Fertility in the Shadow of Cancer: Experiences of Reproductive Loss Among Women with Gynecological Cancers in Ghana

Abstract

Abstract Background Gynecological cancers and their treatments can compromise fertility, with profound psychosocial consequences for women of reproductive age. Yet, women’s lived experiences of cancer-related infertility remain underexplored in low-resource settings, including Ghana. This study examined the impact of gynecological cancers on fertility among reproductive-aged women receiving care at Ho Teaching Hospital, Ghana. Methods A qualitative descriptive design was used. Fourteen women aged 15–49 years with gynecological cancers who had completed or were undergoing treatment were purposively recruited until saturation. Semi-structured interviews (30–45 minutes) were conducted face-to-face or by telephone in English, Twi, or Ewe, audio-recorded, transcribed verbatim, and analyzed using thematic analysis. Strategies to enhance rigor included independent coding, member checking, reflexivity, and peer debriefing. Results Five themes and eighteen subthemes emerged. Participants described infertility as a threat to womanhood and future life plans, expressed as a sense of incompleteness, fear of rejection, denial, and shattered aspirations. Social consequences included stigma and impaired intimate relationships. Treatment-related burdens, menstrual changes, pain, fatigue, and anxiety compounded distress. Economic hardship and educational disruption were common. Women also demonstrated resilience through adherence to treatment, dietary and lifestyle modifications, faith-based coping, and family support. Conclusion Gynecological cancer–related infertility is a multidimensional survivorship burden. Integrating fertility counseling, psychosocial support, symptom management, and financial/social protection into cancer care is critical in Ghanaian settings.