Page 39 - IJPS-11-5

International Journal of
Population Studies Self-compassion for infertility in breast cancer

with cancer. Fertility counseling must align to available 200 young breast cancer survivors (18 – 35 years of age),
resources and legislation per setting to ensure information Gorman et al. (2015) identified strong associations between
on procedures is relevant (Zaami et al., 2022b). In line with reproduction concerns and depression risk, corroborating
the latest guidance of the European School of Oncology the findings of Howard-Anderson et al.’s (2012) systematic
(ESO) and the European Society of Medical Oncology review, which found that depression risk was heightened in
(ESMO) (Paluch-Shimon et al., 2022), enhancing breast cancer survivors due to reproduction concerns and
clinician, patient, and general population knowledge of that these concerns were common. Synthesized qualitative
cancer treatment fertility impact and mitigation options is findings also support this link, and shed light on the lived
therefore recommended. General breast cancer educational experience of breast cancer survivors’ fertility concerns,
interventions and targeted clinical work with patients are with reports that loss of fertility is viewed as the biggest
each indicated to achieve these aims. post-treatment regret (Campbell-Enns & Woodgate,

2.3. Psychological impacts of breast cancer and 2017). Grief over fertility loss in breast cancer patients is
infertility identified as a common theme (Ussher & Perz, 2019). Such
grief over lost possibilities threatens identity and meaning
2.3.1. Psychological impact of breast cancer and for breast cancer patients (Carr et al., 2023), which is
treatment detrimental to psychological functioning (Gilbert, 2022).
The effects of cancer and cancer treatments are well-
documented as having a serious negative impact on 3. Compassion interventions for breast
psychological well-being (Niedzwiedz et al., 2019). cancer patients and survivors
Depression, in particular, is seen to have interactive effects 3.1. Self-compassion is protective against breast
with cancer that can inhibit treatment adherence and cancer-related psychological impact
worsen outcomes (Pinto-Gouveia et al., 2014). Reviewing
the breast cancer-specific literature, Dinapoli et al. (2021) One important psychological factor that has been shown
identify anxiety, distress, post-traumatic stress disorder, to protect against depression, and other psychopathologies
and depression as highly prevalent in breast cancer related to illness, is self-compassion (Pinto-Gouveia
patients. Since findings indicate that psychopathology can, et al., 2014). Self-compassion is the ability to recognize
in addition, independently impact on fertility owing to one’s suffering and respond to alleviate the suffering with
deleterious influence on the endocrine and nervous system supportive self-reassuring (Gilbert, 2009). Self-compassion
(Szkodziak et al., 2020), the psychological impact of breast is commonly conceptualized as comprising components
cancer exacerbates reproductive health problems. of self-kindness (vs. self-judgment), common humanity
(vs. isolation), and mindfulness (vs. over-identification
2.3.2. Psychological impact of infertility with thoughts) (Neff, 2023). Self-compassion activates
Infertility’s impact on psychological well-being itself neurophysiological systems that regulate motivation,
has understandably received much research attention. emotion, and behavior, toward a soothing, rather than
Kiani et al. (2021) have recently systematically reviewed threat-based, orientation (Gilbert, 2014). In this way, self-
the literature and determined that infertile women were compassion counters shame and self-criticism, which
significantly more depressed than the general population are shown to be linked with mental health problems in
of a given country. This effect was particularly pronounced breast cancer patients (Connolly-Zubot et al., 2020). Self-
in low- to middle-income countries. In addition to compassion is positively associated with many positive
depression, anxiety and stress have been found to be mental health outcomes, such as resilience and well-being
higher in infertile females than in the general population (Kotera et al., 2021; Kotera et al., 2022b), and is negatively
(Yusuf, 2016). associated with many negative mental health outcomes,
such as shame and depression (Colman et al., 2022; Kotera
2.3.3. Psychological impact of infertility on breast et al., 2022a), with longitudinal benefits for cancer patients
cancer survivors (Zhu et al., 2019). Pinto‐Gouveia et al. (2014) found self-
By exploring empirical work on the specific psychological compassion to be the only significant predictor of lower
impact of fertility concerns among breast cancer survivors, depression and higher quality of life within a mixed cancer
we found that treatment-related fertility risk evokes the cohort, which included 46% of breast cancer patients. Haj
same level of emotional distress and arousal in young non- Sadeghi et al. (2018) demonstrated, through randomized
cancer infertile females, though accompanied by worse controlled trial, that compassion-focused therapy, which
perceived health-related quality of life (Bártolo et al., emphasizes self-compassion, significantly reduced
2020). After investigating the reproduction concerns of depression and anxiety in breast cancer patients. Todorov

Volume 11 Issue 5 (2025) 33 https://doi.org/10.36922/ijps.1724