Fertility and sexual function in long-term survivors of haematological malignancy: using patient-reported outcome measures to assess a neglected area of need in the late effects clinic.
Problems of sexual function and fertility in long-term survivors (≥5 years) of haematological malignancy are often neglected in clinic. Our centre carried out a questionnaire study in this population addressing patient-perceived fertility and sexual function. 718 patients responded (56% of those invited; 39% Hodgkin, 45% non-Hodgkin lymphoma, 16% acute leukaemia). Respondent women were more likely to remain childless than a normal control population. Self-reported infertility was more likely in men than women [odds ratio (OR) 1·77, P = 0·001]. Myeloablative therapy increased the likelihood of childlessness (OR 2·48, P = 0·004). Few attended fertility support services (12%). 24% of men banked sperm and 29% of these used the sample, of which 46% resulted in successful pregnancy. Fertility clinic attendance and sperm storage was more likely post-1990 (OR 4·05, P < 0·001; OR 5·05, P < 0·001 respectively). Reporting a negative impact of cancer on sexual function was more common in women than men (OR 2·20, P < 0·001), and increased with current age and age at diagnosis (by 3-4% per year, P ≤ 0·001) but decreased with longer follow-up (by 2%/year, P = 0·005). Patients on anti-depressants and those reporting cancer-related body change/appearance concerns more frequently reported a negative impact (P < 0·04 and P < 0·03 respectively). These self-reported outcomes confirm literature findings, suggest improvement over time, but highlight a need for involvement of support services.
Centre for Haemato-Oncology, Barts Cancer Institute, Barts and The London Medical School, Queen Mary University of London, London, UK.
Paul
P
Greaves
Shah-Jalal
SJ
Sarker
Kashfia
K
Chowdhury
Rachel
R
Johnson
Janet
J
Matthews
Rebecca
R
Matthews
Matthew
M
Smith
Ania
A
Korszun
John G
JG
Gribben
T Andrew
TA
Lister
D000293:Adolescent; D000328:Adult; D005260:Female; D019337:Hematologic Neoplasms / Q000503:physiopathology*; D006801:Humans; D007246:Infertility / Q000209:etiology* / Q000503:physiopathology; D008297:Male; D011247:Pregnancy; D011788:Quality of Life; D057566:Self Report; D012735:Sexual Dysfunction, Physiological / Q000209:etiology* / Q000503:physiopathology; D011795:Surveys and Questionnaires; D017741:Survivors; D016896:Treatment Outcome; D055815:Young Adult
fertility; haematological malignancy; long-term survivors; sexual function