School of Women and Children's Health, Faculty of Medicine, UNSW Sydney, Sydney, Australia.
Fertility & Research Centre, Royal Hospital for Women, Randwick, Australia.
Psychooncology. 2019 Jan;28(1):22-30. doi: 10.1002/pon.4927. Epub 2018 Nov 20.
Cancer patients experience reproductive concerns from diagnosis through to survivorship. However, research has yet to investigate the degree of fertility-related psychological distress at different treatment time points: diagnosis, treatment, and survivorship. Currently, cancer patients are offered fertility counselling at the time of diagnosis, to assist fertility preservation decision making. A systematic review of the short-term and long-term psychological impact of infertility in cancer patients would inform on an improved, longitudinal model of psychological care.
A systematic review of the literature was conducted in January 2018 utilising electronic databases Medline, EMBASE, PSYCH Info, Web of Science, and SCOPUS. An initial search identified 708 potentially relevant studies. Literature was assessed that reported on fertility-related psychological distress experienced by male and female cancer patients of reproductive age (<45 years) across oncology treatment time points.
A total of 47 papers were included within the final review. Fertility-related psychological distress persists from diagnosis through to survivorship, with cancer patients reporting a range of negative emotional experiences brought about by threatened infertility. In survivorship, reproductive concerns, unfulfilled desire for a child, nulliparous status, and early menopause were linked to higher rates of mental health disorders and psychological distress.
Fertility-related psychological distress is prevalent and persistent in cancer patients and survivors. As such, patients and survivors would greatly benefit from fertility-related psychological support implemented into standard practice from diagnosis through to survivorship. A revised model of care is proposed.
癌症患者从诊断到生存期间都会经历与生殖相关的问题。然而，目前的研究尚未调查不同治疗时间点（诊断、治疗和生存）的生育相关心理困扰的程度。目前，癌症患者在诊断时会接受生育咨询，以帮助他们做出生育保留决策。对癌症患者不孕的短期和长期心理影响进行系统评价，将为改进癌症患者的心理护理纵向模型提供信息。
2018 年 1 月，我们利用 Medline、EMBASE、PSYCH Info、Web of Science 和 SCOPUS 电子数据库进行了系统的文献回顾。最初的搜索确定了 708 项潜在相关的研究。文献评估报告了各治疗时间点（<45 岁）的男性和女性癌症患者的生育相关心理困扰。
最终综述共纳入 47 篇论文。从诊断到生存期间，癌症患者的生育相关心理困扰一直存在，患者报告了因生育能力受到威胁而产生的一系列负面情绪体验。在生存期间，生殖问题、对孩子的渴望未得到满足、未育和早绝经与更高的心理健康障碍和心理困扰率相关。
癌症患者和幸存者普遍存在并持续存在与生育相关的心理困扰。因此，从诊断到生存期间，为患者和幸存者提供生育相关的心理支持将使他们极大受益。提出了一种修订后的护理模式。
