# Artificial Reproductive Technology Use and Family-Building Experiences of Female Adult Childhood Cancer Survivors: A Qualitative Study

## TL;DR

This study explores the emotional and practical challenges female childhood cancer survivors face when trying to build families, highlighting the need for better support.

## Contribution

The study provides new qualitative insights into the specific challenges female childhood cancer survivors encounter in family-building.

## Key findings

- Participants faced unexpected fertility issues and emotional grief.
- Healthcare experiences were often unsupportive and financially burdensome.
- Alternative family-building options like adoption were complex and challenging.

## Abstract

Female adult childhood cancer survivors often face challenges with fertility due to their cancer treatments. While some may turn to assisted reproductive technology or other family-building options, there is limited research on their experiences. This qualitative study explored the challenges faced by female survivors in a western Canadian province as they navigated family-building options. Interviews with 15 participants revealed five key challenges: unexpected impaired fertility, grief and identity struggles, unsupportive healthcare experiences, the complexities of adoption and international family-building, and significant financial burdens. These findings highlight the complex and emotional nature of fertility and family-building for survivors and point to important gaps in healthcare services. The study emphasizes the need for integrated informational, psychosocial, and financial support related to family-building after cancer.

Purpose: Cancer treatments can result in subfertility or infertility in female adult childhood cancer survivors (ACCSs). While ACCSs may utilize assisted reproductive technology (ART) or other family-building options, the limited evidence describing their experiences remains a hindrance to developing and implementing appropriate patient-centered supports. The study’s aim is to describe the challenges female ACCSs experienced while navigating ART and family-building options, to inform improvements in clinical practice in a western Canadian province. Methods: In this qualitative Interpretive Description study, interviews were conducted with 15 female ACCSs and data were analyzed using an interpretive thematic approach and constant comparative techniques. Results: ACCSs’ narratives suggest they experienced five prominent challenges while navigating ART and family-building options, including (1) confronting unexpected, impaired fertility, (2) grieving loss and redefining identity, (3) encountering unsupportive healthcare, (4) exploring alternative paths of adoption and international family-building, and (5) facing financial strain. Conclusions: This exploratory study provides initial insights into the significant and multifaceted challenges female ACCSs experience related to family building and highlights gaps in healthcare services. Further research is warranted to articulate these challenges across contexts and the development and implementation of mitigating approaches. Implications for Cancer Survivors: The integration of comprehensive informational, psychosocial, and financial supports into existing cancer survivor and family-building services is vital to meeting female ACCSs’ unmet needs.