Current status and influencing factors of fertility preservation decisional conflict among female cancer patients of childbearing age: A scoping review.
TL;DR
This scoping review highlights FP decisional conflict and its influencing factors among women of reproductive age with cancer and suggests future interventions should address attitudes, subjective norms, and perceived behavioural control to improve decision support and reduce decisional conflict.
Abstract
Purpose
Fertility preservation (FP) is essential for reproductive-age women with cancer who face fertility-damaging treatment. Despite technological progress in FP, decision-making is highly complex, utilisation remains suboptimal, and many patients suffer from decisional conflict and limited decision support with unsatisfactory care. This scoping review aims to identify, synthesize, and critically describe evidence on FP decisional conflict and its associated influencing factors among this patient group.
Method
This scoping review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) and the Joanna Briggs Institute (JBI) guidance for scoping reviews. Nine databases were systematically searched for studies published up to 1 October 2025. Eligible studies were screened using pre-specified inclusion and exclusion criteria.
Results
Eighteen studies were included. FP decisional conflict was mainly reflected in concerns about FP technologies, cancer-related sequelae, balancing cancer treatment and fertility, FP costs, limited decision-making time, insufficient decision support, and patients' health status. Influencing factors were grouped into attitudes, including personal values and FP-related knowledge, subjective norms, including social support, healthcare professionals' recommendations, marital status, and reproductive status, and perceived behavioural control, including age, financial burden, decision-making time, treatment timing, decision aids, and psychological factors.
Conclusions
This scoping review highlights FP decisional conflict and its influencing factors among women of reproductive age with cancer. Future interventions should address attitudes, subjective norms, and perceived behavioural control to improve decision support and reduce decisional conflict.