{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T16:05:02Z","timestamp":1789401902202,"version":"build-2803163510"},"reference-count":61,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T00:00:00Z","timestamp":1789344000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cancer treatments threaten fertility in reproductive-age patients. Although fertility preservation (FP) is an effective option, its communication and decision support remain inconsistently implemented in clinical practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To identify factors influencing FP communication and decision support from the perspective of healthcare professionals (HCPs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A qualitative evidence synthesis of qualitative and mixed-methods studies from six databases was conducted. Influencing factors were mapped using the Consolidated Framework for Implementation Research (CFIR). Study quality was appraised using the Joanna Briggs Institute (JBI) critical appraisal checklist for qualitative research and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting standards, and the confidence in the evidence was graded using the Confidence in the Qualitative Evidence (ConQual) scale.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Factors influencing FP communication and decision support were identified across three CFIR domains. Outer setting: local fertility attitudes, geographic barriers, and policy shaped access to and engagement in FP communication and decision support. Inner setting: poor structural characteristics, survival-focused culture, limited FP knowledge, weak relational connections, and suboptimal multi-level communication hindered effective implementation. Individual: family support facilitated engagement, whereas patients\u2019 capacity and emotional state influenced their participation. Four constructs landed at a moderate confidence level, and six constructs landed at a low confidence level.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Effective FP communication and decision support require multi-level, tailored strategies targeting domain-specific barriers and facilitators.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/PROSPERO\/view\/<\/jats:ext-link>\n                      , identifier CRD42024600847.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1913624","type":"journal-article","created":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T15:22:58Z","timestamp":1789399378000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Factors influencing fertility preservation communication and decision support for cancer patients: a qualitative evidence synthesis of healthcare professionals\u2019 perspectives"],"prefix":"10.3389","volume":"17","author":[{"given":"Xing","family":"Jiang","sequence":"first","affiliation":[{"name":"School of Nursing, Nanjing University of Chinese Medicine","place":["Nanjing, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhongbo","family":"Zhang","sequence":"additional","affiliation":[{"name":"School of Nursing, Nanjing University of Chinese Medicine","place":["Nanjing, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yeyi","family":"Lv","sequence":"additional","affiliation":[{"name":"School of Nursing, Nanjing University of Chinese Medicine","place":["Nanjing, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan","family":"Zhu","sequence":"additional","affiliation":[{"name":"School of Nursing, Nanjing University of Chinese Medicine","place":["Nanjing, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,14]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21834","article-title":"Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"74","author":"Bray","year":"2024","journal-title":"CA Cancer J Clin"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.28171","article-title":"Patterns in cancer incidence among people younger than 50 years in the US, 2010 to 2019","volume":"6","author":"Koh","year":"2023","journal-title":"JAMA Netw Open"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1038\/s41571-022-00672-8","article-title":"Is early-onset cancer an emerging global epidemic? 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