Adolescent and young adult (AYA) patients aged 18–39 who are diagnosed with cancer face not only the physical and psychological burdens of disease and treatment but also potential threats to reproductive capacity. Certain cancer therapies can impair fertility, making reproductive planning and access to fertility services an important component of AYA oncology care. This study aimed to identify factors associated with the desire for future children among AYA cancer patients and, among those who desired children or were unsure, to examine predictors of interest in consulting a fertility specialist.
The analysis included AYA patients (n = 4,847) who completed an electronic patient questionnaire (EPQ). The cohort was predominantly female (62%) with a mean age of 32 years. Cancer characteristics and treatment information were obtained from cancer registry data and linked to the EPQ responses.
Participants completed EPQ items assessing physical and mental health, whether they wanted future children, and whether they were interested in a consultation with a fertility specialist. Cancer registry variables provided details on cancer type and treatments received. Specific survey item wording, response options, and timing relative to diagnosis or treatment initiation were not reported in the abstract.
The investigators used multinomial regression to examine factors associated with the categorical outcome of desire for future children. For the subgroup of AYAs who wanted future children, or were unsure, binary regression models assessed factors associated with expressed interest in a fertility consultation. Reported effect estimates in the abstract are odds ratios (OR) with 95% confidence intervals (CI).
In multinomial analysis, several characteristics were associated with a lower likelihood of reporting a desire for future children:
These findings indicate that among this large AYA sample, being female, increasing age, and parenthood status were independently associated with reduced expressed desire for additional children.
Among the subgroup of AYAs who expressed a desire for children, or were unsure, the following factors were associated with greater likelihood of reporting interest in meeting with a fertility specialist:
These results suggest that certain diagnoses and treatments, as well as patient demographics, shape interest in specialist fertility counseling among AYAs who want children.
Authors conclude there is a clear need to systematically address and offer fertility consultation for all AYA patients prior to initiation of cancer treatment. The observed associations between desire for children, interest in consultation, and variables such as sex, age, parenthood status, cancer type, and treatment modalities indicate opportunities to tailor counseling and referral processes.
Systematic referral pathways and timely access to oncofertility services are implied as necessary steps to ensure AYA patients receive information and options for fertility preservation before treatments that may compromise reproductive potential.
The abstract reports key associations and effect estimates but does not provide full methodological details such as sampling frame, recruitment period, response rate, timing of EPQ relative to diagnosis or treatment, or complete covariate lists used in multivariable models. Detailed subgroup counts beyond the overall sample size, potential confounders, and sensitivity analyses are not reported in the abstract. The abstract also does not report on actual uptake of fertility preservation procedures, long-term reproductive outcomes, or patient-reported barriers to obtaining consultations.
Further study is recommended to explore sociodemographic, clinical, and psychosocial determinants of reproductive decision-making in AYA cancer populations and to inform interventions that ensure fertility needs are assessed and addressed consistently in clinical practice.