TY - JOUR
T1 - Contraceptive methods and fertility testing in young adult survivors of childhood cancer
AU - Cherven, Brooke
AU - Quast, Lauren F.
AU - Klosky, James L.
AU - Gerhardt, Cynthia A.
AU - Baust, Katja
AU - Calaminus, Gabriele
AU - Kaatsch, Peter
AU - Hagedoorn, Mariët
AU - Tuinman, Marrit A.
AU - Lehmann, Vicky
N1 - Funding Information: This study was partially funded by a grant from the German Cancer Aid (#70112102; Calaminus, Kaatsch, Langer). Brooke Cherven is supported by the National Institute of Nursing Research of the National Institutes of Health under Award Number K23NR020037. The content of this manuscript is solely the responsibility of the authors and does not necessarily represent the official views of the authors’ affiliations or the National Institutes of Health. Publisher Copyright: © 2023, The Author(s).
PY - 2023/10
Y1 - 2023/10
N2 - Purpose: Reproductive health is important, but often neglected in cancer survivorship care. This study explored contraceptive use and factors associated with fertility testing among young adult survivors of childhood cancer in Germany. Methods: Young adult survivors of childhood cancer were identified through the German Childhood Cancer Registry and completed a mailed survey. Survivors were queried regarding contraceptive use, reproductive goals, uncertainty about fertility, and completion or interest in fertility testing. Multivariable stepwise logistic regression models were used to calculate Odds Ratios (OR) and 95% confidence intervals (CI) as a means of identifying factors associated with completion of and interest in fertility testing. Results: Survivors (N = 472; 57.8% female; aged 23.3 ± 1.5 years, and 14.9 ± 5.0 years from diagnosis), reported high rates of contraceptive use, including 61.2% using a single method, 30.6% dual methods, and 8.1% no/less effective methods. Few survivors had completed fertility testing (13.0%), although 58.8% were interested. Having been diagnosed during adolescence (OR = 2.66, 95%CI: 1.39–5.09), greater uncertainty about fertility (OR = 1.16, 95%CI: 1.03–1.31), and use of dual contraceptive methods (OR = 1.94, 95%CI: 1.02–3.69) were associated with having completed fertility testing. Factors associated with interest in fertility testing included goals of wanting to have children (OR = 7.76, 95%CI: 3.01–20.04) and greater uncertainty about fertility (OR = 1.19 95%CI: 1.06–1.33). Conclusion: In this sample of young adults who survived childhood cancer, most reported contraceptive use. Few survivors had completed fertility testing, although more than half were interested. Interventions are needed to address potential barriers to fertility testing and help survivors manage fertility-related uncertainty.
AB - Purpose: Reproductive health is important, but often neglected in cancer survivorship care. This study explored contraceptive use and factors associated with fertility testing among young adult survivors of childhood cancer in Germany. Methods: Young adult survivors of childhood cancer were identified through the German Childhood Cancer Registry and completed a mailed survey. Survivors were queried regarding contraceptive use, reproductive goals, uncertainty about fertility, and completion or interest in fertility testing. Multivariable stepwise logistic regression models were used to calculate Odds Ratios (OR) and 95% confidence intervals (CI) as a means of identifying factors associated with completion of and interest in fertility testing. Results: Survivors (N = 472; 57.8% female; aged 23.3 ± 1.5 years, and 14.9 ± 5.0 years from diagnosis), reported high rates of contraceptive use, including 61.2% using a single method, 30.6% dual methods, and 8.1% no/less effective methods. Few survivors had completed fertility testing (13.0%), although 58.8% were interested. Having been diagnosed during adolescence (OR = 2.66, 95%CI: 1.39–5.09), greater uncertainty about fertility (OR = 1.16, 95%CI: 1.03–1.31), and use of dual contraceptive methods (OR = 1.94, 95%CI: 1.02–3.69) were associated with having completed fertility testing. Factors associated with interest in fertility testing included goals of wanting to have children (OR = 7.76, 95%CI: 3.01–20.04) and greater uncertainty about fertility (OR = 1.19 95%CI: 1.06–1.33). Conclusion: In this sample of young adults who survived childhood cancer, most reported contraceptive use. Few survivors had completed fertility testing, although more than half were interested. Interventions are needed to address potential barriers to fertility testing and help survivors manage fertility-related uncertainty.
KW - Childhood cancer
KW - Contraception
KW - Fertility testing
KW - Oncofertility
KW - Survivorship
KW - Young adult
UR - http://www.scopus.com/inward/record.url?scp=85168096450&partnerID=8YFLogxK
U2 - https://doi.org/10.1007/s10815-023-02908-7
DO - https://doi.org/10.1007/s10815-023-02908-7
M3 - Article
C2 - 37584730
SN - 1058-0468
VL - 40
SP - 2391
EP - 2400
JO - Journal of Assisted Reproduction and Genetics
JF - Journal of Assisted Reproduction and Genetics
IS - 10
ER -