Abstract
BACKGROUND: This study aimed to investigate the knowledge, attitudes and practices (KAP) of patients with endometriosis regarding surgical treatment and fertility preservation. METHODS: This cross-sectional study was conducted in China between October 2023 and May 2024 among patients with endometriosis. Their demographic characteristics and KAP regarding surgical treatment and fertility preservation were collected using a self-administered questionnaire. RESULTS: The study included 697 patients diagnosed with endometriosis, with an average age of 33.00 ± 6.59 years. Of these participants, 356 (51.08%) reported no intention of conceiving in the future. The median knowledge, attitude, and practice scores were 8 (0–16) (possible range: 0–32), 18 (16–19) (possible range: 6–30), and 1 (1–2) (possible range: 0–8), respectively. Correlation analysis showed that knowledge was correlated with practice (r = 0.2969, p < 0.001), shared decision-making (r = 0.2571, p < 0.001), and doctor-patient relationship (r = 0.2973, p < 0.001). Practice was correlated with shared decision-making (r = 0.235, p < 0.001) and doctor-patient relationship (r = 0.2002, p = 0.0011). Meanwhile, there was also a correlation between shared decision-making and doctor-patient relationship (r = 0.93, p < 0.001). However, attitude was not correlated with any of the other factors. CONCLUSION: Patients with endometriosis exhibited inadequate knowledge, moderate attitudes, and inactive practices concerning surgical treatment and fertility preservation. Enhancing education and promoting shared decision-making may improve patient engagement in surgical and fertility-related decisions. CLINICAL TRIAL NUMBER: Not applicable. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12905-025-04006-5.