Genetic counselors: Bridging the oncofertility information gap

The oncofertility information gap is caused by insufficient patient education on the effects of cancer treatment on fertility and the option of fertility preservation. Many cancer patients do not recall ever discussing the impact of cancer treatment on fertility with their oncologist; because of this, multidisciplinary care that includes fertility treatment is especially valuable for bridging the information gap. Genetic counselors-who are specifically trained to deliver options and facilitate decision making while also focusing on psychosocial issues-are an untapped resource for educating cancer patients about fertility impairment and fertility preservation options. Genetic counselors use a nondirective counseling approach to facilitate a shared decision-making process with patients. Additionally, genetic counselors provide emotional support and can assess when to make a mental health referral. Genetic counselors believe that fertility preservation discussions are important and a part of the genetic counselor role, yet the majority of cancer genetic counselors are not discussing fertility preservation or referring patients, often because of the timing of cancer treatment. A majority (79.7 %) of genetic counselors have reported that the number one barrier to discussing fertility preservation is seeing a patient after they have already undergone cancer treatment. If healthcare providers refer individuals who have a personal or family history suggestive of a hereditary or familial cancer prior to cancer treatment or prophylactic surgery, genetic counselors would have an opportunity to discuss fertility preservation with patients, thereby effectively bridging the oncofertility information gap.