title: Fertility Issues in Adolescent and Young Adult Cancer Survivors.
abstract: OBJECTIVE
  Many adolescent and young adult (AYA) cancer survivors place great importance on fertility. This study explored AYAs' discussions of fertility in the context of discussing their survivorship experiences.
  
  
  METHODS
  Secondary analyses of a qualitative study of young adult survivors of adolescent cancers ("AYA survivors") was performed using semistructured individual interviews and focus groups. Analyses were conducted using grounded theory using thematic content analysis with an inductive data-driven approach.
  
  
  RESULTS
  Participants (n = 43) were 16-24 years old, diagnosed with cancer between ages 14 and 18 years, and were at least 6 months post-treatment. Before treatment, 5 males banked sperm and no females preserved fertility. More males (50%) than females (39%) reported uncertainty about their fertility. Three major categories emerged from the data: fertility concerns, emotions raised when discussing fertility, and strategies used to manage fertility concerns. Fertility concerns focused on dating/partner reactions, health risks, and what potential infertility would mean for their life narrative. Emotions included distress, feeling overwhelmed and hopeful/wishful thinking. Females were more likely to feel distressed and overwhelmed than males. Strategies to manage concerns included acceptance/"making do," desire to postpone concerns, and reliance on assisted reproductive technology.
  
  
  CONCLUSIONS
  Most AYAs in our study reported a number of reproductive concerns and fertility-related distress after treatment, which may affect other areas of psychosocial functioning. Females may be more at-risk for distress than males, particularly in situations of uncertainty and limited knowledge. Future work should explore how to best incorporate fertility-related informational and support services more fully into survivorship care. Implications for survivorship care are discussed.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center , New York, New York.
authors.forename: Catherine
authors.initials: C
authors.lastname: Benedict
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center , New York, New York.
authors.forename: Elyse
authors.initials: E
authors.lastname: Shuk
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center , New York, New York.
authors.forename: Jennifer S
authors.initials: JS
authors.lastname: Ford
mesh_terms: D000293:Adolescent; D001294:Attitude to Health; D004644:Emotions; D005260:Female; D059247:Fertility Preservation / Q000379:methods / Q000523:psychology*; D017144:Focus Groups; D006801:Humans; D007246:Infertility / Q000209:etiology / Q000523:psychology*; D007398:Interpersonal Relations; D008297:Male; D009369:Neoplasms / Q000523:psychology / Q000628:therapy*; D012662:Semen Preservation / Q000523:psychology; D013315:Stress, Psychological / Q000209:etiology; D017741:Survivors / Q000523:psychology*; D014481:United States; D055815:Young Adult
keywords: fertility; fertility preservation; infertility; sperm banking; survivorship
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