Fertility and pregnancy concerns and needs after fertility-sparing surgery in young women with gynecological cancer and their partners: A qualitative study

INTRODUCTION: Many young women treated for gynecological cancer are assumed to experience long-term concerns about fertility and pregnancy, and psychological distress. However, evidence on patients' post-treatment reproductive concerns, decisions to pursue pregnancy, and oncofertility needs is limited. This study aims to provide insight into the perspectives of women treated with fertility-sparing surgery (FSS) for gynecological cancer and their partners. METHODS: Women and their partners were selected for semi-structured interviews from our previously performed questionnaire study through purposive sampling based on self-reported reproductive concerns and pregnancy attempts. Interviews were coded and analyzed using a framework approach until data saturation was reached. RESULTS: Data saturation was achieved after 32 interviews with 24 participants and eight partners. Three participants did not pursue pregnancy and decided not to in the future. Participants expressed reproductive concerns and encounter post-treatment challenges, including a sense of time pressure, fear of cancer recurrence, and a common need for assisted reproductive techniques. Nearly all participants expressed their need for post-operative fertility counseling, although the preferred timing for this support varied. Partners considered their primary role as providing support throughout the treatment (decision) process, deciding to conceive and pursuing pregnancy. Some partners emphasized the importance, but lack of partner support. CONCLUSIONS: Women treated with FSS for gynecological cancer and their partners face persistent uncertainty regarding fertility and pregnancy, yet most women remain motivated to pursue pregnancy. Partners play a supportive role, but also have unmet needs. These findings highlight that reproductive issues should be systematically incorporated into routine clinical care pathways.