Reproductive medicine care in BRCA mutation carriers: an opportunity for early intervention

Case Presentation: A 30-year-old woman with a recently identified BRCA1 mutation presents for fertility preservation counseling.She denies any personal history of cancer but has a strong maternal family history of early-onset breast and ovarian cancers.She is nulligravid and desires at least two children.Her antim ullerian hormone (AMH) level is 0.7 ng/mL, with an antral follicle count of eight.She has met with cancer geneticists but has not yet consulted with breast or gynecologic oncology regarding risk-reducing surgery.The patient is concerned about how to safely and effectively achieve her reproductive goals.Clinical Question: In BRCA mutation carriers pursuing fertility preservation, how can clinicians intervene early to optimize reproductive potential, integrate cancer risk-reduction strategies, and counsel patients on the balance between oophorectomy timing, ovarian aging, and long-term family building?(F S Rep 2026;