Barriers to and Facilitators of Shared Decision-Making Implementation in Fertility Preservation for Patients With Cancer: A Qualitative Study.
Jeehee Han, Youn-Jung Son, Mina Jang and 2 others
PMID 40936297WHAT IT FOUND
Patients and providers described shared decision-making for fertility preservation failing when oncology teams lacked awareness or fertility teams proceeded without verifying understanding.
Time pressure, high costs, and lack of counseling compensation were major barriers. Structured referrals and specialized nurse coordinators facilitated access.
Key findings
01Oncology providers often lacked awareness of fertility preservation or referred patients without explanation, while fertility specialists sometimes proceeded with procedures without verifying patient understanding or discussing alternatives.
02Barriers to implementation included urgent time constraints due to cancer treatment, high costs, lack of compensation for counseling, and patients' fear that fertility preservation would delay or interfere with cancer therapy.
03Facilitators included structured multidisciplinary referrals, the use of digital technology for information delivery, and support from care coordinator nurses specialized in fertility care who provided practical education and psychological support.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Participants were predominantly unmarried women with breast cancer, so findings may not apply to other cancer diagnoses or marital statuses. The study was conducted in South Korea, where cultural norms around family decision-making and specific healthcare policies (such as embryo cryopreservation being limited to married women) may limit generalizability. Only seven healthcare providers were interviewed, including just one oncologist, which restricts the breadth of professional perspectives. Participants' responses regarding shared decision-making were described as relatively superficial by the researchers. The study did not include families, genetic counselors, or bedside nurses, who also influence decision-making.
Declared interests
The authors declare no conflicts of interest. The study was supported by non-U.S. government research funding.
The easy way to misread this
Do not interpret these themes as evidence that specific interventions improve fertility preservation uptake or patient outcomes. This qualitative study describes perceived barriers and facilitators in a specific Korean context and cannot demonstrate that adopting these strategies will change clinical results.