Meta-analysis reveals complex links between endocrine therapy and fertility worries in cancer patients of childbearing age
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Key Takeaway
Depression, education, and endocrine therapy linked to fertility concerns; marriage and multiple children protective.
This systematic review and meta-analysis examined factors influencing fertility concerns among 3,282 cancer patients of childbearing age. The study highlights the intricate relationship between medical interventions and psychological distress in this vulnerable population.
Key findings indicate that depression, higher education levels, full-time employment, and endocrine therapy were positively associated with fertility concerns. Notably, having fertility intentions emerged as a strong predictor, with an odds ratio of 5.96. These results suggest that psychological and social factors play a significant role in patient experiences.
Conversely, being married and having more than one child demonstrated negative associations with fertility concerns, acting as protective factors. Reproductive counseling and endocrine therapy also showed positive links to these concerns. The data underscores the need for holistic care addressing both medical and psychosocial needs.
Limitations include the observational nature of included studies, preventing causal inferences. Clinicians must recognize these complex interplays to provide comprehensive support for patients navigating cancer treatment and fertility considerations.
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View Original Abstract ↓
This study systematically analyzes factors influencing fertility concerns among cancer patients to inform clinical practice.
We conducted a comprehensive search of PubMed, Web of Science, Embase, Cochrane Library, and Scopus from inception through August 2024 for studies examining factors associated with fertility concerns in cancer patients. Two researchers independently performed literature screening, data extraction, and quality assessment. Meta-analyses were conducted using RevMan 5.4 and Stata 17.0.
A total of 13 articles were included, including 11 cross-sectional studies and 2 longitudinal studies, including 3282 patients. which showed that depression (OR = 1.30, 95%CI = 1.14-1.49), higher education level (OR = 1.74, 95%CI = 1.11-2.73), fertility intentions (OR = 5.96, 95%CI = 1.35-26.31), having more than one child (OR = 0.32, 95%CI = 0.23-0.41), being married (OR = 0.44, 95%CI = 0.26-0.75), full-time employment (OR = 1.41, 95%CI = 1.03-1.93), endocrine therapy (OR = 1.31, 95%CI = 1.07-1.62) and reproductive counseling (OR = 1.21, 95%CI=1.01-1.45) were factors associated with fertility concerns in cancer patients.
This study provides the first quantitative evidence that endocrine therapy and prior fertility counseling are significantly associated with elevated fertility concerns, highlighting potential clinical paradoxes and the complex interplay between medical intervention and psychological distress.
https://www.crd.york.ac.uk/prospero/, identifier CRD42024582238.
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