Factors associated with family building in cancer survivors

health professionals, psychological resources or in-house complementary medicine programs available regarding exercise, nutrition and acupuncture. Chi-square tests were used to evaluate the differences between the groups. RESULTS: Of the 376 websites evaluated, 79% were private practice and 21% were academic. 30% of clinics performed R500 cycles a year and 70% performed <500 cycles a year. Overall, 48% of clinics offered psychological resources but only 22% had an on-site mental health professional available to patients in their practice. Large volume clinics (R500 cycles) were more likely to offer psychological resources than small volume clinics (<500 cycle) (66% vs 42%, p < 0.001). However, small volume clinics were more likely to offer on-site mental health resources compared to large programs (33% vs. 18%, p¼0.002) and wellness programs for exercise or yoga (25% vs 13%, p ¼0.007). There was no difference between large and small volume clinics on whether they offered wellness programs for acupuncture or nutrition. There was no difference between academic and private clinics on whether they offered mental health resources, an on-site mental health provider or any of the complementary medicine programs. CONCLUSIONS: Despite data that show that psychological distress is common during fertility treatments, less than half of all SART fertility clinic websites provided psychological resources for patients online and even fewer had on-site mental health providers. Additionally, complementary medicine programs that specifically mentioned resources for nutrition, exercise and acupuncture were extremely limited. As the Internet continues to become a primary source of information gathering for patients, it will be imperative for fertility websites to maintain thorough mental health and wellness resources for patients. Reference: 1. Pasch LA, Holley SR, Bleil ME, et al. Assessing the needs of fertility treatment patients and their partners: are they informed of and do they receive mental health services? Fertil Steril 2016;106:209-215. O-152 Tuesday, October 31, 2017 11:15 AM FACTORS ASSOCIATED WITH FAMILY BUILDING IN J. R. Gorman,b CANCER SURVIVORS. J. R. Ho,a c d e B. W. Whitcomb, J. M. Bouknight, I. Su, K. Chung.a aUSC Keck School of Medicine, Los Angeles, CA; bOregon State University, Corvallis, OR; cUniv. of Massachusetts Amherst, Amherst, MA; dUniv. of Alabama Birmingham, Birmingham, AL; eUC San Diego, San Diego, CA. OBJECTIVE: To test if fertility concerns are associated with subsequent family building behavior (FB) in cancer survivors. To determine demographic and socioeconomic factors associated with FB. DESIGN: Prospective cohort MATERIALS AND METHODS: Female young adult cancer survivors ages 18-44 were recruited to FIRST, a national registry to study reproductive outcomes after cancer. Participants filled out annual online questionnaires. We measured reproductive concerns (Reproductive Concerns After Cancer Scale [RCAC] at Year 1 of follow up and FB (attempting pregnancy, becoming pregnant, adoption, or visiting a fertility specialist) at Year 2. The RCAC has 6 domains (partner disclosure of fertility status, child’s health, personal health, fertility potential, pregnancy, and acceptance of possibly not having children). Higher scores (range 0-6) reflect greater concerns. Multivariable logistic regression models were used to test associations between Year 1 RCAC scores and subsequent FB at Year 2, while controlling for confounding. RESULTS: The 228 participants included in the analysis had a mean age of 32.8 years (SD 5.8) and were 6.8 years from their diagnosis (SD 4.8). The most common cancers were hematologic (34%) and breast (30%). 80% had chemotherapy, 50% had radiation, and 13% had prior oophorectomy or hysterectomy. Between Year 1 and 2, 25 (11%) attempted FB. 10.4% attempted pregnancy or became pregnant, 0% adopted children, and 7.3% visited a fertility specialist. While 2.4% of the cohort had high overall concerns (RCACR4), 47.8% had high fertility concerns. Women with high fertility concerns were more likely to undertake FB (p¼0.02). The other 5 domains were not associated with FB. Unpartnered women were more likely to report high fertility concerns (p¼0.04) but less likely to undertake FB (p¼0.02). Cancer and other demographic and reproductive characteristics were not associated with FB. In a multivariate analysis, high fertility concerns (OR 3.1, CI¼1.2-7.9) and partner status (OR 4.1, CI¼1.3-12.8) remained significantly associated with FB. CONCLUSIONS: High fertility concerns are predictive of subsequent family building behavior in reproductive-aged female cancer survivors. The RCAC fertility subscale identifies women most likely to pursue FB after cancer treatment and may help predict which women will be most likely to benefit from fertility preservation prior to cancer treatments. Supported by: HD 080952-03, UL1 RR024926 pilot.

FERTILITY & STERILITYÒ

Unadjusted and Adjusted Odds for Family Building in Cancer Survivors

Unadjusted OR RCAC Fertility concerns Age Previous oophorectomy or hysterectomy Partner status Income Education

Adjusted OR

No

Ref

Ref

Yes <32 %32 No

3.1 (1.2-7.9) Ref 1.35 (0.57-3.2) Ref

3.4 (1.3-9.2) Ref 1.01 (0.4-2.8) Ref

Yes No partner Partner %$50,000 >$50,000 Did not complete college College grad

0.21 (0.03-1.6) Ref 3.3 (1.2-9.3) Ref 1.1 (0.5-2.1) Ref

0.33 (0.04-2.7) Ref 4.1 (1.3-12.8) Ref 0.83 (0.3-2.0) Ref

2.1 (0.9-4.9)

1.86 (0.7-4.8)

O-153 Tuesday, October 31, 2017 11:30 AM INFORMATION SHARING MOTIVATIONS PREDICT CHANGE IN ADJUSTMENT OF CHILDREN CONCEIVED VIA ASSISTED REPRODUCTION. M. Chen,a R. Arocho,b M. A. Rueter.a aUniversity of Minnesota, St. Paul, MN; bOhio State University, Columbus, OH. OBJECTIVE: To examine the effect of parental motivations for sharing, or not sharing, medically assisted reproduction (MAR) information with children on change in psychosocial adjustment from childhood to adolescence. DESIGN: Longitudinal correlational study of 182 MAR-conceived (IVF, ICSI, or IUI) children (Wave 1: M age ¼ 8.47 years; Wave 2: M age ¼ 13.38 years). MATERIALS AND METHODS: Parents reported the dependent variable, adolescent psychosocial adjustment, at Wave 2 on Child Behavior Checklist internalizing (a ¼ .84), externalizing (a ¼ .89), and attention problems (a ¼ .83) subscales. The independent variable was parental information sharing motivations. Parents of children aware of MAR conception (n ¼ 100 children) rated their motivations for information sharing (1 ¼ Not at all the reason, 5 ¼ A main reason) on the Disclosure Motivations Questionnaire (DMQ). The DMQ’s Permeable Information Boundary (PIB) subscale assessed how much having open family communication was a motivation (4 items; a ¼ .66). The Preemption (PE) subscale assessed information sharing to prevent others from first telling the child (2 items; a ¼ .67). Parents of children unaware of MAR conception (n ¼ 82 children) rated their motivations for not sharing using the Nondisclosure Motivations Questionnaire (NMQ). The NMQ’s Relationship Maintenance (RM) subscale assessed not sharing to protect family members (5 items; a ¼ .71). The Self-Protection (SP) subscale assessed not sharing to protect parents’ identities (4 items; a ¼ .84). Covariates included childhood (Wave 1) psychosocial adjustment (internalizing a ¼ .76, externalizing a ¼ .84, attention problems a ¼ .79), child donor status, age, and sex. With covariates controlled, the association between each motivation type and adolescent adjustment was tested using four separate autoregressive structural equation models (PIB, PE, RM, and SP models). RESULTS: For adolescents aware of their MAR conception, PIB motivations negatively related to relative change in adjustment problems from childhood to adolescence (b ¼ -.24, p ¼ .040) after controlling covariates. PE motivations positively related to change in adjustment problems (b ¼ .23, p ¼ .019). For adolescents unaware of their MAR conception, RM motivations negatively related to change in adjustment problems (b ¼ -.28, p ¼ .002), whereas SP motivations positively related to change in adjustment problems (b ¼ .46, p < .001). CONCLUSIONS: Parents’ motivations for sharing or not sharing information about MAR conception with their children may have long-term positive, or negative, effects on child psychosocial adjustment. Supported by: University of Minnesota (UMN) Agriculture Experiment Station, UMN Grant-in-Aid, UMN College of Education & Human Development Research Development Investment Grant, National Science Foundation Graduate Research Fellowship (Grant No. DGE-1343012).

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