Decision-Making About Fertility Preservation After Cancer Diagnosis: A Qualitative Study of Patients' Experiences and Perspectives.

Background: Rising cancer incidence in reproductive-aged individuals, coupled with improved long-term survival, indicates an increasing need for fertility preservation (FP) in this population. However, limited evidence exists on the decision-making of FP from the perspectives of cancer patients in a Chinese context. This qualitative study aimed to examine the patient perceptions of the FP decision and to identify barriers and unmet needs, addressing a significant gap within evolving precision oncology and fertility care contexts. Methods: Face-to-face, semi-structured interviews were conducted with 12 cancer patients from a tertiary hospital in Hunan Province, China, from March 2024 to June 2024. The interviews were audio-recorded, transcribed verbatim, and analyzed thematically using Colaizzi's seven-step analysis. Results: Three themes and nine subthemes were identified: insufficient information support (lack of information sources, inappropriate timing of information disclosure, and poor doctor-patient communication); personal and family concerns (impact on cancer treatment, impact on offspring health, marital and reproductive status, financial constraints); ethical dilemmas (conflicts with survival needs, and emotional challenges). Conclusion: Young cancer patients predominantly aspire to preserve fertility but face multiple decision-making challenges. To address these challenges, healthcare professionals should fully understand the patients' needs, provide accurate and timely information tailored to their needs, and enhance communication skills to facilitate informed decision-making regarding FP, with important implications for clinical practice and public health.