title: A cross-sectional study of the psychosexual impact of cancer-related infertility in women: third-party reproductive assistance.
abstract: BACKGROUND
  This study empirically assessed emotional and sexual functioning, reproductive concerns, and quality of life (QOL) of cancer-related infertile women in comparison to those without a cancer history and explored awareness of third-party reproduction options in cancer survivors.
  
  
  METHODS
  One hundred twenty-two cancer survivors (Gynecologic and Bone Marrow/Stem Cell Transplant) with cancer-related infertility and 50 non-cancer infertile women completed a self-report survey assessing: reproductive concerns (RCS), mood (CES D), distress (IES), sexual function (FSFI), menopause (SCL), QOL (SF 12), relationships (ADAS), and exploratory (reproductive options) items.
  
  
  RESULTS
  Cancer survivors exhibited greater sexual dysfunction and lower physical QOL than non-cancer infertile women (P < 0.001). No significant group differences were identified for mood (CES-D), mental health QOL (SF-12), reproductive concerns (RCS), and relationship satisfaction (ADAS). All groups scored in the FSFI range of sexual dysfunction, and with RCS scores above published means. Multivariate comparisons showed comparable depression and distress levels for all groups, but cancer survivors had poorer physical QOL [F(5,146)=4.22, P < 0.01]. A significant effect was also found for knowledge of third-party reproductive options on depression and distress levels [F(3,97)=4.62,P < 0.01]. Adjusted means demonstrated higher depression and distress scores for women with perceived unmet informational needs.
  
  
  CONCLUSIONS
  Overall, loss of fertility was an emotionally challenging experience for women regardless of its cause. Cancer survivors were found to have lower scores of physical QOL and sexual function than non-cancer infertile women. Unmet informational needs about reproductive options appeared to be associated with negative mood and increased distress in cancer survivors.
  
  
  CONCLUSIONS
  Targeted interventions to increase knowledge about reproductive options could be of great assistance to women pursuing parenthood in cancer survivorship. Additionally, intervention studies to improve sexual functioning and QOL in women with cancer-related infertility should be a priority of future research.
authors.affiliation: Department of Psychiatry, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA. gynbreast@mskcc.org
authors.forename: Jeanne
authors.initials: J
authors.lastname: Carter
authors.forename: Leigh
authors.initials: L
authors.lastname: Raviv
authors.forename: Linda
authors.initials: L
authors.lastname: Applegarth
authors.forename: Jennifer S
authors.initials: JS
authors.lastname: Ford
authors.forename: Laura
authors.initials: L
authors.lastname: Josephs
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Grill
authors.forename: Charles
authors.initials: C
authors.lastname: Sklar
authors.forename: Yukio
authors.initials: Y
authors.lastname: Sonoda
authors.forename: Raymond E
authors.initials: RE
authors.lastname: Baser
authors.forename: Richard R
authors.initials: RR
authors.lastname: Barakat
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000523:psychology* / Q000628:therapy; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology*; D027724:Reproductive Techniques, Assisted; D012307:Risk Factors; D020018:Sexual Dysfunctions, Psychological / Q000523:psychology* / Q000628:therapy; D017741:Survivors / Q000523:psychology*; D055815:Young Adult