Cancer genetic testing and assisted reproduction.
OBJECTIVE
Because of increasing uptake of cancer genetic testing and the improving survival of young patients with cancer, health care practitioners including oncologists will increasingly be asked about options for assisted reproduction by members of families affected by hereditary cancer syndromes. Among these reproductive options, preimplantation genetic diagnosis (PGD) offers the opportunity to select embryos without familial cancer-predisposing mutations.


METHODS
A review of the published literature supplemented by a survey of PGD centers in the United States.


RESULTS
Prenatal diagnosis and/or embryo selection after genetic testing has already been performed in the context of more than a dozen familial cancer syndromes, including the common syndromes of genetic predisposition to colon and breast cancer.


CONCLUSIONS
While constituting new reproductive options for families affected by cancer, the medical indications and ethical acceptance of assisted reproductive technologies for adult-onset cancer predisposition syndromes remain to be defined. Continued discussion of the role of PGD in the reproductive setting is needed to inform the responsible use of these technologies to decrease the burden of heritable cancers.
Offit
Kenneth
K
Clinical Genetics Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10021, USA. offitk@mskcc.org
Kohut
Kelly
K
Clagett
Bartholt
B
Wadsworth
Eve A
EA
Lafaro
Kelly J
KJ
Cummings
Shelly
S
White
Melody
M
Sagi
Michal
M
Bernstein
Donna
D
Davis
Jessica G
JG
D001943:Breast Neoplasms / Q000235:genetics; D003110:Colonic Neoplasms / Q000235:genetics; D020022:Genetic Predisposition to Disease; D005820:Genetic Testing / Q000941:ethics; D019538:Health Care Surveys; D006801:Humans; D009369:Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000235:genetics*; D019836:Preimplantation Diagnosis / Q000941:ethics; D011640:Public Policy; D027724:Reproductive Techniques, Assisted / Q000941:ethics; D013577:Syndrome; D014481:United States