Alongside the increased chance of recovery from cancer, various social changes have also had a big influence on the psychological aspects of the desire to have children in patients who had cancer. For example, maternal age at the birth of the first child has increased in the last 30 years from about 25 to 30 years, so that the likelihood of the mother having cancer before the birth of her first child has increased strongly.
Accordingly, the need for fertility protection measures is rising among 35-40 year-old women, whose fertility is already limited for biological reasons. In these patients, the psychological stress from ovariotoxic therapy combines with the age-related higher likelihood of ovarian damage, age-related reduced effectiveness of fertility protection and the current concrete desire to have children.
The question is how frequent and strong these worries about fertility actually are during and after cancer therapy. The number of studies on this question is still very small, but what studies there are allow some important conclusions. It should be noted that the view that any potential infertility is less relevant for a young woman in view of her life-threatening disease is wrong. The contrary is the case: The expected loss of fertility is just as stressful to her as the confrontation with her cancer.
In a survey, Schover et al. (Cancer, 1999, 86: 697-709) asked both men and women approx. 3-5 years after cancer therapy about their fears and attitudes towards a desire to have children. The results were nearly identical for both sexes. 76% of the respondents who had been childless at the time of cancer therapy had a wish to have children in the future. Among the respondents who already had children, only 29% expressed that wish. An average of 93% of respondents felt well enough for parenthood, 63% wished to have a child even if they died prematurely.
These data show a high level of psychological stress due to reduced fertility caused by cancer therapy, especially for childless couples. The extent to which the psychological stress can be reduced by fertility protection measures is being investigated by the FertiPROTECT network.