Abstract
The uptake of preimplantation genetic testing for monogenic disorders (PGT-M) of adult onset reflects an increase in accessibility of genetic testing among reproductive aged patients. Recent studies show that patient interest in PGT-M is highest for hereditary cancer syndromes, indicating a need for routine discussions of fertility preservation and assisted reproductive options within the oncology setting. Various professional society guidelines recommend that oncology patients be counseled on fertility preservation options prior to treatment. However, research shows that fertility preservation remains one of the least implemented services in oncology, with only a minority of providers discussing PGT-M and/or referring patients to appropriate specialists. No studies to date have explored what practice resources non-genetic oncology providers need to increase knowledge of available reproductive technologies and how best to facilitate referrals to appropriate providers.This qualitative research study aims to understand the experiences of oncology providers with PGT-M and identify clinical resources to help initiate conversations and coordinate appropriate referrals to fertility specialists. Results from this study suggest that provider knowledge and established referral pathways are lacking. In general, participants believe that detailed discussions of PGT-M are beyond the scope of practice for oncology providers but acknowledge the need to refer to appropriate specialists. Participants express the need for a streamlined referral pathway to specialists who can address the reproductive needs of oncology patients and facilitate access to fertility preservation services in a timely manner. To address gaps in care, participants desire a current and centralized resource with PGT-M practice recommendations to guide the referral process. Support from allied health professionals trained in oncofertility to help ensure comprehensive care is provided to oncology patients at various points of care in the cancer journey was also desired. Overall, providers in this cohort suggest that a unified multidisciplinary approach is necessary to meet the overall fertility needs of oncology patients, including PGT-M, that can be readily incorporated into their existing treatment plan.