Great questions and very relevant right now with increased adjuvant options. Unfortunately, I am not well versed in this topic, but I will share what I know.
I believe that it will depend on a patient’s insurance whether the cost of fertility counseling is covered. I recently had a patient in this situation; the cost of counseling was covered, but not the fertility preservation (egg harvesting or IVF). And it is incredibly expensive (one patient told me $10-20,000).
We have referred patients to a nearby IVF center for counseling. However, it would be really helpful to identify a resource within the institution.
The idea of asking Pharma about their experiences is a good one. It sounds like we should contact our reps and inquire about post marketing data. We have to start somewhere to learn about this very important issue!