Induced Perceived Infertility Related to Psychological Distress among Adult Women Receiving Chemotherapy at a Tertiary Care Hospital, Karachi, Pakistan; an Analytical Cross-Sectional Study

Abstract

Globally, many individuals of reproductive age are affected by cancer and may experience perceived infertility because of its treatment. The primary objectives of this study were to estimate the mean score of fertility-related distress and to examine the association between perceived infertility and distress among adult women receiving chemotherapy at a tertiary care hospital in Karachi, Pakistan. The secondary objective was to assess the relationship between fertility-related distress and other associated factors in this population.

This was an analytical cross-sectional study conducted at a single private tertiary care teaching hospital in Karachi, Pakistan. A sample size of 137 participants was calculated; however, 150 participants successfully completed the survey. The inclusion criteria comprised female patients aged 18 to 50 years undergoing chemotherapy, with no pre-existing infertility issues. Exclusion criteria included a prior psychiatric diagnosis, history of surgery involving reproductive organs, reproductive organ cancer, pregnancy, and single/unmarried status.

Fertility-related distress was assessed using the Fertility Problem Inventory Scale, while associated factors were evaluated through a structured questionnaire. The participants had a mean age of 39.75 ± 6.85 years and demonstrated a mean fertility-related distress score of 79.30 ± 1.30. Multivariable linear regression analysis revealed that women who were not planning to have children (β = 6.43, 95% CI: 2.21–10.64) and those undergoing radiation therapy (β = 20.86, 95% CI: 15.77–25.94) were significantly associated with higher distress levels. Perceived infertility was not directly associated with distress. However, a significant interaction was observed between perceived infertility and family status, resulting in a negative effect (β = −2.5, 95% CI: −4.7 to −0.2).

Healthcare providers should proactively address fertility-related concerns and provide timely support to women undergoing cancer treatment. Such interventions may help reduce distress and improve the overall psychological well-being of patients.