Perceived infertility and contraceptive use in the female, reproductive-age cancer survivor
| Autor: | Alexa C.O. Medica, Brian W. Whitcomb, H. Irene Su, Andrew C. Dietz, Shaylyn S. Stark, Tracy N. Hadnott, Maria Elena Martinez |
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| Rok vydání: | 2019 |
| Předmět: |
Cancer survivors
Reproductive health and childbirth Cancer Survivors Reproductive Surveys and Questionnaires Contraceptive Agents Female Contraception Behavior media_common Cancer education.field_of_study Obstetrics Age Factors Obstetrics and Gynecology Contraception Pill Public Health and Health Services Female Contraceptive implant Infertility Adult medicine.medical_specialty Adolescent media_common.quotation_subject Population Clinical Sciences Fertility Context (language use) oncofertility Article Paediatrics and Reproductive Medicine Young Adult Contraceptive Agents Clinical Research medicine Humans education Obstetrics & Reproductive Medicine Oncofertility Cancer survivor business.industry Prevention Contraception/Reproduction Sterilization Reproductive Sterilization medicine.disease Cross-Sectional Studies Good Health and Well Being Reproductive Medicine fertility perception Perception business Intrauterine Devices |
| Zdroj: | Fertility and sterility, vol 111, iss 4 |
| Popis: | Objective To estimate the association between perceived fertility potential and contraception use and to characterize factors important in contraceptive decision making in reproductive-age, female cancer survivors. Design Cross-sectional study. Setting Participants were from two state cancer registries, physician referrals, and cancer survivor advocacy groups in the United States. Patient(s) A total of 483 female survivors aged 18–40 years. Intervention(s) Online questionnaire. Main Outcome Measure(s) Contraception use. Result(s) Eighty-four percent of participants used contraception; 49.7% used highly effective, World Health Organization tiers I and II methods (surgical sterilization, intrauterine devices, contraceptive implant, combined hormonal contraceptives, medroxyprogesterone acetate, progestin-only pills, contraceptive diaphragm). Contraception non-use was more common among survivors who perceived themselves to be infertile, compared with survivors who perceived themselves to be as or more fertile than similarly aged peers (prevalence ratio 4.0, 95% confidence interval 2.5–7.4). In mediation analysis that adjusted for clinical infertility, 59% of the association between prior chemotherapy and contraception non-use was explained by perceived infertility. Contraception efficacy (n = 62, 25.8%) and ease of use (n = 50, 20.8%) were the most cited reasons for using tier I/II methods; compared with lack of hormones (n = 81, 49.7%) as the predominant reason for using less-effective, tier III/IV methods. Conclusion(s) Although female, reproductive-age cancer survivors had high uptake of contraception, those who perceived themselves to be infertile were less likely to use contraception. Throughout survivorship, clinicians should counsel survivors on fertility potential in the context of their prior cancer treatments and on factors, including contraceptive efficacy and hormone-free contraception, that inform reproductive decision making in this population. |
| Databáze: | OpenAIRE |
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