Genetic counseling

For over 4000 years, people have noticed that certain diseases run in families, but the "why" was unknown until modern science showed how genetic information is transmitted.

Present-day medicine recognizes that genetic diseases are inherited based on the nature of DNA, genes, and chromosomes. Now that the human genome has been completely sequenced, scientists are better able to study how changes in DNA cause human disease. This will ultimately help in diagnosing and treating genetic disorders.

Many diseases that involve a single gene defect can now be diagnosed very early in pregnancy. Prenatal diagnosis involves looking at fetal cells, amniotic fluid, or amniotic membranes to detect problems with the growing baby.

Couples who have a high risk of passing a genetic (hereditary) disorder to a child may consider pre-implantation genetic diagnosis (PGD). The procedure is done about 3 -4 days after fertilization. Laboratory scientists remove a single cell from each embryo and screen the material for specific genetic disorders. According to the American Society for Reproductive Medicine, PGD can help parents decide which embryos to implant, which decreases the chance of passing a disorder onto a child. The technique is controversial and not offered at all centers.

Genetic counseling and prenatal diagnosis provides parents with the knowledge to make intelligent, informed decisions regarding possible pregnancy and its outcome. Some parents choose to become pregnant and have the disease status of the fetus determined early in the pregnancy. The pregnancy is continued if the fetus is disease-free. If a genetic defect is identified in the fetus, parents who decide to continue the pregnancy may be better prepared to care for the infant by educating themselves about the disease in advance. For example, if a baby is born with a genetic disease that leads to diet problems, both the mother and baby may need to be treated with specialized diets.

However, until science has the knowledge to treat some of the more serious, sometimes deadly genetic disorders, the best option is prevention. Based on genetic counseling, some parents (in the face of possibly deadly genetic disease) have chosen to adopt instead of getting pregnant, while others have opted for egg or sperm donation from an anonymous donor who is not likely to be a carrier of the specific disease.

See also:

• Heredity and disease (genetics)
• In vitro fertilization