Objective To investigate the current status and influencing factors of patient involvement in healthcare decision-making for preimplantation genetic testing (PGT), and to provide a basis for the effective implementation of doctor-patient shared decision making in clinical practice. Methods A mixed method was adopted. A total of 307 patients who underwent PGT were investigated using the general information questionnaire, the Control Preference Scale (CPS), Health Literacy Management Scale (HELMS), Patient Doctor Relationship Questionnarie,15-Item Version (PDRQ-15), and the Dyadic Coping Inventory (DCI); Fourteen PGT patients were selected for the semi-structured interviews by purposive sampling. Results The passive decision-making participation still dominated among PGT patients (50.16%). Multivariate logistic regression analysis showed that health literacy and level of couple support coping were the main factors influencing patients′ participation in healthcare decision-making (both P<0.05). The qualitative study distilled 2 themes, namely, patients′ attitudes toward participation in shared decision-making and patients′ experiences of participation in healthcare decision-making (insufficient relevant knowledge and ability to identify the information，individual traits and poor communication between spouse scaused negative emotions, treatment burden and poor doctor-patient communication). Conclusion The level of PGT patients′ participation in healthcare decision-making still needs to be further improved, and the influencing factors are diverse. Clinical workers should intervene for the main influencing factors to promote patients′ participation in healthcare decision-making and improve the quality of decision-making.