Protocol - Offspring and Fertility History
- Causes and Treatments of Known Infertility - Female
- Causes and Treatments of Known Infertility - Male
- Current Contraception Use - Female
- Current Contraception Use - Male
- Difficulty Getting Pregnant - Current Duration
- Difficulty Getting Pregnant - Prospective Assessment
- Difficulty Getting Pregnant - Retrospective Assessment
- Reproductive History - Female
- Reproductive History - Male
Description
The Offspring/Pregnancy History section of the Childhood Cancer Survivor Study includes three self-administered questions for males and females about pregnancy, pregnancy outcomes, and/or the ability to father children.
Specific Instructions
The Sickle Cell Disease Genitourinary Working Group notes the sensitive nature of some questions may bring back past painful experiences for respondents. Investigators should provide a private space for completing assessments and to be prepared to offer appropriate support.
Availability
Protocol
Offspring/Pregnancy History section of the Childhood Cancer Survivor Study (CCSS)
1. Have you and a partner ever become pregnant?
[ ] No -> go to end
[ ] Yes
2. Including live births, stillbirths, miscarriages, and abortions, how many times have you become pregnant or had a woman become pregnant by you?
Times | |
3. Please fill in the following information for each of your pregnancies, or each time a woman has become pregnant by you, regardless of the outcome.
Outcome | Your age (years) at beginning of pregnancy | Weeks pregnancy lasted | |||||||||||||
Live birth | Stillbirth | Miscarriage | Medical abortion | Under 15 | 15–20 | 21–25 | 26–30 | 31–35 | 36 and over | Less than 12 weeks | 12 – 24 weeks | 25 – 32 weeks | 33 – 37 weeks | 38 – 40 weeks | |
Pregnancy 1 | [ ] | [ ] | [ ] | [ ] | [ ] | [ ] | [ ] | [ ] | [ ] | [ ] | [ ] | [ ] | [ ] | [ ] | [ ] |
Pregnancy 2 | [ ] | [ ] | [ ] | [ ] | [ ] | [ ] | [ ] | [ ] | [ ] | [ ] | [ ] | [ ] | [ ] | [ ] | [ ] |
Pregnancy 3 | [ ] | [ ] | [ ] | [ ] | [ ] | [ ] | [ ] | [ ] | [ ] | [ ] | [ ] | [ ] | [ ] | [ ] | [ ] |
Pregnancy 4 | [ ] | [ ] | [ ] | [ ] | [ ] | [ ] | [ ] | [ ] | [ ] | [ ] | [ ] | [ ] | [ ] | [ ] | [ ] |
Pregnancy 5 | [ ] | [ ] | [ ] | [ ] | [ ] | [ ] | [ ] | [ ] | [ ] | [ ] | [ ] | [ ] | [ ] | [ ] | [ ] |
(Please attach a separate sheet of paper, if more than 5 pregnancies.)
Personnel and Training Required
None
Equipment Needs
None
Requirements
Requirement Category | Required |
---|---|
Major equipment | No |
Specialized training | No |
Specialized requirements for biospecimen collection | No |
Average time of greater than 15 minutes in an unaffected individual | No |
Mode of Administration
Self-administered questionnaire
Lifestage
Adolescent, Adult
Participants
Adolescent and adult males and females
Selection Rationale
The Offspring/Pregnancy History section of the Childhood Cancer Survivor Survey is a validated, self-administered questionnaire about pregnancy history and pregnancy outcome to determine fertility in a population with chronic illness.
Language
English
Standards
Standard | Name | ID | Source |
---|
Derived Variables
None
Process and Review
Not applicable
Protocol Name from Source
Childhood Cancer Survivor Study (CCSS)
Source
Green, D. M., Whitton, J. A., Stovall, M., Mertens, A. C., Donaldson, S. S., Ruymann, F. B., Pendergrass, T. W., & Robison, L. L. (2002). Pregnancy outcome of female survivors of childhood cancer: A report from the Childhood Cancer Survivor Study. American Journal of Obstetrics and Gynecology, 187(4), 1070–1080. https://doi.org/10.1067/mob.2002.126643
General References
Green, D. M., Whitton, J. A., Stovall, M., Mertens, A. C., Donaldson, S. S., Ruymann, F. B., Pendergrass, T. W., & Robison, L. L. (2003). Pregnancy outcome of partners of male survivors of childhood cancer: A report from the Childhood Cancer Survivor Study. Journal of Clinical Oncology, 21(4), 716–721. https://doi.org/10.1200/JCO.2003.04.085
Protocol ID
880701
Variables
Export VariablesVariable Name | Variable ID | Variable Description | dbGaP Mapping | |
---|---|---|---|---|
PX880701_Fertility_History_Ever_Pregnant | ||||
PX880701010000 | Have you and a partner ever become pregnant? | N/A | ||
PX880701_Fertility_History_Number_Times_Pregnant | ||||
PX880701020000 | Including live births, stillbirths, more | N/A | ||
PX880701_Fertility_History_Pregnancy_1_Age | ||||
PX880701030200 | Pregnancy 1 - Your age (years) at beginning more | N/A | ||
PX880701_Fertility_History_Pregnancy_1_Duration | ||||
PX880701030300 | Pregnancy 1 - Weeks pregnancy lasted | N/A | ||
PX880701_Fertility_History_Pregnancy_1_Outcome | ||||
PX880701030100 | Pregnancy 1 - Outcome | N/A | ||
PX880701_Fertility_History_Pregnancy_2_Age | ||||
PX880701040200 | Pregnancy 2 - Your age (years) at beginning more | N/A | ||
PX880701_Fertility_History_Pregnancy_2_Duration | ||||
PX880701040300 | Pregnancy 2 - Weeks pregnancy lasted | N/A | ||
PX880701_Fertility_History_Pregnancy_2_Outcome | ||||
PX880701040100 | Pregnancy 2 - Outcome | N/A | ||
PX880701_Fertility_History_Pregnancy_3_Age | ||||
PX880701050200 | Pregnancy 3 - Your age (years) at beginning more | N/A | ||
PX880701_Fertility_History_Pregnancy_3_Duration | ||||
PX880701050300 | Pregnancy 3 - Weeks pregnancy lasted | N/A | ||
PX880701_Fertility_History_Pregnancy_3_Outcome | ||||
PX880701050100 | Pregnancy 3 - Outcome | N/A | ||
PX880701_Fertility_History_Pregnancy_4_Age | ||||
PX880701060200 | Pregnancy 4 - Your age (years) at beginning more | N/A | ||
PX880701_Fertility_History_Pregnancy_4_Duration | ||||
PX880701060300 | Pregnancy 4 - Weeks pregnancy lasted | N/A | ||
PX880701_Fertility_History_Pregnancy_4_Outcome | ||||
PX880701060100 | Pregnancy 4 - Outcome | N/A | ||
PX880701_Fertility_History_Pregnancy_5_Age | ||||
PX880701070200 | Pregnancy 5 - Your age (years) at beginning more | N/A | ||
PX880701_Fertility_History_Pregnancy_5_Duration | ||||
PX880701070300 | Pregnancy 5 - Weeks pregnancy lasted | N/A | ||
PX880701_Fertility_History_Pregnancy_5_Outcome | ||||
PX880701070100 | Pregnancy 5 - Outcome | N/A |
Measure Name
Fertility History
Release Date
August 15, 2023
Definition
A measure to assess a participant’s fertility history, including the ability to become pregnant or to father children, the number of pregnancies, and the outcome of those pregnancies.
Purpose
This measure can be used to understand pregnancy history and pregnancy outcomes in patients with chronic medical conditions, such as sickle cell disease.
Keywords
fertility, offspring, pregnancy, infertility, SCD, sickle cell disease, chronic disease, CCSS, Childhood Cancer Survivor Study
Measure Protocols
Protocol ID | Protocol Name |
---|---|
880701 | Offspring and Fertility History |
Publications
There are no publications listed for this protocol.