Table of Contents
Abstract
The Oncofertility Support Scale (OSS) represents a significant advancement in psycho-oncology and reproductive health measurement. Developed specifically for young women navigating breast cancer, this 19-item instrument quantifies the multidimensional support patients receive regarding their reproductive futures. As survival rates for breast cancer climb, the clinical focus has rightly expanded to encompass survivorship quality, where fertility preservation is a paramount concern. Gonadotoxic treatments can severely compromise reproductive capacity, making timely and comprehensive support essential.
Originally derived from the Fertility Information Support Scale, the OSS was refined to better capture the actual provision of support rather than merely assessing a patient's baseline knowledge. By evaluating informational, practical, and communicative dimensions of care, the scale provides researchers and clinicians with a robust metric to identify gaps in service delivery. For graduate students studying health psychology or behavioral medicine, this tool exemplifies how clinical needs drive psychometric innovation, transforming a recognized gap in patient care into a quantifiable, actionable construct.
📊 Psychometric Scorecard
19
Multidimensional
0.95
0.95
0.914
📍 China
Authors
Purpose
In the realm of psycho-oncology, a critical gap has existed between the recognized need for fertility counseling and our ability to measure its delivery effectively. While previous instruments attempted to gauge fertility-related cognitive support, they often inadvertently measured a patient's health literacy or factual knowledge rather than the actual support provided by healthcare systems and social networks. The OSS was engineered specifically to rectify this measurement flaw.
For clinicians and researchers, the OSS serves as a vital diagnostic tool for healthcare delivery. It allows oncology teams to systematically evaluate whether young breast cancer patients are receiving adequate guidance on fertility preservation, sexual health, and psychosocial coping. By pinpointing specific deficiencies—such as a lack of communication about embryo cryopreservation or inadequate peer support—the scale empowers institutions to tailor their survivorship programs, ultimately mitigating the profound psychological distress associated with cancer-related infertility.
Construct
The psychological construct of 'Oncofertility support' is inherently biopsychosocial, bridging medical information delivery with emotional and relational scaffolding. Theoretically, it posits that effective support cannot be monolithic; it must address the physiological realities of cancer treatment while simultaneously nurturing the patient's psychological resilience and interpersonal communication.
The OSS operationalizes this construct through four distinct but interrelated dimensions. The first two dimensions focus on medical information, specifically the impact of treatments on fertility and the available preservation strategies. The third dimension shifts to practical lifestyle guidance, encompassing sexual health and contraception. Finally, the fourth dimension captures the psychosocial environment, evaluating the patient's ability to communicate their reproductive needs with healthcare providers, partners, and peer networks. Together, these facets create a holistic picture of the patient's supportive ecosystem.
Validity
The validation framework for the OSS is highly rigorous, employing multiple psychometric strategies to ensure the tool measures what it claims to measure. Content validity was exceptionally strong, achieving a coefficient of 0.95, which indicates near-unanimous agreement among experts and patients regarding the relevance of the items. To establish convergent validity, the developers examined the scale's relationship with broader medical social support. While the correlation was statistically significant, its relatively weak magnitude (r = 0.18) is actually theoretically sound; it demonstrates that Oncofertility support is a highly specialized construct, distinct from general medical support.
Furthermore, the scale demonstrated excellent known-group validity. As one would hypothesize, younger patients (under 30) reported receiving significantly more information regarding fertility preservation compared to older cohorts. The robust Average Variance Extracted (AVE values exceeding 0.63) and Composite Reliability metrics further cement the scale's construct validity, indicating that the items within each subscale share a high degree of variance.
Convergent & Discriminant Validation Correlations
| Reference Instrument | Correlation Coefficient (r) |
|---|---|
| Medical Social Support Survey | r=0.18 |
Reliability
When evaluating the precision of the OSS, the reliability metrics are exemplary. The instrument demonstrated an internal consistency of 0.95 using both Cronbach's alpha and McDonald's omega. For those studying advanced psychometrics, the inclusion of McDonald's omega is particularly noteworthy. Unlike alpha, omega does not rely on the strict assumption of tau-equivalence (the idea that all items contribute equally to the construct), making it a more robust and modern indicator of reliability.
These high coefficients suggest that the 19 items function cohesively to measure the overarching construct of Oncofertility support without excessive redundancy. A reliability score of 0.95 indicates that the scale is highly sensitive and stable, making it suitable not only for broad epidemiological research but potentially for individual clinical assessments where measurement error must be minimized.
Factor Analysis
The structural integrity of the OSS was established through a classic split-sample design, a gold standard in scale development. An initial Exploratory Factor Analysis (EFA) on the first subsample successfully reduced the item pool, eliminating items with poor loadings to reveal a clean, four-factor structure that accounted for nearly 76% of the total variance. This high variance explained indicates that the extracted factors capture the vast majority of the construct's underlying dimensionality.
Subsequently, a Confirmatory Factor Analysis (CFA) using a Maximum Likelihood Robust estimator was applied to the second subsample. The model demonstrated acceptable fit, with a Comparative Fit Index (CFI) of 0.914 and a Root Mean Square Error of Approximation (RMSEA) of 0.079. Crucially, the researchers also conducted multigroup CFA to test for measurement invariance. They successfully demonstrated that the scale's factor structure holds steady regardless of the patient's age or their baseline desire for future fertility, ensuring that group comparisons made using this scale are mathematically valid.
Subscales
| Subscale | Items | Description |
|---|---|---|
| Information Support on Fertility Impact | 1, 2, 3, 4 | Measures the extent to which healthcare providers explain the effects of cancer treatments and genetics on future fertility and offspring health. |
| Information Support on fertility preservation | 5, 6, 7 | Assesses the provision of information regarding specific fertility preservation methods, their risks, and access to specialist consultations. |
| Fertility and Sexual Guidance | 9, 10, 11, 12 | Evaluates practical guidance received regarding sexual health improvements, contraception methods, and breastfeeding post-treatment. |
| Fertility Communication and Supportive Networks | 15, 16, 17, 18, 19, 20, 21, 22 | Captures the patient's ability to actively communicate about fertility needs with family, peers, and healthcare providers, as well as their psychological adaptation. |
Instrument
| Test Type | Self-report questionnaire |
| Format | 19 items |
| Language | Chinese |
| Population | Medical patients |
| Age Group | 18-45 years |
| Administration | Online survey |
Oncofertility Support Scale Items
Items are currently not available
The individual items of this scale are not publicly available. Researchers interested in using this instrument should contact the original authors directly to request the scale materials.
Sample
The validation sample consisted of 343 young adult women diagnosed with breast cancer in China. The participants had a mean age of 34.32 years (SD = 4.48, range 20-45). The sample was recruited via an online survey and was randomly split into two subsamples for exploratory (n=123) and confirmatory (n=220) factor analyses.
Cite This Paper
Li Hu, Pui Hing Chau, Chanchan Wu, Edmond Pui Hang Choi (2025). Oncofertility Support Scale. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer. https://doi.org/10.1007/s00520-025-10250-0
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Cite this article
Mohammed looti (2026). Oncofertility Support Scale. PSYCHOLOGICAL SCALES. Retrieved from https://scales.arabpsychology.com/s/oncofertility-support-scale/
Mohammed looti. "Oncofertility Support Scale." PSYCHOLOGICAL SCALES, 14 Aug. 2026, https://scales.arabpsychology.com/s/oncofertility-support-scale/.
Mohammed looti. "Oncofertility Support Scale." PSYCHOLOGICAL SCALES, 2026. https://scales.arabpsychology.com/s/oncofertility-support-scale/.
Mohammed looti (2026) 'Oncofertility Support Scale', PSYCHOLOGICAL SCALES. Available at: https://scales.arabpsychology.com/s/oncofertility-support-scale/.
[1] Mohammed looti, "Oncofertility Support Scale," PSYCHOLOGICAL SCALES, vol. X, no. Y, ص Z-Z, August, 2026.
Mohammed looti. Oncofertility Support Scale. PSYCHOLOGICAL SCALES. 2026;vol(issue):pages.