Infertility, cancer, and changing gender norms
Recent improvements in cancer detection, treatment, and technology have increased survivorship rates. These same life-saving treatments, however, can lead to infertility or sterility. Oncofertility, an emerging field at the intersection of cancer and oncology, centers on providing cancer patients with the potential to preserve their biological fertility.
We examine the history of how men and women have been treated for infertility and analyze contemporary studies of how women without cancer respond to infertility.
Both female and male cancer patients and survivors value their fertility, although there is conflicting evidence on the degree to which women and men value fertility. Some studies have found that women and men value their fertility equally while others found that women value their fertility more than men. Gendered norms around fertility and parenthood seem to be changing, which may minimize these discrepancies.
Although oncofertility is a nascent field, infertility is a historically relevant medical condition that is characterized by gendered narratives and norms. An analysis of the historical evolution of the understanding and treatment of infertility leads insight into modern conceptualizations of infertility both generally and in the case of cancer. Understanding these historical and current gendered influences helps to define the current context in which cancer patients are confronting potential infertility.
Implications for cancer survivors
The insight gained from this analysis can be used to inform clinical practice, offering guidance to healthcare providers approaching cancer patients about potential infertility, regardless of gender.
KeywordsOncofertility Infertility Gender History Cultural narratives
- 1.Horner, MJ, Ries LAG, Krapcho M, Neyman N, Aminou R, Howlader N, Altekruse SF, Feuer EJ, Huang L, Mariotto A, Miller BA, Lewis DR, Eisner MP, Stinchcomb DG, Edwards BK, editors. SEER Cancer Statistics Review, 1975–2006, National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/csr/1975_2006/, based on November 2008 SEER data submission, posted to the SEER web site, 2009.
- 10.Crawshaw MA, Sloper P. ‘Swimming against the tide’—the influence of fertility matters on the transition to adulthood or survivorship following adolescent cancer. Eur J Cancer Care. 2010 Jan 19, Epub ahead of print.Google Scholar
- 11.Apple RD, Golden J. Introduction. In: Apple RD, Golden J, editors. Mothers and motherhood: readings in American history. (PAGES) Columbus: Ohio State University Press; 1997.Google Scholar
- 12.Marsh M, Ronner, W. The empty cradle: infertility in America from Colonial times to the present. Johns Hopkins University Press. 1996.Google Scholar
- 13.May ET. Barren in the promised land: childless Americans and the pursuit of happiness. New York: Basic Books; 1995.Google Scholar
- 20.Blech GM. The Practitioner’s guide to the diagnosis and treatment of diseases of women. Chicago: M. Robertson; 1903.Google Scholar
- 23.Mormon MT. The influence of fear appeals, message design, and masculinity on men’s motivation to perform the testicular self-exam. J Appl Commun Res. 2000;28:81–116.Google Scholar
- 24.Greil AL. Not yet pregnant: infertility couples in contemporary America. New Brunswick: Rutgers University Press; 1991.Google Scholar
- 25.Inhorn MC. Sexuality, masculinity, and infertility in Egypt: potent troubles in the Maritaland medical encounters. Special Issue on “African Masculinities,” Lahoucine Ouzgane, editor. Journal of Men’s Studies. 2002;10(3):343–359.Google Scholar
- 26.Daniels CR. Exposing men: the science and politics of male reproduction. New York: Oxford University Press; 2006.Google Scholar
- 28.U.S. Census Bureau. Press release: Father’s day. http://www.census.gov/Press-Release/www/releases/archives/facts_for_features_special_editions/006794.html. Published June 12, 2006. Accessed March 11, 2010.
- 30.Horden AJ, Street AF. Communicating about patient sexuality and intimacy after cancer: mismatched expectations and unmet needs. Med J Aust. 2007;186(5):224–7.Google Scholar