Table 2.

Overview of parenthood considerations (i.e., arguments against and in favor of having children)

Arguments against having children	n*
Cancer-specific arguments
Chance of relapse or early death; limited life expectancy	54
not wanting to leave a child (or partner with a child) behind; regrets if one would not be able to care for or see the child grow up
Worries about whether one would be healthy enough to raise children	44
due to fatigue/low energy; raising a child would be too stressful/annoying; insecurities/doubts about being a bad parent (and what one would have to offer)
Pregnancy too risky or complicated	43
assisted reproductive technologies (ART) would be too burdensome; worries about emotional burden of (repeated) miscarriages; previous negative experiences; worries about stopping hormonal treatments       and inability to breast feed or give birth vaginally
Genetic risks, mutation, or health of potential offspring	27
Insecurities about fertility	7
worries about being unable to get pregnant; decision to not try to get pregnant to save oneself from heartache; feelings of guilt towards partner
Generic arguments
Big change/responsibility or loss of freedom	39
less time (for work, relationship); less sleep
Ecological footprint/climate, sustainability, overpopulation	23
there is too much misery in this world
Finances/financial insecurity	14
Or needing a bigger house/more space
Being happy with what you have (e.g., being alone, with a partner, or with existing children)	15
Not having a partner (or options) to have a child	10
Increased age (own or partners’ age)	9
No desire to have children	6
Having children considered as an egoistic choice	6
Other	21
(e.g., alternatives to biological parenthood are too complex; being unsure about reproductive goals, worries about possible regret, no support system; child should not become a caregiver later in life)

Arguments in favor of having children	n
(Always wanted to) care for a child/become a parent, life goal	88
desire to create a legacy and recognize yourself in a child/see them grow up; being biologically wired to have children; wish to become a grandparent one day  **participants’ cancer treatment/fertility problems also reinforced their wish to have children; they believed they would be a good parent/teacher (after everything they have overcome); they also have the right   to be a parent
Meaning-making, enriching, joy, happiness	55
appreciate and live life now/to the fullest; enjoying community, not being lonely
Complete picture/wanting a family	40
including wanting to have a big family; adding a sibling (to existing children)
Procreate with partner, expression of love with partner/having a family together with partner	31
Wanting to have a family with current partner; “allowing” partner to have children (of yours)
(Unconditional) love	23
Move on with life, having a good prognosis**	7
Timing: otherwise, it might be too late	7
**enough time has passed since cancer diagnosis
Other	24
(e.g., having the right partner; social pressure/not feeling left out (when everyone has children); having children as an insurance for later; not being alone later in life)

 *Number of times mentioned; n = 116 participants provided at least one written response

 **Indicates a cancer-specific reason amongst “generic” arguments