Infertility-related distress following cancer for women and men: A mixed method study

Abstract

Objective: Infertility-related distress is recognised to be a long-term effect of cancer. There have been attempts to examine predictors of such distress, but there is inconsistency in the findings. This study examined the psychological impact of infertility-related distress in women and men cancer survivors, across age group, parity, cancer type, time since diagnosis, and relationship context; and the association of distress with acceptance of illness and relationship satisfaction.

Methods: 693 women and 185 men completed a self-report survey examining infertility-related distress (fertility problem inventory [FPI], acceptance of cancer (acceptance of illness scale [AIS]), psychological distress (Kessler psychological distress scale [K10]), quality of life (QoL) (ladder of life), and relationship satisfaction relationship assessment scale [RAS]); 61 women and 17 men took part in one-to-one interviews to examine subjective experiences of infertility distress.

Results: Infertility distress was positively correlated with psychological distress and negatively correlated with QoL, relationship satisfaction, and acceptance of cancer across gender, cancer type and stage, relationship status, and age. Women reported significantly higher infertility distress than men. In multiple regression analysis, unique statistical predictors of infertility distress for women were childlessness, cancer acceptance, and QoL. Childlessness and relationship satisfaction were unique predictors for men. Thematic analysis of interviews identified loss and grief, identity threat, relationship concerns or support, and acceptance of cancer and infertility as key themes.

Conclusions: Concern about cancer-related infertility is associated with decrements in psychological well-being and QoL, particularly for those without children. Psychological support to address cancer-related infertility distress should acknowledge the different meanings of infertility across gender, and the impact of acceptance of cancer and relationship satisfaction.

Keywords: acceptance of illness; cancer related infertility distress; childlessness; gender; mixed methods; quality of life; relationship satisfaction.