Bibliographic record
Abstract
Background/Purpose: Many adolescent and young adult female (AYA-F) cancer survivors face infertility risks after gonadotoxic treatments and may need to consider alternative family-building options.Uncertainty, distress, and avoidant coping may impact AYA-Fs' confidence in making decisions about parenthood.This study evaluated relationships among fertility-related information needs, reproductive concerns, avoidant behaviors, and decision self-efficacy about family-building after cancer.Methods: A cross-sectional survey study assessed AYA-F survivors' fertility experiences.Measures included an investigator-designed Unmet Information Needs scale about fertility/family-building, the Reproductive Concerns After Cancer Scale, the Impact of Events Scale-Avoidance subscale (focusing on fertility concerns), and the Decision Self-Efficacy scale.Descriptive statistics characterized the sample and outcomes.Linear regression evaluated correlates of decision self-efficacy about family-building after cancer, controlling for a priori covariates.Results: AYA-Fs (N = 111) averaged 31-year-old (SD = 5.49) and 90% were nulliparous, with a median of 3-year post-treatment (range: 1-23 years).Most common diagnoses were leukemia (24%), breast (22%), and Hodgkin lymphoma (19%).Before treatment, 78% remembered having a fertility discussion with a provider and 16% underwent fertility preservation.After treatment, 15%-31% reported satisfactory discussions about fertility/family-building topics during survivorship care; 38% had a fertility evaluation post-treatment.High rates of unmet information needs (M = 3.28, SD = 1.84, range: 0-5) and reproductive concerns (M = 60.35,SD = 10.56,range: 35-86) were reported, along with avoidant behaviors (M = 1.61,SD = .88,range: 0-3.75).Average decision self-efficacy about family-building was relatively high (M = 70.50,SD = 22.91, range: 6.82-100).In multivariate modeling controlling for age, years since treatment, nulliparity, and post-treatment fertility evaluation, greater reproductive concerns (B = -.24,p = 0.03) and greater avoidance of fertility (B = -0.24,p = 0.02) related to lower decision self-efficacy about family-building; unmet information needs was unrelated (B = -0.15,p = .16;F[7,83] = 4.68, p < 0.001). Conclusions and Implications:After cancer, high fertility distress and avoidant coping are associated with lower self-confidence in making family-building decisions.Follow-up fertility counseling post-treatment is needed to address survivors' psychosocial concerns and facilitate decision-making about pursuing parenthood.Longitudinal studies are needed to better understand AYA-Fs' evolving needs and decisionmaking processes as they consider fertility and family-building options.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.000 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.003 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.856 | 0.614 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".