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

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. 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. 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. 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.

Ussher JM ，Perz J 《-》

Infertility After Cancer: How the Need to Be a Parent, Fertility-Related Social Concern, and Acceptance of Illness Influence Quality of Life.

Adolescents and young adults (AYAs) given a diagnosis of cancer who experience infertility concerns often report having poorer quality of life (QoL). However, the role of infertility-related stressors and illness acceptance on QoL is not clear. The aim of this study was to describe the impact of psychosocial factors surrounding cancer treatment and infertility on QoL. We hypothesized that need for parenthood and infertility-related social concerns would be directly related to QoL and indirectly related to QoL through acceptance of illness. Cancer patients/survivors (n = 178; 75.3% female) aged 15 to 29 years completed measures of QoL, acceptance of illness, infertility-related social concerns, and need for parenthood. Path analysis was used to test the hypothesized and subsequent models to determine the best fit for predictors of QoL. The final model explained 28.36% of the variance in QoL. Lower infertility-related social concerns were directly and indirectly related to higher QoL scores. Need for parenthood did not directly relate to QoL, instead relating directly to increased infertility-related social concerns. Higher acceptance of illness (β = .39) and older age (β = .19) were directly related to higher QoL scores. Female patients had higher need for parenthood (β = .17). These findings suggest that social concerns and expectations surrounding infertility have a negative impact on AYA cancer survivors' and patients' QoL, which increases as AYAs approach socially normative parenting age. Providing survivors with specialist support to manage their infertility-related social concerns and improve their acceptance of illness has the potential to improve their QoL.

Patterson P ，Perz J ，Tindle R ，McDonald FEJ ，Ussher JM ... -  《-》

Resilience acts as a moderator in the relationship between infertility-related stress and fertility quality of life among women with infertility: a cross-sectional study.

Li Y ，Zhang X ，Shi M ，Guo S ，Wang L ... -  《-》

Threat of biographical disruption: the gendered construction and experience of infertility following cancer for women and men.

Ussher JM ，Perz J ，Australian Cancer and Fertility Study Team (ACFST) 《BMC CANCER》

The Fertility Quality of Life Questionnaire (FertiQoL) Relational subscale: psychometric properties and discriminant validity across gender.

Is the Fertility Quality of Life Questionnaire (FertiQoL)-Relational Scale a valid measure to assess the relational domain regarding quality of life in women and men undergoing infertility treatment? The FertiQoL-Relational scale (FertiQoL-REL) showed good psychometric properties and captured core aspects of couple relationships. FertiQoL has become a gold standard for the assessment of infertility-related quality of life in patients undergoing assisted reproduction treatment (ART). Despite its growing importance, no previous studies have examined the convergent validity of the FertiQoL-REL and its discriminant validity across gender. Baseline cross-sectional data as part of a longitudinal study of infertile couples undergoing an ART between February 2013 and January 2015. Five hundred and eighty-nine patients (301 females and 288 males), prior to starting an ART in a private clinic, filled in the Fertility Quality of Life Questionnaire (FertiQoL) and several measures of the marital relationship (Dyadic Adjustment Scale, Marital Commitment Inventory and ENRICH Marital Satisfaction Scale) and infertility-related distress (Fertility Problem Inventory). Confirmatory factor analysis showed that the FertiQoL four-factor solution provided a good fit for the observed data. Reliability of the FertiQoL-REL was higher for women than men. Significant correlations between the FertiQoL-REL scores and all the other measures of marital relationship were found for both women and men. FertiQoL-REL scores did not differ significantly in women and men. The FertiQoL-REL was able to differentiate subjects as regards the Dyadic Adjustment Scale and ENRICH Marital Satisfaction Scale threshold. Findings are limited because the data were obtained from only one Italian private clinic. FertiQoL-REL threshold scores are useful for identifying those patients undergoing ART who are more likely to report poor or good relationship quality. Clinicians should tailor their counselling strategies to the positive qualities in a couple's relationship, so as to reinforce the overall quality of life, especially among women, and to support patients in tackling the psychological burden, so that they can either continue treatment or choose discontinuation. This research was supported by funds provided by Centro Andros S.r.l., Palermo, Italy. The authors declare no financial or commercial conflicts of interest in this study. Not necessary.

Donarelli Z ，Lo Coco G ，Gullo S ，Salerno L ，Marino A ，Sammartano F ，Allegra A ... -  《-》