Uncertain fertility and distress among female survivors of childhood cancer

The purpose of this study was to explore the relationship between fertility-related distress and uncertainty among emerging adult survivors of childhood cancer. Females (aged 18-29 years), diagnosed with cancer <21 years and >1 year from treatment completion, with a history of gonadotoxic treatment exposure were recruited from 4 pediatric cancer centers across the United States. Participants completed a web-based survey assessing fertility-related distress (Fertility Problem Inventory, modified Reproductive Concerns Scale, Reproductive Concerns After Cancer-Partner Disclosure subscale) and uncertainty regarding fertility status (1=very certain to 5=very uncertain). Developmental characteristics were assessed using the Markers of Adulthood scale. Pearson bivariate correlations were used to evaluate the relationships between distress and uncertainty separately for participants in emerging adulthood (EA, 18-24y) and young adulthood (YA, 25-29y). Of the 201 participants, 144 (71.6%) were 18-24y (EA) and 53 (26.4%) 25-29y (YA). Among both EA and YA groups, greater uncertainty was associated with increased fertility concerns (EA r=.19, p=.033; YA .30, p=.017), concerns regarding their health or health of offspring (EA r=.27, p=.002, YA .39, p=.004) and distress related to partner disclosure of potential infertility (EA r=.27, p=.012; YA .42, p=.005). Among EA, uncertainty was also associated with fertility-related social distress (r=.25, p=.002), while among YA, uncertainty was associated with increased needs for fertility-related information (r=.46, p