Psychological aspects of fertility preservation in men and women affected by cancer and other life-threatening diseases

BACKGROUND: With advances in treatment, the number of young cancer survivors who may benefit from fertility preservation is growing. The aim of this study was to review the literature investigating psychological aspects of fertility issues and fertility preservation in patients undergoing fertility-compromising therapy for cancer or other life-threatening diseases, previous to or during their reproductive lifespan. METHODS: Articles were identified in PubMed, Embase and PsycLIT as well as manually retrieved from literature citations for the time period from 1999 to 2008. Inclusion criteria were (i) qualitative or quantitative design, (ii) focus on patients previous to or during their reproductive lifespan and (iii) dealing with aspects such as (1) impact of fertility issues in cancer patients or (2) health professionals' and/or patients' attitudes towards fertility preservation or (3) counselling. RESULTS: Twenty-four studies were identified. According to the studies on aspect (1), fertility is an important issue for cancer patients. Health professionals as well as patients and parents consider fertility preservation as an important option for young cancer patients; all parties involved, however, were noted to have knowledge and information deficits. Patients recalling counselling about the impact of cancer treatment on fertility ranged from 34% to 72%. Counselling is far from being offered globally to all patients at risk, and providing information seems to be selective. CONCLUSIONS: The existing literature demonstrates the need for and the limits of current counselling. Future research should target the means to facilitate the decision-making process for patients and health professionals.