Fertility decision-making in cancer patients – current status and future directions

Introduction: With long-term cancer survivor rates increasing, quality of life, and a pivotal component of it, the ability to procreate are of growing importance. As treatment can compromise fertility, patients need to be informed about the currently available options to preserve it. However, decisional conflict may arise, as decisions have to be made within the short time frame after diagnosis and before treatment.Areas covered: Decisional conflict reflects the personal perception of uncertainty in choosing between different options. It is typical in decision-making in the context of fertility preservation (FP). It comprises factors such as feeling uninformed, lack of clarity regarding personal values, lack of support, and uncertainty and is associated with decisional regret. Research has shown that additional support tools such as decision aids have the potential to increase knowledge and reduce decisional conflict.Expert commentary: Improvement in the availability of and access to adequate and personalized support for all young cancer patients concerning FP is needed. Information provision should be comprehensive and tailored to individual needs and ideally complemented with a decision aid. Future research should focus on more individualized decision aids and on the male perspective, as existing decision aids are targeted at female cancer patients.