IVF clinics are already offering clients the possibility of sifting their embryos to ensure that they will not inherit the breast cancer genes BRCA1 and BRCA2. Belgian doctors told the European Society of Human Reproduction and Embryology (ESHRE) conference in Istanbul that preimplantation genetic diagnosis (PGD) for the genes is now feasible and established and that there have been good success rates.
PGD for the BRCA genes is highly controversial. While most PGD procedures are used to eliminate the risk of inherited sex-linked and single gene diseases (such as cystic fibrosis) in the children of affected couples, PGD for BRCA genes cannot remove the risk completely – because there is 10% background risk of breast cancer. Moreover, breast and ovarian cancers usually have a late onset. Prevention and therapeutic options constantly improving, so the chances of successful treatment and many years of healthy life are high.
Nor is breast cancer inevitable. A defective BRCA gene increases susceptibility to breast or ovarian cancer, but does not make the diseases inevitable. However, with female carriers of a mutation in either gene having a lifetime risk of 60-80% for breast cancer, and a risk of 30-60% (BRCA1) or 5-20% (BRCA2) for ovarian cancer, most doctors favour the procedure.
In Australia, two leading IVF clinics in Melbourne told the Sydney Morning Herald that 10 couples had used the test to screen embryos since 2008. “Cancer is a horrible disease… so these people want to get rid of it from their family tree,” said Dr Lyndon Hale, medical director of Melbourne IVF. Using the test is said to double the cost of an IVF cycle from about A$3,500 to $7,000.
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