Background: Chemotherapy and radiation therapy effectively eradicate cancer cells, but they can negatively impact
the reproductive system, particularly in females, by reducing the quantity and quality of oocytes. Aim: to examine effect of patient-centered decision counseling on empowering young women regarding fertility preservation before cancer treatment. Design: a quasi-experimental study design was applied Setting: It was conducted at the outpatient clinics of the Oncology and Burns Hospitals, subordinating Beni-Suef University Hospital. Subjects: A purposeful sample of 100 young women planned to receive cancer treatment. Tools: four instruments were used. A structured interviewing questionnaire, barriers to fertility preservation discussion questionnaire, knowledge of fertility preservation questionnaire, and the Decisional Conflict Scale (DCS). Results: the study findings revealed that, within control group &study group, patient characteristics and beliefs about fertility preservation, as well as regrets about information and counseling, were key barriers to initiating discussions about fertility preservation with physicians. Moreover, the total score of knowledge regarding fertility preservation improved as;(64.0%,4.0%) of them had a poor and good level of knowledge pre-intervention , whereas, after one month, (6.0%,62.0%) of them had poor and good knowledge level with a statistically high significant difference (P= 0.001). Also, high significant reduction of the study group decisional conflict occurred: as no woman experienced optimal decision-making conditions pretest, whereas, after one month half of them were extremely certain to not have decisional conflict as compared to the control group. Conclusion: Patient-centered decision counseling improved fertility preservation knowledge among young women, reduced decision making conflict about whether to accept engagement in fertility preservation discussion or referral before cancer treatment. Recommendation: it is recommended to incorporate patient-centered decision counseling into standard cancer care to ensure patients are well-informed and confident in their treatment choices.