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Sun M, Xue C, Lu Y, Ma Y, Pan T, Wang X, Fan L, Shen J, Hao Y, Zheng D, Li J, Li M, He Y, Mei C. The fertility willingness and acceptability of preimplantation genetic testing in Chinese patients with autosomal dominant polycystic kidney disease. BMC Nephrol 2020; 21:147. [PMID: 32334565 PMCID: PMC7183678 DOI: 10.1186/s12882-020-01785-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 03/26/2020] [Indexed: 01/02/2023] Open
Abstract
Background With the development and progression of genetic technology, preimplantation genetic testing (PGT) has made it possible to block the inheritance of autosomal dominant polycystic kidney disease (ADPKD) as early as possible. However, we need to know the patients’ fertility intentions and their acceptance of PGT. Methods A questionnaire survey was conducted to collect data on the basic demographic data, quality of life, social support, fertility willingness, and level of understanding of genetic testing for blocking the inheritance of ADPKD among patients aged 18–45 years in seven hospitals from January 2018 to December 2018. After verification, statistics were calculated. Results A total of 260 patients with ADPKD were interviewed, including 137males (52.7%) and 123 females (47.3%). The overall fertility willingness rate was low (n = 117, 45.0%). The proportion of married patients aged 25–34 years that were at the optimal reproductive age but did not yet have children was relatively high (n = 77, 67.0%). The fertility intentions of ADPKD patients were significantly influenced by age (OR: 0.101, 95% CI 0.045–0.225, P < 0.001) and education level (OR: 2.134, 95% CI 1.162–3.917, P = 0.014). Among patients who are willing to have children, 207 (79.6%) of them would choose PGT technology. Among those who were not sure whether they would choose PGT technology, the first major concern was technical safety (49.2%). Conclusions The reproductive desire of childbearing ADPKD patients in China was low. Strengthening the health education of ADPKD genetic knowledge and reducing the cost of related technologies may improve the fertility intentions and reduce the barriers to acceptance of PGT.
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Affiliation(s)
- Mingji Sun
- Department of Nephrology, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, 200003, China
| | - Cheng Xue
- Department of Nephrology, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, 200003, China
| | - Yunhui Lu
- Department of Nephrology, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, 200003, China
| | - Yiyi Ma
- Department of Nephrology, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, 200003, China
| | - Ting Pan
- Department of Nephrology, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, 200003, China
| | - Xiaoliu Wang
- Department of Nephrology, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, 200003, China
| | - Li Fan
- Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, NHC Key Laboratory of Nephrology (Sun Yat-sen University), Guangdong Provincial Key Laboratory of Nephrology, Guangzhou, 510080, China
| | - Jiandong Shen
- The Center of Reproductive Medicine, the First Affiliated Hospital of Nanjing Medical University, State Key Laboratory of Reproductive Medicine, 16 Yongqing Lane, Nanjing, 210029, China
| | - Yan Hao
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, 230022, China
| | - Danxia Zheng
- Division of nephrology, Peking University Third Hospital, 49 Huayuanbei Road, Beijing, 100191, China
| | - Junhua Li
- Division of Nephrology, Tongji hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Road, Wuhan, 430030, China
| | - Mingxu Li
- Division of Nephrology, Sixth medical center of general hospital PLA, 6 Fucheng Road, Beijing, 100048, China
| | - Yaping He
- School of Public Health, Shanghai Jiao Tong University, 227 South Chongqing Road, Shanghai, 200025, China.
| | - Changlin Mei
- Department of Nephrology, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, 200003, China.
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Solem EP, Primiano M, McQuillen MP, Zak Goelz M. Factors associated with parental knowledge of neurofibromatosis type 1 (NF1): Parental affected status and genetic counseling. J Genet Couns 2020; 29:1151-1158. [PMID: 32196829 DOI: 10.1002/jgc4.1275] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 02/26/2020] [Accepted: 02/28/2020] [Indexed: 12/16/2022]
Abstract
Neurofibromatosis type 1 (NF1) is a genetic condition characterized by various cutaneous, neurological and psychological manifestations. The present study examined whether parental knowledge of NF1 is associated with a parent's NF1 status, affected or unaffected, and exposure to genetic counseling. Parents of children with NF1 were invited to complete an online survey answering true or false and multiple-choice questions to evaluate their overall knowledge of NF1. The study included 274 respondents, of which NF1 knowledge scores were significantly higher for unaffected parents (p < .001), and for parents who reported previously meeting with a genetic counselor (p < .001). Items pertaining to NF1-related cancer were least likely to be answered correctly. The results of the current study revealed lower overall NF1 knowledge in affected parents and knowledge gaps identifying areas where focused NF1 education may be beneficial.
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Affiliation(s)
- Emily P Solem
- Department of Genomic Medicine and Pediatric Genetics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Michelle Primiano
- Clinical Cancer Genetics Services, Weill Cornell Medicine, New York, New York
| | - Marshall P McQuillen
- Department of Biology and Environmental Studies, Long Island University, Brookville, New York
| | - Monika Zak Goelz
- Department of Biology and Environmental Studies, Long Island University, Brookville, New York
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Phipps J, Skirton H. A Qualitative Study to Explore the Views and Attitudes towards Prenatal Testing in Adults Who Have Muenke Syndrome and their Partners. J Genet Couns 2017; 26:1130-1142. [PMID: 28332077 DOI: 10.1007/s10897-017-0094-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2017] [Accepted: 03/06/2017] [Indexed: 11/28/2022]
Abstract
Muenke syndrome constitutes the most common syndromic form of craniosynostosis, occurring in 1 in 30,000 live births. The phenotype is variable, ranging from no clinical findings to complex presentation. Facilitating reproductive decision making for couples at genetic risk of having a child with Muenke syndrome is an important aspect of genetic counselling. Prenatal genetic testing for Muenke syndrome is accurate; however the value of testing is uncertain with a variable phenotype. The purpose of this study was to explore attitudes towards prenatal testing in couples where one partner had tested positive for the Muenke mutation. We used a qualitative approach based on thematic analysis and collected data using individual semi-structured interviews with eight parents. Five key themes were: The Muenke journey; Impact and knowledge of diagnosis; Knowledge and attitude to prenatal testing; Stigma and sharing of information; and Information retention. Knowledge of Muenke syndrome and prenatal testing was poor. Genetic information was provided when treatment of their affected child was their paramount concern. Couples reported not sharing genetic information with family due to fear of stigmatisation. Couples cannot make reproductive decisions if lacking appropriate understanding of the choices: timely genetic counselling regarding prenatal testing is needed when relevant to them.
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Affiliation(s)
- Julie Phipps
- Oxford Centre for Genomic Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford, UK. .,Faculty of Health and Human Sciences, University of Plymouth, Plymouth, UK.
| | - Heather Skirton
- Faculty of Health and Human Sciences, University of Plymouth, Plymouth, UK
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Carrieri D, Farrimond H, Kelly S, Turnpenny P. Families dealing with the uncertainty of genetic disorders: the case of Neurofibromatosis Type 1. SOCIOLOGY OF HEALTH & ILLNESS 2016; 38:753-767. [PMID: 26864895 DOI: 10.1111/1467-9566.12401] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Some scholars contend that genetic medicine is transforming the experience of illness and the social category of the family - bringing future risks into the present, and potentially strengthening familial biological bonds in light of these shared genetic risks. However, research has shown that genetic information is interpreted and acted upon through a rich repertoire of adaptable social, cultural and familial factors which pre-exist and interact with biomedical knowledge. This paper reports research into families living with Neurofibromatosis Type 1 (NF1), a highly uncertain condition the manifestation of which can vary considerably also within the same family and, for this reason, has been defined as a 'condition without parameters'. These characteristics make NF1 a particularly informative condition for the examination of family dynamics around genetic information. The study and the methodology are based on the exploration of family networks and allow us to investigate the interrelation of individual and familial constructions of the uncertainty of NF1. This also allows both theoretical and policy claims to be made about the danger of reductionist thinking about the transformative potential of genetic technologies.
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Affiliation(s)
- Daniele Carrieri
- Egenis, Department of Sociology, Philosophy and Anthropology, University of Exeter, UK
| | - Hannah Farrimond
- Egenis, Department of Sociology, Philosophy and Anthropology, University of Exeter, UK
| | - Susan Kelly
- Egenis, Department of Sociology, Philosophy and Anthropology, University of Exeter, UK
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Abstract
Many hereditary cancer predisposition syndromes are associated with cutaneous findings, both benign and malignant. Dermatological examination and histopathology, when combined with a thorough personal and family medical history, play an important role in the diagnosis of cancer predisposition syndromes. Skin findings are an important diagnostic tool for a variety of cancer syndromes, including Cowden syndrome, Birt-Hogg-Dubé, hereditary leiomyomatosis renal cell carcinoma, and others. This article focuses on the phenotype, medical management, and genetic testing for 4 hereditary cancer syndromes that include cutaneous findings: hereditary melanoma, basal cell nevus syndrome, neurofibromatosis type 1, and neurofibromatosis type 2.
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Parrott RL, Silk KJ, Condit C. Diversity in lay perceptions of the sources of human traits: genes, environments, and personal behaviors. Soc Sci Med 2003; 56:1099-109. [PMID: 12593881 DOI: 10.1016/s0277-9536(02)00106-5] [Citation(s) in RCA: 82] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Individual beliefs about the origins of illness and disease contribute to personal behavior to gain or maintain health and well-being. Both perceptions of the efficacy of recommended actions and the confidence individuals have in their ability to carry out prevention and detection practices may be associated with beliefs about illness causation. This study explored the perceptions of African American and European American men and women ages 18-45 years regarding the respective roles of inherited genes, social factors, personal behavior, and ecological environment on disease as compared to other human attributes, including height, weight, mental abilities, and talents. Results from focus group (N=16) data indicated that participants' (N=77) assignment of influence to various causative factors varied non-systematically by gender, race, education, economic class, and type of characteristic.
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Affiliation(s)
- Roxanne L Parrott
- Department of Communication Arts & Science, Pennsylvania State University, 302 Sparks Building, University Park, PA 16802, USA.
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