Fertility Preservation Needs of Men Undergoing Cancer Treatment: An Explorative Qualitative Study

Men undergoing cancer therapy are at risk of treatment-related infertility, which can negatively affect quality of life. Although fertility preservation (FP) is routinely recommended for men of reproductive age who are diagnosed with cancer, less is known about how they navigate these decisions or what informational and emotional supports they require across the diagnosis-treatment-survivorship trajectory. We conducted a qualitative secondary analysis of a subset of data from a broader study of cancer and FP decision-making. In-depth interviews with 12 men who had undergone fertility-threatening cancer treatments and had experienced FP were analyzed using a thematic analysis approach. Participants reported gaps in clear, timely and practical information, including costs, clinic access, sperm storage and future use. Men and their partners described feelings of fear, uncertainty and diminished control, especially when decisions had to be made quickly, before treatment began. Their choices were influenced not only by clinical advice but also by social expectations related to masculinity. Structural/logistical barriers such as diagnostic uncertainty, illness severity and poorly coordinated care pathways further undermined their agency and contributed to distress. These findings indicate that men's experience of FP is not a straightforward medical procedure but a complex and ongoing process with logistical, informational and psychosocial challenges. Integrating organized counselling and continuous emotional support into oncology care may reduce distress and enhance decision-making processes.