Abstract
Purpose
Hematopoietic stem cell transplantation (HSCT) causes severe gonadotoxicity. This study assessed fertility-related knowledge, childbearing attitudes, and their sociodemographic determinants among female HSCT survivors.Methods
This cross-sectional study evaluated 209 women (≥ 1 year post-HSCT) at Iran's largest referral center. Data were collected using sociodemographic profiles, a researcher-developed Fertility Knowledge Questionnaire, and the Attitude Toward Fertility and Childbearing Scale. Multivariable linear regression identified independent predictors.Results
Participants' mean age was 34.72 ± 9.05 years. Fertility knowledge was poor (mean score: 4.56 ± 1.92 out of 10), with critical deficits regarding post-transplant pregnancy timing (92.3% incorrect) and treatment-related risks (94.7% incorrect). Conversely, childbearing attitudes were relatively positive (mean score: 63.25 ± 10.73), and 47.4% desired future children. A significant inverse correlation emerged between knowledge and attitude scores (r = - 0.334, p 2 = 0.46). Younger age, fewer children, and superior economic status predicted more positive attitudes (R2 = 0.31).Conclusions
Female HSCT survivors exhibit critical fertility knowledge deficits despite positive parenthood attitudes. The inverse knowledge-attitude correlation suggests that enhanced risk awareness might temper reproductive optimism.Implications for cancer survivors
These findings necessitate incorporating structured, multidisciplinary, and psychologically informed fertility counseling into routine HSCT survivorship care, ideally initiated prior to conditioning regimens, to facilitate informed reproductive decision-making.