Originally published as JCO Early Release 10.1200/JCO.2006.06.6100 on July 13 2006

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Cancer Genetic Testing and Assisted Reproduction

Kenneth Offit, Kelly Kohut, Bartholt Clagett, Eve A. Wadsworth, Kelly J. Lafaro, Shelly Cummings, Melody White, Michal Sagi, Donna Bernstein, Jessica G. Davis

From the Clinical Genetics Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center; Division of Human Genetics, Department of Pediatrics, New York-Presbyterian Hospital, New York, NY; Cancer Risk Clinic, Department of Medicine, University of Chicago Medical Center, Chicago, IL; Department of Human Genetics, Hadassah-Hebrew University Hospital, Jerusalem, Israel

Address reprint requests to Kenneth Offit, MD, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10021; e-mail: offitk{at}mskcc.org

PURPOSE: 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.

CONCLUSION: 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.

published online ahead of print at www.jco.org on July 13, 2006.

Supported by a grant from the Joseph LeRoy and Ann C. Warner Fund of the Lymphoma Foundation, as well as by the Carmel Family Fund, the Niehaus-Weissenbach-Southworth Fund, and the Evan Frankel Foundation.

Terms in blue are defined in the glossary, found at the end of this article and online at www.jco.org.

Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.

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