Fertility counseling for patients with hereditary breast and ovarian cancer syndrome.

Purpose of the review: Among patients with hereditary breast and ovarian cancer, risk reduction strategies have a direct impact on fertility. In this review, we highlight the importance of early referral of those patients to fertility specialists for fertility planning, as the consideration for these risk-reducing procedures is overlaid with thoughts on childbearing.

Recent findings: Increased utilization of genetic testing has identified individuals with inherited pathogenic variants increasing risks of breast and ovarian cancer. For those patients, studies have identified potential areas for improvement including counseling on reproductive potential, fertility preservation, and the option for preimplantation genetic testing. Recent guidelines have emphasized the importance of consultation with a reproductive endocrinologist in the care of those patients.

Summary: Early referral to fertility specialists would ensure that reproductive concerns are met in a timely fashion and would facilitate future fertility planning, reviewing options for IVF, oocyte and embryo cryopreservation, and consideration of preimplantation genetic testing.