title: Desire for children, difficulties achieving a pregnancy, and infertility distress 3 to 7 years after cancer diagnosis.
abstract: OBJECTIVE
  The aim was to investigate desire for children, difficulties achieving a pregnancy, and infertility distress among survivors 3 to 7 years after cancer treatment in reproductive age.
  
  
  METHODS
  Cancer survivors were identified in national population-based cancer registries. Eligible subjects presented with selected cancer diagnoses between 2003 and 2007 between the ages of 18 to 45. A postal questionnaire including study-specific questions, the Short-Form 36 Health Survey and the Fertility Problem Inventory, was sent to 810 survivors, and 484 participated (60 % response).
  
  
  RESULTS
  Most survivors who had a pretreatment desire for children still wanted children 3-7 years after treatment, and this group was characterized by young age and being childless at diagnosis. In addition, a substantial group of survivors (n = 55, 17 %) that did not have a pretreatment desire for children had changed their mind about wanting children after treatment. About a third of the survivors with a desire to have children had experienced difficulties achieving a pregnancy after the cancer treatment, and an unfulfilled desire to have children was associated with worse mental health. Survivors presently facing difficulties achieving a pregnancy reported moderate levels of infertility distress and expressed low interest in using gamete donation.
  
  
  CONCLUSIONS
  Health professionals in cancer care need to be aware that patients' plans for future children may change, particularly if they are young and childless. All patients of reproductive age should be provided with adequate information about the impact of cancer treatment on future fertility and fertility preservation.
authors.affiliation: Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 23300, 141 83, Huddinge, Sweden, gabriela.armuand@ki.se.
authors.forename: Gabriela M
authors.initials: GM
authors.lastname: Armuand
authors.forename: Lena
authors.initials: L
authors.lastname: Wettergren
authors.forename: Kenny A
authors.initials: KA
authors.lastname: Rodriguez-Wallberg
authors.forename: Claudia
authors.initials: C
authors.lastname: Lampic
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007246:Infertility / Q000453:epidemiology / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology / Q000523:psychology*; D012042:Registries / Q000706:statistics & numerical data*; D043762:Reproductive Behavior / Q000523:psychology* / Q000706:statistics & numerical data; D017741:Survivors / Q000523:psychology* / Q000706:statistics & numerical data; D013548:Sweden / Q000453:epidemiology