A survey of fertility and sexual health following allogeneic haematopoietic stem cell transplantation in New South Wales, Australia

Br J Haematol. 2016 Feb;172(4):592-601. doi: 10.1111/bjh.13872. Epub 2015 Dec 21.

Abstract

Four hundred and twenty-one adult allogeneic haematopoietic stem cell transplant (HSCT) survivors participated in a cross-sectional study to assess sexual dysfunction and infertility post-transplant. Survey instruments included the Sydney Post-Blood and Marrow Transplant (BMT) Survey, Functional Assessment of Cancer Treatment (FACT) - BMT, the Depression, Anxiety, Stress Scales (DASS 21), the Chronic Graft-versus-Host Disease (cGVHD) Activity Assessment- Patient Self Report (Form B), the Lee cGVHD Symptom Scale and The Post-Traumatic Growth Inventory. Most HSCT survivors reported sexual difficulties (51% of males; 66% of females). Men reported erectile dysfunction (79%) and decreased libido (61·6%) and women reported loss of libido (83%), painful intercourse (73%) and less enjoyment of sex (68%). Women also commonly reported vaginal dryness (73%), vaginal narrowing (34%) and vaginal irritation (26%). Woman had much higher rates of genital cGvHD than men (22% vs. 5%). Age and cGVHD were significantly associated with sexual dysfunction. Few survivors had children following transplant (3·3%). However, for those of reproductive age at HSCT, 22% reported trying to conceive, with 10·3% reporting success. This study is the largest to date exploring sexual function in survivors of allo-HSCT. This data provides the basis for health service reform to better meet the needs of HSCT survivors, including evidence to support counselling and education both pre- and post-transplant.

Keywords: Australia; allogeneic HSCT; infertility; sexual dysfunction; survey; survivors.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Distribution
  • Aged
  • Cross-Sectional Studies
  • Female
  • Hematopoietic Stem Cell Transplantation / adverse effects*
  • Humans
  • Infertility / epidemiology
  • Infertility / etiology*
  • Infertility / prevention & control
  • Male
  • Middle Aged
  • New South Wales / epidemiology
  • Quality of Life
  • Sexual Dysfunction, Physiological / epidemiology
  • Sexual Dysfunction, Physiological / etiology*
  • Sperm Banks
  • Transplantation, Homologous / adverse effects
  • Young Adult