Decision-making and psychological outcomes in women with breast cancer: Insights into the choice against fertility preservation and implications for supportive care

Objective: To explore decision-making experiences of women who decide not to undergo fertility preservation therapy before breast-cancer treatment. Methods: This quantitative, descriptive study recruited women diagnosed with breast cancer who underwent the decision-making process regarding fertility preservation, ultimately deciding not to pursue fertility preservation. Participants completed a questionnaire after a routine medical examination. Results: Of 39 participants, 18 (46.2%) wanted to have children pre-diagnosis, and 10 (25.6%) expressed this wish afterward. Twenty-four percent of women who did not undergo fertility preservation indicated that they did not have sufficient information, and 14% felt uncertain about their decision. Women who wished for children even post-diagnosis frequently expressed regret about not undergoing treatment. Conclusions: These findings underscore the importance of providing adequate and timely information, decision-making support, and post-decisional psychological care for women facing fertility decisions following a cancer diagnosis. Developing systems to guide when and how to intervene immediately post-diagnosis is essential to promote informed reproductive decision-making and support women in managing these complex, value-laden choices.