title: Receiving information on fertility- and menopause-related treatment effects among women who undergo hematopoietic stem cell transplantation: changes in perceived importance over time.
abstract: Hematopoietic stem-cell transplantation (HSCT) is associated with high rates of gonadal failure, which is distressing for younger patients desiring to start a family. The perceived importance and optimal timing of discussing fertility- and menopause-related information with women undergoing aggressive treatment such as HSCT is not well defined. Questionnaires were sent to 532 patients who underwent HSCT between January 1987 and September 2004 at the ages of 16 to 50 years. The questionnaire assessed demographic data, the need for fertility- and menopause-related information at various times during treatment, and standardized measures of anxiety, quality of life, and menopausal symptoms. The return rate was 40.2%, with 196 patients participating. Of these, 38% reported that they had discussed fertility-related issues with health-care providers since their diagnosis; 54% had discussed menopause-related issues. At the time of diagnosis, participants considered receiving information on fertility and menopause as being of equal importance. However, after HSCT, information about menopause was considered more important than information on fertility (P < or = .0001). Being <40 years, being childless, desiring to bear children in the future, and having a high score on the State-Trait Anxiety Inventory (STAI) correlated with higher ratings of importance for both fertility- and menopause-related information. Our results suggested that healthcare providers should provide information on fertility and menopause repeatedly throughout the treatment period, and that menopause-related information should be reemphasized after HSCT. Such counseling is crucial for patients who are young and childless.
authors.affiliation: Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA.
authors.forename: Kazutaka
authors.initials: K
authors.lastname: Nakayama
authors.forename: Ping
authors.initials: P
authors.lastname: Liu
authors.forename: Michelle
authors.initials: M
authors.lastname: Detry
authors.forename: Leslie R
authors.initials: LR
authors.lastname: Schover
authors.forename: Andrea
authors.initials: A
authors.lastname: Milbourne
authors.forename: Joyce
authors.initials: J
authors.lastname: Neumann
authors.forename: Gabriela
authors.initials: G
authors.lastname: Rondon
authors.forename: Belinda
authors.initials: B
authors.lastname: Thewes
authors.forename: Richard E
authors.initials: RE
authors.lastname: Champlin
authors.forename: Naoto T
authors.initials: NT
authors.lastname: Ueno
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001293:Attitude to Death; D001294:Attitude to Health; D005239:Fear; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007247:Infertility, Female / Q000209:etiology / Q000523:psychology*; D008594:Menopause, Premature / Q000523:psychology*; D008875:Middle Aged; D019653:Myeloablative Agonists / Q000009:adverse effects; D009369:Neoplasms / Q000523:psychology / Q000601:surgery; D010353:Patient Education as Topic; D017060:Patient Satisfaction; D016649:Primary Ovarian Insufficiency / Q000209:etiology / Q000523:psychology*; D011788:Quality of Life; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*; D013997:Time Factors; D019172:Transplantation Conditioning / Q000009:adverse effects*; D014916:Whole-Body Irradiation / Q000009:adverse effects; D055815:Young Adult
chemical_list: D019653:Myeloablative Agonists