Fertility decision-making under certainty and uncertainty in cancer patients

The objective of this study was to understand how reproductive-age women with breast cancer make fertility-related decisions.Using grounded theory methodology, we collected data from 11 reproductive-age women with breast cancer between March and August 2016. Verbatim transcriptions were analyzed using constant comparative analysis and open, axial, and selective coding."Fertility Decision-Making under Certainty and Uncertainty" emerged as a core category. Fertility decision-making started with the participants' "values and preferences" about having a child. In making a decision, there were certainty ("Information" and "Emotional support") and uncertainty ("Time constraints," "Recurrent risk," "Labeling," and "Unmet needs") factors. Participants had more uncertainty factors than certainty factors, and healthcare professionals' services accounted for one of the uncertainty factors.After fertility preservation counseling, women with cancer made difficult decisions in stressful situations without sufficient healthcare information and support. Tailored information should be provided to individual women in collaboration between oncology and reproductive health professionals.