risks. Wiley-IEEE Press (4th ed) Hoboken, NJ: John Wiley & Sons
Partridge AH (2008) Fertility preservation: a vital survivorship issue for young women with breast cancer. J Clin Oncol 26(16):2612–2613
Packard E (2007) That teenage feeling. Monitor Psychol 38:20–21
Rosso IM, Young AD, Femia LA, Yurgelun Todd DA (2004) Cognitive and emotional components of frontal lobe functioning in childhood and adolescence. Ann N Y Acad Sci 1021(1):355–362
Sowell ER, Thompson PM, Holmes CJ, Jernigan TL, Toga AW (1999) In vivo evidence for postadolescent brain maturation in frontal and striatal regions. Nat Neurosci 2:859–861
Sowell ER, Thompson PM, Tessner KD, Toga AW (2001) Mapping continued brain growth and gray matter density reduction in dorsal frontal cortex: inverse relationships during postadolescent brain maturation. J Neurosci 21(22):8819–8829
Agarwal A, Ranganathan P, Kattal N, Pasqualotto F, Hallak J, Khayal S et al (2004) Fertility after cancer: a prospective review of assisted reproductive outcome with banked semen specimens. Fertil Steril 81(2):342–348
Crha I, Ventruba P, Zakova J, Huser M, Kubesova B, Hudecek R et al (2009) Survival and infertility treatment in male cancer patients after sperm banking. Fertil Steril 91(6):2344–2348
Descombe L, Chauleur C, Gentil-Perret A, Aknin-Seifer I, Tostain J, Lévy R (2008) Testicular sperm extraction in a single cancerous testicle in patients with azoospermia: a case report. Fertil Steril 90(2):443, e1–e4
Friedler S, Raziel A, Schachter M, Strassburger D, Bern O, Ron-El R (2002) Outcome of first and repeated testicular sperm extraction and ICSI in patients with non-obstructive azoospermia. Hum Reprod 17(9):2356–2361
Gabrielsen A, Fedder J, Agerholm I (2006) Parameters predicting the implantation rate of thawed IVF/ICSI embryos: a retrospective study. Reprod Biomed Online 12(1):70–76
Ginsburg ES, Yanushpolsky EH, Jackson KV (2001) In vitro fertilization for cancer patients and survivors. Fertil Steril 75(4):705–710
Hallak M (1998) Why cancer patients request disposal of cryopreserved semen specimens posttherapy: a retrospective study. Fertil Steril 69(5): 889–893
Heidenreich A, Altmann P, Engelmann UH (2000) Microsurgical vasovastomy versus microsurgical epididymal sperm aspiration/testicular extraction of sperm combined with intra-cytoplasmic sperm injection. Eur Urol 37:609–614
Kolettis PN (2002) The evaluation and management of the azoospermic patient. J Androl 23(3):293–305
Modder TK, Kohler T, Brannigan RE (2007) Fertility preservation: outcomes for Onco-TESE in male cancer patients prior to oncological therapy. Fertil Steril 88:S393–S394
Ragni G, Arnoldi M, Somigliana E, Paffoni A, Brambilla ME, Restelli L (2005) Reproductive prognosis in male patients with azoospermia at the time of cancer diagnosis. Fertil Steril 83(6):1674–1679
Ethics Committee of the American Society for Reproductive Medicine (2005) Fertility preservation and reproduction in cancer patients. Fertil Steril 83(6):1622–1628
Schover LR, Brey K, Lichtin A, Lipshultz LI, Jeha S (2002) Knowledge and experience regarding cancer, infertility, and sperm banking in younger male survivors. J Clin Oncol 20(7):1880–1889
Schover LR, Rybicki LA, Martin BA, Bringelsen KA (1999) Having children after cancer. Cancer 86(4):697–709
Dotinga R (2010) Fast-freeze may help sperm survive storage, Study finds. http://health.usnews.com/health_news/family-health/womens-health/articles/2010/09/14/fast-freeze
Fatimathas L (2010) Hope for post-childhood cancer sperm production. http://wwww.Bio-news.org.uk/page_64914.asp
Berger DM (1980) Couples’ reactions to male infertility and donor insemination. Am J Psychiatry 137(9):1047–1049
Daniels K, Blyth E, Crawshaw M, Curson R (2005) Short communication: previous semen donors and their views regarding the sharing of information with offspring. Hum Reprod 20(6):1670–1675
Daniels KR, Thorn P, Westerbrooke R (2007) Confidence in the use of donor insemination: an evaluation of the impact of participating in a group preparation programme. Hum Fertil 10(1):13–20
Daniluk JC (1988) Infertility: intrapersonal and interpersonal impact. Fertil Steril 49(6):982–990
Petok WD (2006) The psychology of gender specific infertility diagnosis. In: Covington SN, Burns LH (eds) Infertility counseling: a comprehensive handbook for clinicians. 2nd edn. Cambridge University Press, New York, NY, pp 37–60
Thorn P (2006) Recipient counseling for donor insemination. In: Covington S, Hammer Burns L (eds) Infertility counselling a comprehensive handbook for clinicians, 2nd edn. Cambridge University Press, Cambridge-New York, NY, pp 305–318
Baron A, Pannor R (1993) (2nd ed) Lethal secrets: the psychology of donor insemination, problems, and solutions. Amistad, New York
Berger DM, Eisen A, Shuber J, Doody KF (1986) Psychological patterns in donor insemination couples. Can J Psychiatry Revue Canadienne de Psychiatrie 31(9):818–823
Carr EK, Friedman T, Lannon B, Sharp P (1990) The study of psychological factors in couples receiving artificial insemination by donor: a discussion of methodological difficulties. J Adv Nurs 15(8):906–910
Clarke RN, Klock SC, Geoghegan A, Travassos DE (1999) Relationship between psychological stress and semen quality among in-vitro fertilization patients. Hum Reprod 14(3):753–758
Daniels KR (2004) Building a family with the assistance of donor insemination. Dunmore Press, Palmerston N, New Zealand
Nachtigall RD, Becker G, Wozny M (1992) The effects of gender-specific diagnosis on men’s and women’s response to infertility. Fertil Steril 57(1):113–121
Van Thiel M, Mantadakis E, Vekemans M, Gillot VF (1990) A psychological study, using interviews and projective tests, of patients seeking anonymous donor artificial insemination. J de gynécologie, obstétrique et biologie de la reproduction 19(7):823–828
Hart VA (2002) Infertility and the role of psychotherapy. Issues Mental Health Nurs 23(1):31–41
Horowitz JE, Galst JP, Elster N (2010) Ethical dilemmas in fertility counseling. American Psychological Association Books: Washington, DC
Goldstein J, Freud A, Solnit A (1973) Beyond the best interests of the child. Wiley Online Library, Free Press, New York
Silber SJ, Nagy Z, Devroey P, Camus M, Van Steirteghem AC (1997) The effect of female age and ovarian reserve on pregnancy rate in male infertility: treatment of azoospermia with sperm retrieval and intracytoplasmic sperm injection. Hum Reprod 12(12):2693–2700
Ethics Committee of the ASRM (2004) Family members as gamete donors and surrogates. Fertil Steril 82:S217–S223
Marshall LA (2002) Ethical and legal issues in the use of related donors for therapeutic insemination. Urol Clin North Am 29(4):855–861
Nikolettos N, Asimakopoulos B, Hatzissabas I (2003) Intrafamilial sperm donation: ethical questions and concerns. Hum Reprod 18(5):933–936
Lui S, Weaver S, Robinson J, Debono M, Nieland M, Killick S et al (1995) A survey of semen donor attitudes. Hum Reprod 10(1):234–238
Mahlstedt PP, Probasco KA (1991) Sperm donors: Their attitudes toward providing medical and psychosocial information for recent couples and donor offspring. Fertil Steril 4(56):747–753
Pedersen B, Nielsen AF, Lauritsen JG (1994) Psychosocial aspects of donor insemination: sperm donors-their motivations and attitudes to artificial insemination. Acta Obstet Gynecol Scand 73(9):701–705
Purdie A, Peek J, Irwin R, Ellis J, Graham F, Fisher P (1992) Identifiable semen donors--attitudes of donors and recipient couples. N Z Med J 105(927):27–28
Rowland R (1985) The social and psychological consequences of secrecy in artificial insemination by donor (AID) programmes. Soc Sci Med 21(4):391–396
Crawshaw MA, Blyth ED, Daniels KR (2007) Past semen donors’ view about the use of a voluntary contact register. Reproductive medicine online [serial on the Internet]. http://www.rbmonline.com/4DCG1/Issues/Details. 14:411–417
Robertson AD, Missmer SA, Ginsburg ES (2011) Embryo yield after in vitro fertilization in women undergoing embryo banking for fertility preservation before chemotherapy. Fertil Steril 96(1):122–125
Abdallah RT, Muasher SJ (2006) Surviving cancer, saving fertility: the promise of cryopreservation. Sex Reprod Menopause 4(1):7–12
Lutchman Singh K, Davies M, Chatterjee R (2005) Fertility in female cancer survivors: pathophysiology, preservation and the role of ovarian reserve testing. Hum Reprod Update 11(1):69–89
Meirow D (2010) Fertility preservation: New developments. Clin Obstet Gynecol 53(4):727–739
Maunsell E, Pogany L, Barrera M, Shaw AK, Speechley KN (2006) Quality of life among long-term adolescent and adult survivors of childhood cancer. J Clin Oncol 24(16):2527–2535
Kim SS (2006) Fertility preservation in female cancer patients: current developments and future directions. Fertil Steril 85(1):1–11
Silber SJ (2005) How to get pregnant. Hachette Digital, Little Brown, New York
Taylor A (2001) Systematic diversities of ovarian failure. J Soc Gynecol Invest 8:S7–S9
Sauer MV, Kavic SM (2006) Oocyte and embryo donation 2006: reviewing two decades of innovation and controversy. Reprod Biomed Online 12(2):153–162
Balaban B, Urman B, Isiklar A, Alatas C, Aksoy S, Mercan R et al (2001) The effect of pronuclear morphology on embryo quality parameters and blastocyst transfer outcome. Hum Reprod 16(11):2357–2361
Sher G, Davis VM, Stoess J (2005) In vitro fertilization: the art of making babies: facts on file, 3rd edn. Checkmark Books, New York
Bedaiwy MA, Shahin AY, Falcone T (2008) Reproductive organ transplantation: advances and controversies. Fertil Steril 90(6):2031–2055
Clark O (2010) Scientists create ‘artificial’ ovary. BioNews. http://www.bionews.org.uk/page_70822.as;?dinfo=HM.PYHdDBZDHtfOTuNsZ9gok
Sit ASY, Modugno F, Weissfeld JL, Berga SL, Ness RB (2002) Hormone replacement therapy formulations and risk of epithelial ovarian carcinoma. Gynecol Oncol 86(2):118–123
Zhang J, Grifo JA, Del Priore G (2005) Gestational carrier pregnancy with oocytes obtained during surgery for stage IIIc ovarian cancer after controlled ovarian stimulation. Fertil Steril 83(5):1547, e15–e17
Practice Committee of the ASRM and the Practice Committee of the Society for Assisted Reproductive Medicine (2006) Ovarian tissue and oocyte preservation. Fertil Steril 86(Suppl 3): S241–S246
Patrizio P, Caplan AL (2010) Ethical issues surrounding fertility preservation in cancer patients. Clin Obstetrics Gynecol 53(4):717–726
Oehninger S (2005) Strategies for fertility preservation in female and male cancer survivors. J Soc Gynecol Invest 12(4):222–231
Schover LR (2005) Sexuality and fertility after cancer. Hematology 2005(1):523–527
MacCallum F, Lycett E, Murray C, Jadva V, Golombok S (2003) Surrogacy: the experience of commissioning couples. Hum Reprod 18(6):1334–1342
Jadva V, Murray C, Lycett E, MacCallum F, Golombok S (2003) Surrogacy: the experiences of surrogate mothers. Hum Reprod 18(10):2196–2204
Blyth E (1994) «I wanted to be interesting. I wanted to be able to say «I’ve done something interesting in my life»: interviews with surrogate mothers in Britain. J Reprod Infant Psychol 12:189–198
Ciccarelli JC, Beckman LJ (2005) Navigating rough waters: an overview of psychological aspects of surrogacy. J Soc Issues 61(1):21–43
van den Akker OBA (2005) A longitudinal pre-pregnancy to post-delivery comparison of genetic and gestational surrogate and intended mothers: confidence and genealogy. J Psychosom Obstet Gynecol 26(4):277–284
van den Akker O (2007) Psychosocial aspects of surrogate motherhood. Hum Reprod Update 13(1):53–62
Farr RH, Forssell SL, Patterson CJ (2010) Parenting and child development in adoptive families: does parental sexual orientation matter? Appl Dev Sci 14(3):164–178
Moss A (2004) Adoption: challenges and solutions after breast cancer. http://www.lbbc.org/content/newsletter.
Rosen A (2005) Third party reproduction and adoption in cancer patients. J Natl Cancer Inst Monogr March 1
Grotevant HD (1997) Coming to terms with adoption: the construction of identity from adolescents into adulthood. Adopt Q 1:3–27
Brodzinsky D (1990) A stress and coping model of adoption adjustment. In: Brodzinsky D, Schecter M (eds) Psychology of adoption. Oxford University Press, New York, NY, pp 3–24
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2012 Springer Science+Business Media B.V.
About this chapter
Cite this chapter
Horowitz, J.E. (2012). Non-traditional Family Building Planning. In: Quinn, G., Vadaparampil, S. (eds) Reproductive Health and Cancer in Adolescents and Young Adults. Advances in Experimental Medicine and Biology, vol 732. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-2492-1_9
Download citation
DOI: https://doi.org/10.1007/978-94-007-2492-1_9
Published:
Publisher Name: Springer, Dordrecht
Print ISBN: 978-94-007-2491-4
Online ISBN: 978-94-007-2492-1
eBook Packages: Biomedical and Life SciencesBiomedical and Life Sciences (R0)