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Fertility under uncertainty: exploring differences in fertility-related concerns and psychosocial aspects between breast cancer survivors and non-cancer infertile women

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Abstract

Background

The threat to fertility due to anticancer treatments can be distressing to women who wish to complete their family. The current study assessed the fertility-related concerns, psychological distress and health-related quality of life (HRQoL) of breast cancer survivors in comparison to non-cancer women with infertility history and to healthy controls from the general population.

Methods

We surveyed young adult women aged 18 to 40 who wished to have a (or another) biological child. Participants completed self-report measures assessing fertility concerns, anxiety, depression and physical, emotional, role and social functioning. Group differences were assessed using multivariate comparisons as well as univariate tests and discriminant analysis for individual measures.

Results

A total of 136 women were recruited, of whom 43 were breast cancer survivors, 56 non-cancer infertile women and 37 healthy controls. Considering the female cancer survivors as the focus of the analysis, data suggested that these women presented identical concerns to the non-cancer infertile group and higher than the healthy women with regard to fertility potential (p < 0.01). However, women diagnosed with cancer reported worse HRQoL than their counterparts, showing lower scores in physical functioning (p < 0.05) than infertile women and lower role (p < 0.05) and social HRQoL (p < 0.01) than the controls. Anxiety and depressive symptoms did not differ between the three groups.

Conclusions

The results suggest that living with uncertainty about reproductive potential after cancer can be a disruptive experience. Breast cancer survivors and infertile women are at risk of future emotional maladjustments, given the reported level of fertility concern.

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Acknowledgements

This article was supported by National Funds through FCT—Fundação para a Ciência e a Tecnologia within CINTESIS, R&D Unit (reference UID/IC/4255/2020); and a PhD fellowship to the first author [SFRH/BD/115855/2016].

Author information

Authors and Affiliations

  1. Center for Health Technology and Services Research (CINTESIS), Department of Education and Psychology, University of Aveiro, Campus Universitário de Santiago, 3810-193, Aveiro, Portugal

    Ana Bártolo & Sara Monteiro

  2. Department of Education and Psychology, University of Aveiro, Aveiro, Portugal

    Maria Neves & Beatriz Carvalho

  3. Department of Gynecology and Obstetrics, Centro Hospitalar Universitário de São João, Porto, Portugal

    Salomé Reis

  4. Breast Clinic, Instituto Português de Oncologia Francisco Gentil, Porto, Portugal

    Elisabete Valério

  5. William James Center for Research, Department of Education and Psychology, University of Aveiro, Aveiro, Portugal

    Isabel M. Santos

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  1. Ana Bártolo
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  4. Salomé Reis
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by AB, MN, BC, IMS and SM. The first draft of the manuscript was written by AB and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Ana Bártolo.

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Conflict of interest

No potential conflict of interest was reported by the authors.

Research involving human participants and/or animals

All procedures performed involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Approval was granted by the Ethics Committee of the Instituto Português de Oncologia Francisco Gentil (No. 110R/2017) and Centro Hospitalar Universitário de São João (No. 130/17) in Porto.

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Informed consent was obtained from all individual participants included in the study.

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Bártolo, A., Neves, M., Carvalho, B. et al. Fertility under uncertainty: exploring differences in fertility-related concerns and psychosocial aspects between breast cancer survivors and non-cancer infertile women. Breast Cancer 27, 1177–1186 (2020). https://doi.org/10.1007/s12282-020-01124-w

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  • DOI: https://doi.org/10.1007/s12282-020-01124-w

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