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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
Author(s) -
Greaves Paul,
Sarker ShahJalal,
Chowdhury Kashfia,
Johnson Rachel,
Matthews Janet,
Matthews Rebecca,
Smith Matthew,
Korszun Ania,
Gribben John G.,
Lister T. Andrew
Publication year - 2014
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/bjh.12651
Subject(s) - fertility , medicine , term (time) , malignancy , sexual function , outcome (game theory) , pediatrics , intensive care medicine , environmental health , population , physics , mathematics , mathematical economics , quantum mechanics
Summary 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% H odgkin, 45% non‐ H odgkin 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, P = 0·001]. Myeloablative therapy increased the likelihood of childlessness ( OR 2·48, P = 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, P < 0·001; OR 5·05, P < 0·001 respectively). Reporting a negative impact of cancer on sexual function was more common in women than men ( OR 2·20, P < 0·001), and increased with current age and age at diagnosis (by 3–4% per year, P ≤ 0·001) but decreased with longer follow‐up (by 2%/year, P = 0·005). Patients on anti‐depressants and those reporting cancer‐related body change/appearance concerns more frequently reported a negative impact ( P < 0·04 and P < 0·03 respectively). These self‐reported outcomes confirm literature findings, suggest improvement over time, but highlight a need for involvement of support services.