Motivations for having children after cancer--a systematic review of the literature.

Over the last decade, fertility-related issues have come to the fore of clinical oncology. The majority of research though has focused on a medical perspective without considering reproductive motivations that influence decisions on fertility-preserving options. In order to identify specific parenthood motivations in young survivors of various types of cancer, a systematic review of the literature was conducted. Relevant literature was searched manually and using databases (Medline/PubMed, PsycInfo). Of 4848 articles retrieved, 20 studies met a priori defined inclusion criteria. Cancer was found to have a likely effect on reproductive intentions. All studies reported on specific reproductive concerns, mostly related to negative consequences for the patient or on the future child. Pregnancy concerns were overrepresented in breast cancer survivors. Practical barriers to post-cancer parenthood were financial or partner-referred. Overall, fewer incentives than disincentives for post-cancer parenthood were reported. They included the importance of parenthood, achieving normality and a desire to focus on the positive. As reproductive motivations and concerns affect the majority of cancer survivors of reproductive age, they should be assessed as early as possible post-diagnosis. While researchers should focus on the development of appropriate assessment methods, clinicians might address specific reproductive concerns.