Researchers find healthy teens raise fertility concerns from threat of disease

Healthy teens raise fertility concerns from threat of disease; researchers validate quality-of-life assessment tool

Researchers at Moffitt Cancer Center and colleagues have found that healthy adolescent females have predetermined expectations for becoming parents in the future, but have concerns about fertility and childbearing should they develop a life-threatening illness, such as cancer.

The study appeared in the February issue of the Journal of Adolescent Health.

According to the researchers, this study helped further validate a tool that seeks to understand teenage girls' hopes and feelings about reproduction, especially when fertility is threatened by cancer. The participants were given the same survey tool previously used to determine the values and hopes of female adolescents who had cancer diagnoses. The researchers included healthy controls to compare their responses to those of teens who have been diagnosed with cancer and whose fertility may be at risk.

"This study sought to examine if girls who did not have cancer wanted to have children in the future and determine if they would feel negatively about losing the ability to have a biological child due to a life-threatening illness, such as cancer," said study lead author Gwendolyn P. Quinn, Ph.D., member of the Health Outcomes and Behavior Program at Moffitt. "We found that teen girls with cancer had the same hopes and dreams for the future as their healthy peers."

The researchers suggested that their data could demonstrate to health care professionals that the desire to have children does not change with a cancer diagnosis and could serve to "motivate health professionals to discuss fertility and preservation options with more of their teen patients in the future," issues rarely discussed among the age groups tested.

Control group participants included 25 female adolescents ages 12 to 18. They were divided into two age groups: 12 to 14, and 15 to 18. A 10-statement survey was designed to elicit responses about if a participant would feel sad, disappointed or frustrated if facing fertility impairment. Participants were also allowed to write about their feelings. Each provided feedback on the research tool, commenting on the types of statements and wording of questions.

The researchers found differences between the older and younger group responses to a few of the survey statements. For example, the older participants felt that they should have more opportunity to express their feelings rather than agree or disagree with predetermined ideas.

"The reproductive concerns of healthy female adolescents parallel those of adolescents with cancer in the same age ranges," explained Quinn. "Because this study highlights the fertility concerns among healthy adolescents, it strengthens the argument for using the adapted 10-item scale to assess girls with cancer."

The scale, researchers said, can be used in the clinic to determine the values female adolescents with cancer hold regarding fertility and how the life-altering event of cancer has impacted these values.

"Understanding the importance of reproductive concerns of adolescents confirms the need for interventions and developmentally appropriate tools to prevent negative quality- of-life effects during survivorship among those diagnosed with cancer," the researchers concluded. "The validation of this tool with a healthy population increases its potential value for use with girls diagnosed with cancer."