title: 'Will I be able to have a baby?' Results from online focus group discussions with childhood cancer survivors in Sweden.
abstract: OBJECTIVE
  What do adolescent and young adult survivors of childhood cancer think about the risk of being infertile?
  
  
  CONCLUSIONS
  The potential infertility, as well as the experience of having had cancer, affects well-being, intimate relationships and the desire to have children in the future.
  
  
  BACKGROUND
  Many childhood cancer survivors want to have children and worry about possible infertility.
  
  
  METHODS
  For this qualitative study with a cross-sectional design, data were collected through 39 online focus group discussions during 2013.
  
  
  METHODS
  Cancer survivors previously treated for selected diagnoses were identified from The Swedish Childhood Cancer Register (16-24 years old at inclusion, ≥5 years after diagnosis) and approached regarding study participation. Online focus group discussions of mixed sex (n = 133) were performed on a chat platform in real time. Texts from the group discussions were analysed using qualitative content analysis.
  
  
  RESULTS
  The analysis resulted in the main category Is it possible to have a baby? including five generic categories: Risk of infertility affects well-being, Dealing with possible infertility, Disclosure of possible infertility is a challenge, Issues related to heredity and Parenthood may be affected. The risk of infertility was described as having a negative impact on well-being and intimate relationships. Furthermore, the participants described hesitation about becoming a parent due to perceived or anticipated physical and psychological consequences of having had cancer.
  
  
  CONCLUSIONS
  Given the sensitive topic of the study, the response rate (36%) is considered acceptable. The sample included participants who varied with regard to received fertility-related information, current fertility status and concerns related to the risk of being infertile.
  
  
  CONCLUSIONS
  The results may be transferred to similar contexts with other groups of patients of childbearing age and a risk of impaired fertility due to disease. The findings imply that achieving parenthood, whether or not with biological children, is an area that needs to be addressed by health care services.
  
  
  BACKGROUND
  The study was financially supported by The Cancer Research Foundations of Radiumhemmet, The Swedish Childhood Cancer Foundation and the Doctoral School in Health Care Science, Karolinska Institutet. The authors report no conflicts of interest.
authors.affiliation: Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, SE-141 83 Huddinge, Sweden jenny.nilsson.1@ki.se.
authors.forename: J
authors.initials: J
authors.lastname: Nilsson
authors.affiliation: Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, SE-141 83 Huddinge, Sweden.
authors.forename: A
authors.initials: A
authors.lastname: Jervaeus
authors.affiliation: Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, SE-141 83 Huddinge, Sweden School of Health, Care and Social Welfare, Mälardalen University, SE-721 23 Västerås, Sweden.
authors.forename: C
authors.initials: C
authors.lastname: Lampic
authors.affiliation: Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, SE-141 83 Huddinge, Sweden Department of Infectious Diseases, Karolinska University Hospital, SE-141 86 Stockholm, Sweden School of Health Sciences, City University London, Northampton Square, London EC1V 0HB, UK.
authors.forename: L E
authors.initials: LE
authors.lastname: Eriksson
authors.affiliation: Department of Quality and Patient Safety, Karolinska University Hospital, SE-171 76 Stockholm, Sweden Department of Learning, Informatics, Management and Ethics, Medical Management Center (LIME, MMC), Karolinska Institutet, SE-171 77 Stockholm, Sweden.
authors.forename: C
authors.initials: C
authors.lastname: Widmark
authors.affiliation: Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, SE-141 83 Huddinge, Sweden.
authors.forename: G M
authors.initials: GM
authors.lastname: Armuand
authors.affiliation: Department of Women's & Children's Health, Childhood Cancer Research Unit, Karolinska Institutet, SE-171 76 Stockholm, Sweden Department of Pediatric Hematology and Oncology, Karolinska University Hospital, SE-171 76 Stockholm, Sweden.
authors.forename: J
authors.initials: J
authors.lastname: Malmros
authors.affiliation: Department of Women's & Children's Health, Childhood Cancer Research Unit, Karolinska Institutet, SE-171 76 Stockholm, Sweden Department of Pediatric Hematology and Oncology, Karolinska University Hospital, SE-171 76 Stockholm, Sweden.
authors.forename: M
authors.initials: M
authors.lastname: Marshall Heyman
authors.affiliation: Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, SE-141 83 Huddinge, Sweden.
authors.forename: L
authors.initials: L
authors.lastname: Wettergren
mesh_terms: D000293:Adolescent; D003430:Cross-Sectional Studies; D005260:Female; D059247:Fertility Preservation / Q000523:psychology; D017144:Focus Groups; D006801:Humans; D007246:Infertility / Q000523:psychology*; D008297:Male; D011788:Quality of Life; D017741:Survivors / Q000523:psychology*; D013548:Sweden; D055815:Young Adult
keywords: adolescents and young adults; childhood cancer; focus group discussions; infertility; qualitative research