Retrospective Analysis of Differences in Information Provided by Donor Applicants Obtained by Written Application Compared to Genetic Risk Assessment Performed by Certified Genetic Counselor as Part of Routine Screening Process

Background: Historically, it has been considered sufficient to have an egg donor applicant complete a written application that is reviewed by an egg donor program for acceptability. In 2021, ASRM put forth recommendations that "family history review and assessment of donors should be performed by a certified genetic counselor". In 2022, Inception Central Donor Recruitment (CDR) established a process for screening donor applicants that included Genetic Risk Assessment (GRA) with a certified genetic counselor. This study seeks to illustrate the discrepancies between personal and family history information documented on a standardized online application compared to a GRA consultation with a certified genetic counselor.

Objectives: Investigate the rate of new information obtained at GRA which was not included in the full application, as follows:

• New information with no change to health risk assessment (i.e. change in number of relatives)

• New information with a change to health risk assessment (i.e. known or suspected diagnoses for OD or family), with one of the following decisions

• Still acceptable/approved for clinic (ie new multifactorial condition reported, such as diabetes)

• Decline based on TPN internal guidelines alone (ie meets NCCN criteria for genetic testing)

• Decline based on ASRM guidelines (ie first degree relative with a major malformation)