From Implicit Participation to Integration: The Evolving Role of Nurses in Oncofertility

Background Fertility preservation is an essential component of cancer care, particularly for reproductive-age cancer patients. Nurses, due to their continuous interaction with patients throughout diagnosis and treatment, are uniquely positioned to implement fertility preservation services. However, while current guidelines mention healthcare providers' roles in fertility preservation, there are significant variations in nurse involvement across countries, and their specific responsibilities remain undefined. This study aims to clearly define the specific roles and responsibilities of nurses in fertility preservation for cancer patients. Methods This study uses a scoping review methodology to comprehensively analyze the research evidence and characteristics of nurse involvement in fertility preservation for cancer patients. A systematic search was conducted across multiple databases, including PubMed, CINAHL, EMBASE, Scopus, PsycINFO, Web of Science, as well as guideline repositories such as BMJ Best Practice, the Scottish Intercollegiate Guidelines Network, the National Guidelines Clearinghouse, the ECRI Guidelines Trust™, and the National Institute for Health and Care Excellence. The search covered the period from the inception of the databases to April 2025. All studies and clinical guidelines published in English that addressed the role, responsibilities, and practices of nurses in fertility preservation were included. Results A total of 18 guidelines and 39 studies were included. The analysis of the guidelines revealed that the majority of documents referred to healthcare providers or medical staff in general terms, including nurses, but without specific details on their roles. Further analysis of the literature identified five key stages of nurse involvement in fertility preservation: (1) assessment and referral, (2) counseling and decision support, (3) treatment implementation, (4) long-term follow-up, and (5) system optimization. Cross-regional comparisons revealed significant differences in the definition of nurses' roles, their responsibilities, and the scope of services they provide: North America has established an institutionalized nurse-led model; Europe is exploring nurse-led consultation services; Australia emphasizes an efficiency-oriented coordination model; and Asia primarily focuses on supportive participation, emphasizing emotional resonance and humanistic care. Conclusion Existing guidelines recognize the importance of nurses in fertility preservation services, and the role of nurses is shifting from implicit participation to institutionalized integration. However, there are significant differences in the roles and responsibilities of nurses in practice across countries. This study defines five key stages and 23 specific tasks for nurses involved in fertility preservation services for cancer patients, providing practical evidence for future guideline revisions, nurse training, and clinical pathway optimization.