What do you do when your partner or spouse is diagnosed with cancer? What if he or she is thinking about undergoing fertility preservation? While the impacts of both cancer and infertility on relationships have been investigated individually, there is little published research on the intersection of the two. A new book chapter from Oncofertility Communication: Sharing Information and Building Relationships across Disciplines investigates the potential ways partners may participate in the oncofertility process, from digesting a cancer diagnosis to helping make decisions about building a future family.

In the chapter, Incorporating Partners and Spouses in Oncofertility Communication, Drs. Megan Johnson Shen and Hoda Badr discuss the impact of potential infertility on cancer patients, their partners, and their relationship. Infertility in the absence of cancer is already known to cause distress in both members of a couple by causing feelings of loss of control, perceived loss of femininity or masculinity, and loss of attractiveness or self-esteem. Sexual dysfunction is also affected in some cancer patients, including those with prostate and gynecologic cancers. Shen and Badr highlight emerging evidence that open, constructive communication increases marital satisfaction regardless of sexual dysfunction and satisfaction. Such communication may also increase relationship satisfaction when discussing infertility concerns.

Shen and Badr also discuss the different options in fertility preservation for men and women, and the emotional outcomes of oncofertility. Cervical cancer patients who opt for fertility preservation experience decreased distress than those who don’t. While the fertility preservation process may delay cancer treatment, some cancers can incorporate fertility preservation into the cancer trajectory. For example, breast cancer patients may undergo breast surgery first and then preserve fertility while healing and prior to chemotherapy. Of breast cancer patients who opted for fertility preservation, those who were referred to a reproductive specialist prior to, rather than after, surgery, begin chemotherapy an average of 24 days earlier than patients who did not receive a referral until after surgery. In addition, providing communication support for these patients and their significant others facilitates the decision-making process and reduces distress.

When undergoing fertility preservation, patients must make complex decisions regarding the legal rights to the materials or any resulting gametes in the case of death or divorce. These choices often force couples to envision intrinsically distressing scenarios in which they are separated by divorce or death. In the chapter, Incorporating Partners and Spouses in Oncofertility Communication, Shen and Badr advocate for an increased agenda on partner involvement in oncofertility research. This could investigate the partner’s role in contributing to and reducing marital distress, and the need to involve partners in oncofertility discussions.

To read more about the communication needs in oncofertility, read this chapter or others in Oncofertility Communication: Sharing Information and Building Relationships across Disciplines.