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. 2013 Jun;2(2):66–71. doi: 10.1089/jayao.2012.0038

Table 2.

Values Clarification Tool Adapted from Reproductive Concerns Scale31

 1. I would like more information about how my cancer treatment could affect my ability to have children.
 2. I feel like I can talk to my parents about my ability to have a baby in the future.
 3. One day I would like to have a baby.
 4. If I cannot have a baby I will be ______.
 5. I feel frustrated that I might not be able to have a baby in the future.
 6. If I cannot have a baby I would blame my illness/cancer.
 7. If I cannot have a baby I would blame my doctor.
 8. I am worried about having a baby in the future because I might get sick/cancer again.
 9. I am worried about having a baby in the future because my baby might get sick/cancer.
10. I feel like I have control over my ability to have a baby in the future.