# A life put on hold? Navigating fertility-related considerations after cancer in adolescence and young adulthood (AYA)

## TL;DR

This study explores how cancer during adolescence and young adulthood affects fertility goals, relationships, and emotional well-being.

## Contribution

The study identifies how cancer survivors perceive putting fertility goals on hold and the emotional and relational impacts of fertility-related uncertainty.

## Key findings

- 46% of participants felt their reproductive goals were put on hold due to cancer, leading to negative emotions and relationship strain.
- Fertility-related uncertainty was linked to emotions like sadness, anxiety, and insecurity, and correlated with various fertility-related concerns.
- Arguments against parenthood included cancer-specific health risks and generic concerns like loss of freedom, while arguments in favor were mostly generic, such as meaning-making.

## Abstract

To examine fertility-related considerations of patients and survivors diagnosed with cancer during adolescence and young adulthood (AYA). Such fertility-related considerations include perceptions of putting reproductive goals “on hold” and subsequent effects on romantic relationships, parenthood considerations (i.e., arguments for/against having children), fertility-related uncertainty, and fertility-related concerns.

An online cross-sectional survey was completed by of N = 190 patients/survivors of AYA cancer (Mage = 32.5 years, 87% female, diagnosed between ages 12–39 years; 65% were without biological children at study participation).

The majority of participants (72%) likely wanted to have children. Among them, 46% felt like their reproductive goals were put on hold due to cancer, causing negative emotions and negative effects on romantic relationships (e.g., pressure). Arguments against parenthood were predominantly cancer-specific (e.g., concerns/worries about health risks), but also generic (e.g., loss of freedom, sustainability). Arguments in favor of having children were almost all generic (e.g., meaning making). Fertility-related uncertainty caused negative emotions (e.g., sadness, insecurity, anxiety, feeling less human), and was correlated with various fertility-related concerns (r = .3–.7).

Perceptions of putting reproductive goals “on hold” can affect well-being and romantic relationships, and fertility-related uncertainty may cause various negative emotions among young cancer patients/survivors. Arguments against parenthood evolve around cancer-specific concerns, which should be addressed by healthcare providers throughout survivorship. Providers are encouraged to provide patient-specific fertility-related education and psychological support if indicated.

The online version contains supplementary material available at 10.1007/s00520-025-09832-9.