Fertility preservation in young male adolescents and children before and after treatment with cancer in China: factors influencing the decision of parents

Abstract Objective With modern treatments, over 80% of children and adolescents with hematologic malignancies achieve five-year survival. Prioritizing fertility preservation (FP) is crucial to mitigate the potential adverse effects of cancer therapy on future fertility in adulthood. This cross-sectional study examines the current status of FP in China and analyzes factors influencing parents’ decisions regarding FP for male pediatric and adolescent oncology patients. Methods A cross-sectional survey was conducted. Self-administered questionnaires were distributed to parents of male pediatric oncology patients (aged 0–12 years). Participants were categorized into pre‑treatment and post‑treatment groups. The study design followed STROBE guidelines for cross-sectional studies. Results Among 134 enrolled patients (mean age 6.0 ± 2.9 years), 64.9% (87/134) of parents expressed willingness to pursue FP. Multivariable logistic regression stratified by treatment status showed that in the pre‑treatment group, democratic parenting style was significantly associated with higher willingness (OR = 3.557, 95% CI: 1.094–11.567, P = 0.035). In the post‑treatment group, two factors were significantly associated with higher willingness: higher parental education level (OR = 4.054, 95% CI: 1.021–16.094, P = 0.047) and more positive health beliefs (OR = 1.170, 95% CI: 1.045–1.309, P = 0.006). Conclusions Parents’ recognition of cancer treatment’s impact on fertility and their understanding of FP benefits are key drivers of decision‑making. Clinically, healthcare providers should initiate timely, clear communication about FP options before treatment begins. Policy‑wise, integrating FP counseling into standard oncology care and providing accessible educational resources for parents are recommended to improve uptake.