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      I would start the discussion by making it very clear that no decisions have to be made in the moment, the goal of the meeting is just that, a discussion. Ideally I would want to have both of the parents present and ask what their understanding of fertility preservation is. I would then provide general information about fertility concerns and options for fertility preservation with both short term and long term considerations. I would ask the family to consider any cultural, religious, spiritual, financial, and ethical concerns before making a decision. I would acknowledge how difficult and overwhelming the discussion can be and inform them that their child (7+) would need to assent to any procedure being done, if the family is leaning towards fertility preservation. In addition, I would speak with the medical team and assess the child’s cognitive understanding of fertility before bringing them into the conversations.

      For many families I worked with who had pre-pubertal children, fertility preservation was mostly placed on on the back burner due to both the urgency of starting treatment, financial barriers, and the medical institution not being equip with the resources and expertise to provide thorough information or adequate referrals.

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