Oncofertility information interventions in patients with cancer: A systematic review and meta-analysis

Fertility problems are increasingly recognized as a critical challenge for patients with cancer. They are associated with diverse health-related outcomes. This study aims to systematically synthesize and evaluate the impact of oncofertility information interventions in patients with cancer.

A comprehensive search was conducted in PubMed, Embase, Scopus, Web of Science, and Cochrane Library from inception to November 21, 2025. Randomized controlled trials using oncofertility information interventions among patients with cancer were included. The risk of bias was evaluated using version 2 of the Cochrane risk-of-bias tool for randomized trials (RoB 2). The certainty of the evidence was evaluated using the GRADE system. Meta-analysis was conducted using R software (version 4.5.1). The study was registered in PROSPERO (CRD42025641728).

A total of 11 articles were included in this systematic review, involving 1046 participants, with 10 articles included in the meta-analysis. The pooled analysis showed that oncofertility information interventions could statistically significantly improve patients' fertility-related knowledge (standardized mean difference [SMD] = 0.37, 95% confidence interval [95% CI] = 0.01, 0.72; moderate quality of evidence), reducing reproductive concerns (mean difference [MD] = -26.34; 95% CI = -27.86, -24.82; moderate quality of evidence), decisional conflict (MD = -5.83, 95% CI = -10.49, -1.17; moderate quality of evidence), and decisional regret (SMD = -0.57, 95% CI = -1.12, -0.02; low quality of evidence). Subgroup analysis indicated that the non-Asian group, multiple cancers group, multi-session group, online interventions group, and hybrid interventions group were more effective for fertility-related knowledge (P _s < 0.05).

This meta-analysis provides low to moderate quality evidence that oncofertility information interventions were associated with improvements in fertility-related knowledge and reductions in reproductive concerns, decisional conflict, and decisional regret among patients with cancer. Further well-designed and large-scale studies are needed to confirm their effectiveness and to guide broader clinical practice.