Women’s Lived Experiences of Decisional Conflict and Support Needs During First-Time Assisted Reproductive Technology Treatment: A Descriptive Phenomenological Study in China

Xia Hong, Zilian Wang, Yu He, Xinyi Yang, Aike Xu, Qun WeiNursing Department, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou City, Zhejiang Province, People’s Republic of ChinaCorrespondence: Qun Wei, Email [email protected]: To explore the lived experiences of decisional conflict and support needs of women during their first assisted reproductive technology (ART) treatment, providing evidence for optimizing clinical decision support and patient-centered care.Methods: This study employed a descriptive phenomenological approach. Semi-structured interviews were conducted with 21 female infertility patients receiving ART treatment at a tertiary reproductive medical center in Zhejiang Province, China, from March to May 2026. Data were collected until thematic saturation was reached. Themes were extracted using Colaizzi’s phenomenological analysis method.Results: Three core themes and nine sub-themes were identified: ① Inner dilemmas in treatment decision-making, including fear of uncertainty regarding treatment process and outcomes, compromise under family pressure and expectations, and anxiety about self-body and role value; ② Support and resistance in the decision-making process, including the influence of spousal attitudes, family members’ support and intervention, and the guiding role of healthcare providers; ③Adaptation and reflection after decision-making, including expectations and anxiety about treatment outcomes, self-evaluation of the decision-making process, and re-planning for future life.Conclusion: Participants’ accounts suggest that decisional conflict involved more than information deficits and was closely connected to procedural, outcome-related and existential uncertainty. Family involvement was experienced as both supportive and pressuring, and healthcare providers served as important decision anchors. Decisional conflict extended beyond the initial treatment choice into ongoing reflection and meaning-making. These findings highlight the need for processual, relationally attuned, and culturally appropriate decision support for women beginning ART treatment.Keywords: assisted reproductive technology, infertility, decision-making, qualitative research