Patient Navigation and Coordination of Care for the Oncofertility Patient: A Practical Guide

Abstract

Providing care to reproductive-age cancer patients who wish to pursue fertility preservation prior to initiating cancer treatment—the oncofertility patient—requires the collaborative efforts of oncologists, reproductive endocrinologists, nurses, and counselors, and all within a very short time frame. Both clinician and patient education about the potential gonadotoxicity of cancer therapies and the available options for fertility preservation are essential to improve patient access to these procedures. In the hospital setting, an oncofertility patient navigator can help guide patients across institutional and disciplinary boundaries to assess their cancer treatment and infertility risk, seek consultation with reproductive endocrinologists, and discuss treatment options and costs. Electronic medical records can assist in identifying reproductive-age patients who are scheduled for gonadotoxic therapy or who are interested in fertility preservation, so that they can be referred in a timely manner. Reproductive endocrinology practices that accept oncofertility patients must be prepared to provide care on short notice, including access to sperm donors, mental health professionals, and legal counsel. Oncofertility nurse coordinators are essential to ensuring that cancer patients undergo hormonal stimulation for oocyte or embryo cryopreservation efficiently and that their cancer treatment is not unnecessarily delayed by fertility preservation procedures. Unifying each of these steps ensures that decisions can be made in a timely manner and that the patient is given the best information about reproductive options, which may minimize later regret.