Background Cancer treatments such as chemotherapy and radiotherapy can impair fertility, making fertility preservation critical for reproductive-aged patients. Despite clinical guidelines supporting fertility counseling, uptake of oncofertility services remains low.

Objective This systematic review aims to examine the current evidence on cancer patients’ knowledge, attitudes, and perceived barriers toward oncofertility services.

Methods A systematic search of PubMed, Hinari, EBSCOhost, and Google Scholar was conducted for English-language studies published between January 2014 and August 2024. Eligible studies included quantitative, qualitative, or mixed-method designs focusing on fertility preservation knowledge, attitudes, or barriers among patients undergoing cancer treatment. Data were synthesized narratively.

Results Thirteen studies met inclusion criteria. Most patients had limited knowledge of fertility preservation, often due to insufficient counselling. Despite this, many expressed strong interest in fertility preservation. Barriers included lack of information, high costs, systemic inefficiencies, cultural beliefs, and psychological distress.

Conclusion Integration of fertility counselling into oncology care, greater provider training, financial support policies, and culturally sensitive interventions are essential to improve access to oncofertility services.

The authors have declared no competing interest.

The author(s) received no specific funding for this work.

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