Interest in fertility status assessment among young adult survivors of childhood cancer

Background Cancer survivors who received gonadotoxic treatment are at‐risk for future infertility and may desire a fertility status assessment (FSA), defined as semen analysis for males and consultation with a reproductive specialist for females. The purpose of this study was to describe the proportion of, and factors associated with, interest in FSA among young adult survivors of childhood cancer. Methods This retrospective single‐institution review included patients with prior gonadotoxic treatment, aged 18–25 years and >1 year from cancer treatment completion, who received a fertility‐focused discussion during survivorship. Documentation of interest in and completion of FSA, worry about infertility, sociodemographic, and clinical characteristics were ed from medical records. Multivariable logistic regression was performed to calculate odds ratios (OR) and 95% confidence intervals (95%CI) for factors associated with interest in FSA. Results Survivors (N = 259) were on average 19.2 ± 1.2 years at their fertility discussion; 55.6% were male and 57.9% non‐Hispanic white. Interest in FSA was reported by 50.7% of males and 46.1% of females. Factors related to interest in FSA for males and females respectively, included worry about infertility (OR 2.40, 95%CI 1.11–5.27, p = 0.026 and OR 4.37, 95%CI 1.71–12.43, p = 0.003) and ≥2 fertility discussions (OR 3.78, 95%CI 1.70–8.75, p = 0.001 and 2.45, 95%CI 1.08–5.67, p = 0.033). Among males, fertility preservation consult/procedure at diagnosis (OR 3.02, 95%CI 1.09–9.04, p = 0.039) and high‐risk for infertility (OR 2.47, 95%CI 1.07–5.87, p = 0.036) were also associated with interest in FSA. Conclusions Cancer survivors are interested in FSA, particularly those who have had repeated fertility‐focused discussions during survivorship care and who report worry about infertility. For survivors of childhood cancer who are at risk for infertility, a fertility status assessment can provide clarity regarding their current fertility status and options for future biological parenthood. Cancer survivors are interested in fertility status assessment, particularly those who have had repeated fertility‐focused discussions during survivorship care and those who report worry about infertility. Despite interest in a fertility status assessment, few survivors have completed an assessment.