Improving Nutrition Guidance May Optimize Fertility Treatments for Female Cancer Survivors

Get Permission

Researchers have identified potential strategies to promote healthy dietary habits in female cancer survivors with fertility challenges, according to a recent study published by Klobodu et al in Integrative Cancer Therapies.


Cancer may increase the risk of infertility in young female patients. Although consuming healthy foods—including whole grains, fruits, vegetables, and healthy fatty acids—has been found to improve both fertility and cancer survivorship, more than 90% of young adult cancer survivors may follow a diet high in fat and low in fruits and vegetables.

“Clearly, barriers exist for these young [female patients] who are unable to meet healthy dietary recommendations. Yet, to date, no study has investigated nutrition-related barriers to female cancer survivors experiencing fertility challenges,” explained senior study author Brandy-Joe Milliron, PhD, Associate Professor in the College of Nursing and Health Professions at Drexel University.

Study Methods and Results

In this study, researchers conducted in-depth interviews with 20 female cancer survivors who were of reproductive age and had fertility challenges to examine their dietary habits and develop informed dietary interventions for this patient population. In addition to the interviews, each study participant provided three 24-hour dietary recalls involving a report of the foods and beverages they consumed the day before. The researchers then used the Healthy Eating Index 2015 to gauge the quality of patients’ diets and how closely they adhered to the Dietary Guidelines for Americans.

The researchers found that the patients involved in the study reported a poor-quality diet. However, they noted the patients’ faced four main barriers to eating a healthy diet: challenges of a work-life balance; treatment-related fatigue; dietary guidance that was too rigid to follow, if provided; and a lack of nutritional resources and minimal guidance tailored to the patients’ unique needs during and after treatment.

Despite these barriers, the study authors identified several facilitators to healthy eating—especially among participants with higher-quality diets—including building trust between patients and their physicians, identifying a high motivation to improve nutrition-related behaviors, and recognizing the additional benefits of nutrition and a healthy diet.


The researchers noted that their new findings are not generalizable, and future research may be needed to further understand the unique nutrition- and wellness-related needs of young female cancer survivors—across all cancer types and treatments, racial and ethnic groups, educational levels, and socioeconomic backgrounds. They recommended that nutrition programs and interventions for female cancer survivors use evidence-based strategies and tools such as motivational interviewing, self-monitoring, and social support. Customized interventions should accommodate the survivors’ work schedules to improve adherence—and culinary education resources may help improve survivors’ confidence in cooking, motivation, and fatigue management.

“Nutrition interventions that seek to strengthen fertility treatment can be optimized by considering and addressing barriers and facilitators during the development stage,” concluded Dr. Milliron.

Disclosure: The research in this study was supported in part by the American Society for Nutrition Foundation Predoctoral Fellowship Award and the Drexel University College of Nursing and Health Professions Dean’s PhD Student Research Award. For full disclosures of the study authors, visit

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.