Expert recommends Childless genetic counseling

Physician advises childless people to genetic counseling

30.06.2014

Although many couples wish for children, they still have difficulty in procreation. If the desire for a child remains unfulfilled for a long time, many people seek medical advice. Often physicians then examine everything possible, but genetic reasons are given too little attention.

Genetic reasons are given too little attention
According to experts, genetic reasons are given insufficient consideration in couples with unfulfilled desire for children. As the chairman of the German Society for Reproductive Medicine, Tina Buchholz, according to a message from the news agency dpa said, especially in artificial insemination a genetic counseling expensive and burdensome failures save and under certain circumstances increase the chances of pregnancy. In Munich, around 9,000 experts will be discussing these and other questions in their field until Wednesday at the four-day annual congress of the European Society for Reproductive Medicine and Embryology (ESHRE).

„Take your time and look“
For the genetic questions Buchholz demands more attention: „You have to take the time and look“, otherwise valuable time will often be lost. „Then in three or four cycles artificial inseminations are tried - and then it turns out: One of the partners has a translocation.“ In this form of chromosome alteration, chromosome segments are relocated to a different position within the chromosome population, with many people unaware that they are affected because there are no visible effects. However, this can prevent pregnancy, lead to an abortion or cause defects in the children. Since the chances of successful fertilization are significantly lower for these couples, further attempts could be avoided. On the other hand, other causes of genetic infertility may already be treated.

Pedigree over three generations
Therefore, at the latest after a few failed attempts in an artificial insemination genetic causes should be clarified, said the physician and human geneticist. „It does not necessarily have to be a costly, expensive genetic diagnosis. But you have to put a lot more emphasis on making genetic counseling with all these couples, with a detailed pedigree over three generations“, so Buchholz. This shows approximately the ratio of successful and unsuccessful attempts to get children and whether there was an accumulation of miscarriages or stillbirths.

Danger of malformation not proven
In Germany there are about 80,000 inseminations per year in the Petri dish in relevant centers, followed by more than 10,000 births. „It is always brought out: After such artificial insemination, the risk of malformation is greater“, explained Buchholz. Ultimately, however, this is not proven by studies. The risk was not increased by the method itself. The long disputed preimplantation genetic diagnosis (PGD) in Germany is not always appropriate, since the removal of cells from the embryo, depending on the examination method, can in turn increase the risk of miscarriage or treatment failure.

Hurdles and costs for PID are high
According to Buchholz, it has been possible under certain conditions since 2011 to examine embryos produced in the Petri dish for hereditary diseases before they are transplanted. However, couples are only allowed to resort to the method if their genetic make-up is likely to result in a child's miscarriage, miscarriage or serious illness. Then the mother should not be implanted embryos with damage. However, the hurdles and costs of such a PID are very high; Among other things, an ethics committee must approve the woman's application. According to Buchholz, the exact framework conditions were not precisely formulated until last year and have not yet been implemented everywhere in Germany.

Health status and nutrition have an influence
Those couples whose desire to conceive is unfulfilled, even though there are no genetic reasons, might be able to help by following some simple rules. The president of the professional association of gynecologists (BVF), Dr. med. Christian Albring, told the news agency dpa the year before, that, statistically, couples with a desire to have children should have sex every three days to achieve natural fertilization. If this rule of thumb does not help, the timing of ovulation can also be determined to increase the likelihood of pregnancy. In addition, numerous studies have shown that the state of health and nutritional behavior also have an influence. Accordingly, couples with unfulfilled desire for children should make their own lifestyle healthier, which, according to the experts, the diet is relevant. Unhealthy foods should be avoided, existing obesity or obesity should be reduced as possible and smokers should stop their tobacco use. (Ad)