Factors contributing to reproductive and fertility concerns of adolescents and young adults living with chronic Illness

Introduction:  Surprisingly few studies have examined sexual and reproductive behavior, needs, and concerns of adolescents and young adults (AYA) living with chronic illness despite evidence indicating that they are as sexually active as their healthy peers.  In fact, AYA with chronic health conditions may face unique challenges that can increase anxiety about sexuality, pregnancy and childrearing. 

Methods: A survey examined the reproductive health concerns (RHC) of 102 AYA (15-20 years) with chronic renal and rheumatologic conditions recruited from two sub-specialty services located in a tertiary-care pediatric institution. Analyses examined associations between patients’ interest and concerns about fertility and childbearing, and factors thought to be associated with RHC.

Results:  Nearly a third (30%) of the respondents were sexually active. Over two-thirds (68%) reported interest in having children someday, yet 44% worried about their ability to have children some or all of the time; 35% believed that medication might interfere with their ability to have children.  Results indicated that females reported lower life satisfaction (general and body appearance), self-rated health, and greater RHC.  For females, lower body appearance satisfaction and self-rated health predicted worry about childbearing and medication interfering with pregnancy. For males, lower general life satisfaction was associated with worry about childbearing and medication interference. 

Discussion: Healthcare professionals must be proactive in addressing young AYA patients’ sexual and reproductive health concerns -- including how their condition can affect fertility and pregnancy.  This can help minimize anxiety and empower them to make more informed choices about their sexual practices and childbearing/childrearing plans.