Women's fertility decision-making with a diagnosis of breast cancer: A qualitative evidence synthesis

Aim: To synthesize qualitative evidence of premenopausal women's experiences of fertility decision-making with a diagnosis of breast cancer. Background: Breast cancer is increasingly more common in premenopausal women who may have not yet considered starting a family or have completed their families. Design: Qualitative evidence synthesis guided by Thomas and Harden's three-stage approach to thematic analysis. Data Sources: Twelve electronic databases were searched: CINAHL, Embase, Pubmed, Proquest, PsychINFO, Lenus, Scopus, Web of Science, Rian.ie, Medline, EThOS e-theses online and DART Europe. No year limit was set. Review Methods: The ‘Enhancing transparency in reporting the synthesis of qualitative research guidelines’ (ENTREQ) statement was followed. Results: Fifteen qualitative studies were included in the synthesis. Seven review findings under four major themes were identified: (1) first comes survival, (2) making decisions ‘under the gun’, (3) health-care professionals should not make assumptions and (4) we want accurate, detailed information and we want it early. High confidence in six of the review findings was agreed. Conclusion: Most women experienced rushed fertility preservation decision-making at a time when they also faced cancer treatment decisions. Women want detailed, clear information on fertility preservation early after their diagnosis.