Perz J, Ussher J, Gilbert E
Centre for Health Research, School of Medicine, University of Western Sydney, Sydney, NSW, Australia.
Eur J Cancer Care (Engl). 2014 Jul;23(4):514-22. doi: 10.1111/ecc.12165. Epub 2013 Dec 27.
This qualitative study examines the subjective experience of infertility in a large sample of Australian women with breast cancer. Participants were 1830 women, average age 54, who responded to an email invitation to complete an online survey on sexual well-being and fertility concerns after breast cancer. 24.6% (n = 452) reported that cancer had affected their fertility; 21.3% (n = 391) did not know their fertility status. In thematic analysis of open-ended responses provided by 381 women about changes to fertility status, reactions to infertility, and experiences of information and interventions to assist fertility, five themes were identified: 'Negative responses to infertility and early menopause'; 'Sexual changes associated with menopause and infertility'; 'Uncertainty and anxiety about fertility status'; 'Information and fertility preservation'; 'Acceptance of the end of fertility'. These findings confirm previous reports that infertility and premature menopause are a significant cause of anxiety for many women with breast cancer. However, some women closer to natural menopause, or who had completed their families, reported acceptance of changed fertility status. Accounts of deficits in information provision and fertility counselling suggest an urgent need for accessible and comprehensive information about fertility and cancer to be developed and evaluated, as well as education and training of health professionals in addressing fertility concerns following cancer.
这项定性研究调查了大量患有乳腺癌的澳大利亚女性的不孕主观体验。参与者为1830名女性，平均年龄54岁，她们回复了一封电子邮件邀请，以完成一项关于乳腺癌后性健康和生育问题的在线调查。24.6%（n = 452）的人报告称癌症影响了她们的生育能力；21.3%（n = 391）的人不知道自己的生育状况。在对381名女性提供的关于生育状况变化、对不孕的反应以及辅助生育的信息和干预措施经历的开放式回答进行主题分析时，确定了五个主题：“对不孕和过早绝经的负面反应”；“与绝经和不孕相关的性变化”；“对生育状况的不确定性和焦虑”；“信息与生育力保存”；“接受生育的终结”。这些发现证实了先前的报道，即不孕和过早绝经是许多乳腺癌女性焦虑的重要原因。然而，一些接近自然绝经或已完成生育的女性报告称接受了生育状况的改变。关于信息提供和生育咨询不足的描述表明，迫切需要开发和评估关于生育和癌症的可获取且全面的信息，以及对医护人员进行关于解决癌症后生育问题的教育和培训。
