Infertility Counseling Session 5: Genetics

In an effort to get pregnant after repeated unsuccessful attempts and/or miscarriages, individuals and couples face the prospect of undergoing tests to find out the reason for their infertility. A referral is made to an infertility specialist who determines, if possible, the cause of infertility and in doing so, may uncover a genetic anomaly. There are a variety of reasons why a pregnancy may not occur including lack of ovulation, blockages, sperm deficiencies and parental age. The contribution of a genetic factor to infertility is a component that needs to be taken in to account. It has been found that some of the causes of infertility have been associated with specific genetic anomalies including chromosomal abnormalities, gene disorders and mutations and inheritance factors.

The significance of these findings is twofold in that an individual or couple must deal with the shock of an infertility diagnoses and the subsequent shock of discovering there is a genetic disorder.  This opens up a myriad of complex physical and emotional issues that place prospective parents in a position of vulnerability as they decide not only how to proceed with their genetic family goals but whether they should proceed with trying to have a genetically related child.

Genetic issues that arise during testing for pregnancy failure may result in the discovery of a disorder that not only causes infertility buy may also cause health related risks for the parent. Individuals and couples who identify as coming from specific areas of the world or are of a particular race or ethnic background may choose to have genetic testing done before attempting pregnancy only to find out they either have a genetic disorder or may be carriers. Test results from an amniocentesis during pregnancy may show genetic anomalies in the fetus that will impact whether the pregnancy is terminated or not. Genetic anomalies discovered in embryos during IVF present the dilemma of deciding what to do with the embryos. An identified genetic disorder, when first discovered, creates more questions than answers.

Genetic counseling and individual/couples therapy can help answer some of the questions that prospective parents grapple with as they decide their next steps. A diagnosis of infertility triggers a host of feelings including shame, guilt, shock, anger, hopelessness and fear and when combined with the discovery of disease and/or the potential of having an unhealthy baby, the sense of isolation, confusion and sadness is compounded. Genetic counseling provides information on the nature of the disorder and the risks associated with passing along that disorder. In addition, genetic counselors provide information on what types of procedures are available for detecting genetic issues, before, during and after a pregnancy. A therapist can help individuals and couples cope with all the information that has to be processed, while providing a safe space to explore the intense feelings that a diagnosis of infertility and a genetic disorder causes.

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