Reproductive decision making before and after predictive testing for Huntington's disease: an Australian perspective

Authors


Fiona Richards, Department of Clinical Genetics, The Children's Hospital at Westmead, Locked Bag 4001, Westmead, NSW 2145, Australia.
Tel.: +61 2 9845 3212;
fax: +61 2 9845 3204;
e-mail: fionar@chw.edu.au

Abstract

A retrospective study examined both pre- and post-result reproductive decision making for 281 people at risk for Huntington's disease aged 18–45 years who had undergone predictive testing in one centre in Australia between 1990 and 2002. Forty-eight per cent of subjects had one or more pre-result pregnancies, and of these, three had prenatal linkage testing. One high-risk (50%) pregnancy was terminated. Four couples chose an alternative reproductive option. Following testing, data were available for 231 subjects, and no significant difference was found between mutation carriers and non-carriers in the occurrence of post-result pregnancies. This contrasts with the finding of a recent European study, although the outcome of the present study may have been influenced by loss of follow-up data for 50 subjects. Five carriers (17%) had a total of six prenatal tests. Four showed a carrier result and these pregnancies were terminated. Two carriers utilized an alternative reproductive option (donor insemination and pre-implantation genetic diagnosis). The results of this study confirm previous findings of a low uptake of prenatal testing and alternative reproductive options by people at risk for Huntington's disease undergoing predictive testing.

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