I think the social worker did a great job of initiating the conversation. I have been in this situation several times where infertility has not been addressed prior to treatment and now that the patient is older and has transitioned to an adult survivorship clinic the topic gets brought up. Some may commented that they did not think she needed to talk about how this is a common part of care that is overlooked but I think she did a good job at acknowledging the problem and providing other options for future fertility. After she presented some of the fertility options, I would have liked to hear more from his perspective. However, she did a good job of reviewing infertility risks for him, his partner, and the general population as a whole and planting the seed of available options.
I agree that I think discussing that issues with fertility exist outside of post treatment is an important part of the discussion. Discussing that infertility does exist by itself may help Jose not feel too alone. Helping him understand that while the discussion should have taken place prior there are still some options that can be explored. I too would have liked to hear more from him, maybe some pauses after she gave him some information so he could respond/comment. I do think there was a nice balance between giving him information while still providing him with the sensitivity of acknowledging his frustration over not having the discussion ahead of his treatment.