Fertility and sexual function in long‐term survivors of haematological malignancy: using patient‐reported outcome measures to assess a neglected area of need in the late effects clinic. (15th November 2013)

• Record Type: Journal Article
• Authors: Greaves, Paul; Sarker, Shah‐Jalal; Chowdhury, Kashfia; Johnson, Rachel; Matthews, Janet; Matthews, Rebecca; Smith, Matthew; Korszun, Ania; Gribben, John G.; Lister, T. Andrew
• Is Part Of: British journal of haematology. Volume 164:Number 4(2014:Feb.)
• Page Start: 526
• Page End: 535
• Publication Date: 2013-11-15
• Subjects: Hematology -- Periodicals; Blood -- Diseases -- Periodicals; 616.15
• DOI: 10.1111/bjh.12651
• Languages: English
• ISSNs: 0007-1048

Abstract

<abstract abstract-type="main" id="bjh12651-abs-0001"> <title>Summary</title> <p>Problems of sexual function and fertility in long‐term survivors (≥5 years) of haematological malignancy are often neglected in clinic. Our centre carried out a questionnaire study in this population addressing patient‐perceived fertility and sexual function. 718 patients responded (56% of those invited; 39% Hodgkin, 45% non‐Hodgkin lymphoma, 16% acute leukaemia). Respondent women were more likely to remain childless than a normal control population. Self‐reported infertility was more likely in men than women [odds ratio (OR) 1·77, <italic>P </italic>=<italic> </italic>0·001]. Myeloablative therapy increased the likelihood of childlessness (OR 2·48, <italic>P </italic>=<italic> </italic>0·004). Few attended fertility support services (12%). 24% of men banked sperm and 29% of these used the sample, of which 46% resulted in successful pregnancy. Fertility clinic attendance and sperm storage was more likely post‐1990 (OR 4·05, <italic>P </italic><<italic> </italic>0·001; OR 5·05, <italic>P </italic><<italic> </italic>0·001 respectively). Reporting a negative impact of cancer on sexual function was more common in women than men (OR 2·20, <italic>P </italic><<italic> </italic>0·001), and increased with current age and age at diagnosis (by 3–4% per year, <italic>P </italic>≤<italic> </italic>0·001) but decreased with longer follow‐up (by 2%/year, <italic>P </italic>=<italic> </italic>0·005). Patients on anti‐depressants and those reporting cancer‐related body change/appearance concerns more frequently reported a negative impact (<italic>P </italic><<italic> </italic>0·04 and <italic>P </italic><<italic> </italic>0·03 respectively). These self‐reported outcomes confirm literature findings, suggest improvement over time, but highlight a need for involvement of support services.</p> </abstract>