Sunday, October 13, 2013

Genetic Family Swap

CUTAG of the Week:


It has been common knowledge for years that certain genetic variations inherited from our parents or ancestors can predispose us to certain diseases. For example, a mutation in an inherited gene HER2 can predispose a person to breast cancer. A new study has linked a mutation in a males sperm to an increased likelihood to develop ALL, Acute Lymphoblastic Leukemia, the most common type of blood cancer in children. Even though it doesn’t directly cause ALL to develop in children, do you think that men looking to have children should now have their sperm tested for this genetic variation? For women, knowing that your potential partner has this mutation in their sperm, would you be less likely to have children and stay in a relationship with your partner? For men, knowing that you have this variation, would you be less likely to want to have children?

61 comments:

  1. As the article says it is common knowledge that genes inherited from out parents can predispose us to certain diseases, so why should be treat ALL any differently than the other diseases. Before starting a family, everyone should screen themselves in order to find out what illnesses run in the family and what their children might be subjected to. Ie. Sickle Cell.

    Therefore, yes I do believe that men looking to have children should be tested for this genetic variation. However, as a woman I don't believe that I would leave my partner because of a genetic variation. I would just try to have children by using a sperm donor. Also since genetic variation is becoming an option for people who wish to change the genes of their children for mostly trivial things such as eye color or height, I would use it to change the gene that predisposes my children to the disease ALL.

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  2. I believe genetic testing a powerful tool, especially for couples looking to start families. However, with ALL, and all other hereditary diseases, I would only advocate for genetic testing if an individual’s family history, personal health and environment would make them a good candidate for testing. If it is not likely that a person carries the mutation then it is not worth the time or money just for the sake of knowing.

    As a woman, I would strongly consider the results of a positive ALL test and weigh my options; I would never leave my partner for it, though. All people should consider whether they are emotionally and fiscally committed to conceiving a child when an ALL mutation is likely to be passed on.

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  3. Considering the prevalence of ALL in children I think that people with a family history with ALL should be tested. Testing everyone would be time consuming and wasteful. If the day comes when it is inexpensive and less time consuming to test peoples genome, then everyone should be tested for many common mutations that predispose chronic illnesses.
    If I had this variation I would not be less likely to have kids. I would discuss this with my partner and make sure we were ready to financially and emotionally undertake this challenge, if our child develops ALL. Also I believe that in the future it will be possible to alter these mutations to effectively eliminate them at an inexpensive cost.

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  4. Genetic testing has become a highly influential and valuable source to obtain knowledge about our genes. For couples planning to have children, genetic testing can be beneficial in determining if their child (or future child) may be predisposed to a disease, such as ALL, or even carry the mutation/genetic variation. Even though genetic testing can be very valuable, it is still very expensive. I think that only those who know they may have a chance of caring the genetic variant of ALL, have a family history of Leukemia, or have been exposed to environmental factors that may increase this mutation should be tested. I’m also very curious to know what types of environmental factors play a role in the development of cancer, especially one like ALL?

    As a woman, I would also very carefully consider my options for having children if my partner carried the ALL variant. I would never leave my partner because of a genetic variation and would probably consider adopting children or maybe even using a sperm donor, as I would not want to risk having a child with ALL. I also agree wholeheartedly with what Danielle stated above, however, I think it should be expanded to having children in general. When deciding to have children, it is important to be both financially and emotionally stable, regardless of whether an ALL gene is involved in the picture or not.

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  5. I do not think that it should be required for men to have genetic testing to ensure that they will not have an affected offspring. I believe that they should have a choice whether they want to know or not. However, I think that it should be urged because if the parents have the genetic defect that causes a child to be predisposed to leukemia, the right preparations can be made to ensure that the child does not develop it.

    The article states that even if they have the defected gene, only children with the variant type would be affected, which decreases the chance of having a child that is predisposed to leukemia. Even then, the child would have to have the right environmental factors that would lead to cancer. If the family knew that they might have a child susceptible to cancer, preventable measures can be taken.

    If I found out that my partner had this mutation, I would choose to still have children and deal with the responsibilities if that child was in fact susceptible to leukemia. Of course, prior to having a child, I would research more about leukemia.

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  6. If I were in a serious relationship, I think I would want my husband to get tested to see if he carried ALL. I strongly agree with the notion that quality of life can be diminished greatly if one carries a disease as serious as ALL. If I were a man, I would definitely opt to get tested. Bringing a child into the world knowing they may have a debilitating disease seems rather cruel to me. I think my socioeconomic decision would be a huge factor in this as well. Someone who may not have the monetary resources to take care of a child with a serious disease definitely should not have kids if they carry this mutation. I feel like it would lessen the quality of life for the entire family, especially the child. For people who may not have the economic resources to get tested, I think that they should only spend the money on it if it is likely that their husband is a carrier. They should do as much research as they can so they make the most informed decision possible.

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  7. The problem of passing down undesirable genes to offspring is a complicated issue address, and in my opinion largely depends on the parents’ personal preferences and decisions. Although a mutation in PRDM9 may predispose an individual’s child to having ALL, I don’t think it should be required that men have their sperm tested. I also think it is important that men know the risks of passing down the disease and the implications for their family if they do not have their sperm screened, but at the end, it should be the couple’s decision as to whether the sperm should be screened or not. Making this decision an informed one is what I believe to be more important than having the screening required. While one may want to be screened, another couple may not for personal reasons.

    As a woman, knowing that my potential partner has this mutation would definitely make me be more wary of having children, but that wouldn’t be a cause for leaving my partner. With today’s technology, there are so many options (such as screening out sperm that has the mutation – as we went over in class with Alzheimer’s disease) to decrease the chances of passing on harmful genes to offspring. There are a variety of options that are likely available to couples planning around such a scenario – screening, adoption, etc. And of course as previously mentioned, the financial and emotional factors involved play a large role in making this decision that would have an important impact on the family.

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  8. I think men and women should be educated about this discovery and what it means. It should not be required, but testing for the genetic variance should be made available to men who want it. Knowing that a potential partner has this genetic variation would probably make it difficult to imagine having children with that person, however it would not be the sole factor in a decision to stay with or leave that person. It really depends on my dynamic with that person and the relationship and attachment we could form. If I could see myself with this person in the future I would continue to be with them regardless of whether they have the genetic variation or not. Yes, there is a high risk of the mutation being passed on but there is also a possibility that it will not, or even not be expressed. Genetic testing is can be very useful in family planning; I definitely think it should be more widely available. Especially because being aware helps with preventing potential issues due to socioeconomic background.

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  9. I think men and women should be educated about this discovery and what it means. It should not be required, but testing for the genetic variance should be made available to men who want it. Knowing that a potential partner has this genetic variation would probably make it difficult to imagine having children with that person, however it would not be the sole factor in a decision to stay with or leave that person. It really depends on my dynamic with that person and the relationship and attachment we could form. If I could see myself with this person in the future I would continue to be with them regardless of whether they have the genetic variation or not. Yes, there is a high risk of the mutation being passed on but there is also a possibility that it will not, or even not be expressed. Genetic testing is can be very useful in family planning; I definitely think it should be more widely available. Especially because being aware helps with preventing potential issues due to socioeconomic background.

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  10. As many people have already mentioned, men should have their sperm tested for the genetic variation, but only if they have probable cause and the means to do so. In essence, if they know someone in their family who has this mutation, or if they have a family history of ALL, AND they have the financial means to get the genetic testing done, then they should have their sperm tested for the genetic variation. However, if they do not have probable cause to do so, then they should not subject themselves to testing. Not only is it a waste of resources, but it is also time-consuming. The human species has gone this long without any outside interventions, so one genetic variant in the PRDM9 gene should not be a life-threatening cause for concern. As mentioned in the article, there are other mutations and environmental factors to consider; this is not the sole source or cause of ALL. Therefore, while it would be great if men could have their sperm tested, it should not be a requirement by any means. It is good to know whether your children could be susceptible to ALL, but it is not necessarily something people should lose their heads over.

    Even if my partner has this mutation, I would not leave him, or be less likely to have children. As I have mentioned in the previous blog post, genes and genetics do not alter my relationships. I base my social interactions on people’s personalities and behaviors, not their underlying genome. Therefore, it would not prevent me from being with the person I am involved with. In addition, having a family is a big decision. Genetic variations might affect that decision, but it would not be a deciding factor. There are ways to manage diseases, and there are ways to prevent ALL from occurring. In addition, in this day and age, there are many alternatives to producing children and having a family. A genetic variation should not prevent you from enjoying this joy in life.

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  11. Elisabeth BellissimoOctober 15, 2013 at 1:05 PM

    I think that all men or women interested in starting a family have an obligation to be screened for any genetic diseases that they could possibly pass on to their children. I don't think ALL should be any different. It would almost be irresponsible not to be screened, knowing that you could possibly be a carrier for a disease that could change your child's life forever.

    As a woman, if I am in a long-term, committed relationship with a man who has this mutation, I do not think I would leave him solely based on this discovery. As it is explained in the article, a man who has this mutation in his sperm is not guaranteed to pass it on to his children, so I think more research and consideration would have to be pursued before I could decide whether or not to have children with this man.

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  12. If I were married I would want my husband to get tested for ALL. Carrying this mutation could be detrimental for the future of the family. I think that it isn’t worth the diminished quality of life the carries of the disease would have and could pass on to offspring. I would be weary of having children knowing this mutation could be passed to them. The negative effects of the disease definitely outweigh all other positive aspects of having a family because this mutation affects the entire quality of life for all members of the family. Now that this information is out there, I think everyone should take initiative in being screened. Education of this discovery should be a high priority for the health care world.

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  13. Genetic tests are powerful resources that have allowed many families to adequately plan for the future, identifying possibly gene mutations or testing for genetic disorders. However, I do not think that genetic tests should be mandatory because a test can drastically alter a person and their family’s life. I believe that a healthcare provider should advocate for genetic tests, especially in people that have a family history of detrimental diseases such as breast cancer or ALL. But ultimately it should be up to the family whether to get the genetic test or not.

    As a woman, knowing that my potential partner had this mutation in their sperm would not make me leave the relationship, but it would make me seriously consider having a child together. In today’s world there are so many options for couples in this situation or in which the woman is unable to get pregnant. With numerous adoption agencies and even sperm donors, it is not worth the risk of having a child that could have a potentially fatal genetic mutation.

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  14. With a heredity mechanism now found that predisposes children to Acute Lymphoblastic Leukemia (ALL), I would consider having my significant other tested. However, I still believe that the ultimate decision would be his as it is his genome. It would also depend on our financial situation, if ALL was part of his past or generational history, or if there was any evidence suggesting the need for testing. Thus, in cases of other relationships, I would say the answer to testing would be based on context.

    In terms of my role in the relationship, I would not leave my partner due to a genetic variation. I do not think it is fair to judge someone solely based upon a difference on a microscopic level. It does not make them any less of a person in my eyes. As well, I would still want to have children but knowing that there might be family history of the genetic variation I would suggest my partner to be tested.

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  15. As Shani stated, I don't think ALL should be treated any differently than other genetic diseases. Not everyone gets genetic testing for other diseases, so a test for ALL should not be required. However, it should be encouraged to those who have had a family history of it, just in case. In the event the test is positive, those affected should be educated, but they should not necessarily hold off from having children. Considering it is not a guarantee that the child would develop ALL, that would be quite a sacrifice.

    I would not leave my potential partner if they had this mutation, just like I would not leave them if they had some other genetic mutation they could pass along to our offspring. I would be offended if my partner left me because of my genetics, so why would I do that to someone else? Unfortunately, there are so many things that can go wrong with childbirth and genetic mutations. If we all were so careful about our offspring developing a disease, no one would have babies.

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  16. As ALL is the most common blood cancer in children I think a genetic test for it should be strongly recommended but not required. If you had the power to know about these diseases before potentially passing them onto your kids then it would be foolish not to take the opportunity. It is almost wrong to turn the other cheek and potentially take away the right for your child to have a better quality of life. Therefore, if I had the opportunity to have my husband tested before we had a child then I would most certainly take advantage of it. If the results were positive then I would take action to speak with doctors about the possibility of my children getting ALL and with that knowledge I could potentially be swayed to adopt instead. With this being said, a majority of pregnancies are never planned and happen by chance so in these scenarios the parents wouldn't even have the chance to test beforehand. I think that if the technology is available and the family would like to do it as a step they take in the process of getting ready to build a family then that would be a very wise decision. However, since there is no certainty that a child will necessarily get ALL even if the father is positive then I do not think it should be a required test.

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  17. Men should be tested for this mutation because it drastically increases the likelihood for the offspring to develop Leukemia. Men that have the mutation should seriously consider the consequences and inform their partner before attempting to reproduce. It is not possible to require men to be tested for this variation because it is up to the person to make their own decisions about what is best for themselves and their offspring.
    If I found out that I have this genetic variation, I would be less likely to have children. It does not seem fair to produce a life that you know will be at elevated risk for a long painful disease. That does not consider the extreme emotional and financial turmoil a disease like leukemia can cause. This does not mean that I would not seek alternative methods of parenting (IVF or adoption). The decision to have children would have to be carefully considered by myself and my partner.

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  18. I think it is really important to remember that this is one of the first studies of this kind on this subject and that having this mutation does not guarantee that it will be passed on to children and that they will automatically develop ALL. Rather, it is just a component of ALL development. Before I made any decisions regarding genetic testing for my partner and having children, I would like to know what percentage of children inherent the genetic variant from fathers who have the mutation and from those who do inherent the variant, what percentage go on to develop ALL. Without this knowledge, I feel that having men undergo genetic testing for the gene would be a waste of money and could potentially lead to unnecessary anxiety. I feel that men should only be tested if they really want to and if they think the results will have a significant impact on their decision to have children. I think that I would only be less likely to decide to have children if I know there was a very substantial causation between the mutation and the development of ALL. However, if the link is not extremely strong, I would not let it alter my decision to have children. Many risks come with having children and I think if someone decides to have children, risks are something they are well aware of. Even if a child does not carry the mutation for ALL, there is still a chance that they can develop other life-threatening diseases at some point in their life. However, I don’t think that fear causes too many people who planned on having children to decide not to.

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  19. I understand the importance of genetic testing and its role in families; however, in this case and all other cases involving hereditary diseases, I think the choice of whether or not to perform genetic testing should be left up to the parents. I would recommend genetic testing for parents who have a family history of a particular hereditary disease, but even then, the family history is only a predisposition, not a guarantee that the disease will occur.

    As a woman, knowing that my partner has this mutation wouldn’t necessarily affect my decision to have children and definitely wouldn’t impact my relationship with my partner. Only half of the affected children in the study with the mutation inherited the genetic variant. In addition, the variant predisposes the child to ALL, but does not cause the disease. Many other factors contribute to the manifestation of ALL. Therefore, my partner and I would have to evaluate all of these factors before deciding to conceive a child and risk the ALL mutation being passed on.

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  20. I feel as though I would rather not be tested for genetic variations and diseases like that. It's a very controversial topic and it's hard not to step on people's toes by talking about it, but in my opinion, everybody is born and lives for a reason and has a purpose in life, whether their life be cut short due to unfortunate circumstances or if they live for a really long time. I know that everybody sees this differently and I see where others are coming from, I just personally believe everybody has a purpose and everybody has a right to fulfill that purpose. I know that if I were a guy, I would probably feel the same way too. I would love my child no matter what disease they have and would support them as much as I could. Knowing my partner had a genetic variation (whether I wanted to know about it or not) would not stop me from having a child. It doesn't mean the child won't get the disease, but it does not guarantee that they will either, and I will do everything I can to make him/her as happy as possible no matter what the circumstances are.

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  21. Genetic diseases like this which may have the mutation, which may cause the disease are always a difficult topic. Such as breast cancer markers, a woman could live her whole life with the mutation and not contract breast cancer. She might also get a mastectomy for no reason, but want to be on the safe side. I think that it comes down to the man and his partner to ultimately decide if they want to take the risk in knowing whether he carries the mutation or not. The problem is, as we learned in the genentic counseling lecture, what do they do with the information once they have it? If he is positive does that mean he has all his sperm screened and use insemination with a non-mutated sperm? Or does the couple take the chance and just see what happens? Hopefully they would love their child regardless but the ALL diagnoses could drastically change their life outcome from soccer games to weekly doctor visits. If my partner had this mutation I do not think it would affect whether or not I stay with him. I think we would have to evaluate how we choose to get pregnant from that point. Ultimately, I just want my child to be happy and have the best life possible in accordance to their diagnosis.

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  22. If a person knows that their family is predisposed to a certain condition, I firmly believe that they should have their sperm/eggs tested if, and only if, they feel that if their child possesses this disease that it would change and control their life. In this case, acute lymphoblastic leukemia is a disease that would require great precaution because of the potential damaging effects it could have on the child. The statistics on ALL however cannot predict at a percentage higher than 75% if the child will inherit the disease. The article states that the susceptibility to ALL is partially hereditary, finding that three fourths of the parents of children with ALL have an atypical form of the PRDM9 gene. However they have also discovered that only half have inherited the abnormality. As someone who suffers from a genetic disparity, vertigo, which is passed down from the women in my family, I personally know what it feels like to suffer from a genetic predisposition however my mother knew this but felt that having rare attacks of vertigo do not outweigh the experiences of having a child and thus decided to have me. It really depends on how severe the disease is when passed down and the decisions of the parents. As a woman, I would not end a relationship if my significant other had a genetic predisposition to ALL however I would want to get his sperm checked and talk to a genetic counselor of the likelihood of my child receiving ALL and what I can do from there on. As a result, the overall situation is relative the family and the inherited abnormality.

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  23. I strongly believe that if testing sperm is accessible and inexpensive to becoming aware of our own genetic variation before we have kids, it should be offered to every male who is thinking of parenthood. Whether or not someone decides to be tested is up to them.

    However, the huge argument is whether or not knowing negative genetic variations will influence someone's decision to have a baby or not. For this reason, I believe a choice should be offered to people to test their sperm.

    We should keep in mind that knowing testing genetic variation in sperm should be used for the purpose of aiding that child in the future and not to become a primary reason in whether or not someone should have a kid or not. Everyone has a history of some medical issue but to have that be a factor in birth is simply immoral.

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  24. I agree with many of the students that have posted saying that sperm testing would be unnecessary in this case. The vast majority of families in the United States grapple with illnesses that may have hereditary roots, and it's a large accomplishment in the field of medicine to be able to begin to screen for those illnesses, allowing us to make decisions before conceiving children. However, if we begin to push for more regular sperm screening, and begin to push women to have their partners' sperms screened, we are allowing a culture of fear to develop in the United States.

    In addition, there are still many unknowns in the field of genetics. Perhaps choosing not to conceive because a child would have ALL would forfeit other evolutionary adaptations that could benefit populations in the future.

    Certainly, if somebody chooses, of their own volition, to be screened for ALL, because they feel like it would be unfair to raise a child with that mutation, then they should be able to take advantage of the accomplishments made in the field of genetics. But we cannot, as a society, push for screening to become the norm.

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  25. I think that sperm testing for genetic variation is a personal issue and should never be required of anyone. Although some people argue that screening is important for determining the future health of your child, others believe that it shouldn’t matter. Some people believe that this is getting into the area of eugenics and “playing the role of god” because people who are getting screened might ultimately be deciding if they would want to terminate the pregnancy. They are therefore determining the fate of another human. Proponents of this idea would argue that it shouldn’t matter what the child’s predispositions to any of the diseases are; god has created them for a reason, and the results of a screening test would not change anything.

    If my partner were to have this mutation in his sperm, I would definitely be cautious about having children, but it is difficult to say at this time what I would do. I know there is a chance that the baby would be perfectly fine, but part of me thinks that the risks might outweigh the benefits. I plan on working full-time, as well as my husband, so I wouldn’t want the burden of having to take care of an ill child around the clock. However, I have always wanted to have children, and might decide that it is worth the risk. The main point is that my husband and I would have to decide together what the best thing is for us. I would hope that I would continue the relationship with him and work it out together.

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  26. As a women, I do not think that I would be less likely to have children and stay in a relationship with my partner given that there may be risk for ALL, especially considering that it is not guaranteed that children will develop it. Someone could make that same argument for me and say that because I am a women with certain genes that could pose a risk to offspring and come from a certain background, they wouldn't want to have children with me. I do not think that someone should choose a partner based on their genome, because there are so many different variables that could come with that. Furthermore, I think that it may be extreme to necessarily mandate sperm testing for ALL in males who want to have children...this goes for the same argument I made above. This would open up a can of worms and scientists can always find more diseases and conditions to test for, so I wouldn't press for this issue.

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  27. Based on this information regarding gametes and the possibly of increased risk for ALL, I would say that I would not consider this enough information to base a decision off of. Because there are only about 75% of ALL cases that have the mutated gene of focus, PRDM9, and only half of these cases were hereditary, for me this does not warrant any decision making at this point. Given how many different genetic mutations there are that can be passed on to offspring, I would personally conclude that there are more important and more thoroughly studied mutations that should be screened for if deciding whether to screen for this mutation as opposed to others. I do not, however, think that having this knowledge would be particularly harmful. If a man discovers his sperm contains this gene form, he can weigh his decisions more carefully, while knowing that, as the article pointed out, it does not directly affect his personal risk. I would never want to leave a relationship I was in with a man because I discovered he has a genetic mutation. However, I think that this information would definitely be cause for a discussion in different options for having children such as donors or adoption, but without these choices being necessary.

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  28. Since Acute Lymphoblastic Leukemia (ALL) is the most common type of blood cancer in children, I would encourage my husband to have his sperm tested for this genetic variation. By having this knowledge, we can further prepare for our future; whether to have kids or not or to make sure we are financially ready for it. It is better to know and address this issue rather than avoid it! Even if my partner has this mutation for their sperm, I would obviously not leave them. As stated in the article, it is not guaranteed that mutation would be passed on to the child even if the father has the genetic variation. But I still believe that if we are not financially stable then I would less likely have a child with him because it would not be fair to our child.

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  29. I believe that men should have their sperm tested for this genetic variation simply because it is always good to be one hundred percent sure, than take a wild shot in the dark and having actions result in negative consequences, for yourself or someone else. However, I do not think that the chance of passing down this variation is a good enough reason to reject a potential life partner or completely deny oneself the chance at parenthood (if that is something the individual or couple really wants). If I had any interest in men, I’m sure I would want him to get tested, but only to eliminate the element of surprise. In deciding whether or not to have children, I think it is important to consider the quality of life said child would have if he or she inherits the genetic variation, and the emotional, financial, and psychological effects of raising the child, on the parent(s). As stated by Julie Hussin, although the child may be at a genetic predisposition to acute lymphoblastic leukemia (ALL), it takes other factors to trigger “the process of cancer cell proliferation”. Additionally, early treatments are typically very successful and result in a good chance for a cure (www.cancer.gov). So even if the disease is present, it can be managed and should not diminish one’s willingness to live life to the fullest. As some of my peers have mentioned, there are other options to building a family that would eliminate these concerns altogether, such as adoption or sperm donation. Ultimately, getting tested is a personal choice, requiring the individual to weigh the advantages and disadvantages carefully, in order to make an informed decision.

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  30. I think that like any other disease that can be inherited by the offspring from the parents, ALL is just another potential disease that parents have to think about if there is a possibility of passing on that gene to their children. If either the mother or father, have a strong family history of certain diseases, I would recommend that they be tested to confirm whether or not they carry mutations for those genes so that they can be better prepared for when they decide whether or not to have offspring who might inherit those genetic mutations.

    As a woman, if my potential partner had the mutation for this gene, it personally would not affect my being in a relationship with him nor would it necessarily mean that I wouldn’t have children. As the article states, there are many factors that affect whether or not the child would develop ALL. I would have to consider the odds of having offspring with the gene as well as the likelihood that the offspring will develop ALL. The article states that like many other inherited genes that predispose individuals to diseases, other factors such as other mutations and environmental factors influence the development of these diseases as well. These are all considerations that one should look into before making a definitive decision on whether or not the risks outweigh the benefits for potential parents.

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  31. More data needs to be collected to better understand and confirm this concern. Assuming that the link is legitimate, it still isn't a guarantee that the child will suffer the disease. Given that other factors are necessary to have ALL, I don't feel that this should discount someone from having a child.

    However, this is great reason to encourage screening so that a father can be prepared to protect the child from whatever environmental conditions that can induce getting ALL. I believe that adults have a responsibility to know about their own bodies and should be mature enough to handle their genetic information. I believe this especially so if an adult chooses to have a child.

    In terms of choosing to leave your partner on account of this, the reason for having a partner should be the positive emotional relationship that they provide, not money, power, or perfect genes. When it comes to having children, it's about how good a father your partner can be. Discriminating partners based on genetic mutations is not that different from discriminating based on race or looks. It's how you're born and, for the most part, you can't change it.

    As a man, if I possessed the mutation, I would be more careful about having children but it wouldn't prevent me from having children at all.

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  32. All genetic testing should be completely voluntarily. Woman and men should not have no feel compelled to be tested. However, if evidence strongly correlates a genetic mutation to developing a disorder, especially in potential children, then I think it would be a good idea to have testing done. Parents may be more prepared to have a child with cancer if they are aware that the father has a mutation increasing the likelihood of their child developing ALL. They would be more proactive about monitoring their child's health and ensuring that he or she is screened to determine if ALL is present.

    That being said, leukemia is very treatable. This type of testing only allows parents to be better prepared to parent a child with cancer. If more evidence suggests that this genetic mutation strongly correlates to having a child with ALL then I would have my sperm tested. Testing positive would not keep my from having a biological child as this mutation does not directly correlate to cancer. Additionally, leukemia is very treatable and testing would only give myself and my partner a better chance to prepare effective intervention to ensure a healthy life for our child.

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  33. It seems kind of ridiculous to me that someone would pick a partner based on their genome. It seems like the plot of some kind of science fiction movie where everyone’s genes are tested and based on their genome fitness they are matched with a scientifically compatible partner. And the plot twist is that a someone tries to break the rules and find true love. I actually think one of the things that makes us human is the ability to make connections irrelevant to the Darwinian ideas of reproduction and survival, which can include companionship and love(maybe that sounds really cheesy and romantic). Personally, I would not ask my partner to get his sperm tested unless there was a history of ALL in his family. I just think if might be unnecessary and wasteful if there was very minimal chance of him actually having the gene. If he did have a family history and happened to also have the gene, I would not leave him but either find other means of having a child or adopting. If I personally had the gene, I would likewise find another way of having raising children(if at the time that was something my partner and I wanted).

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  34. Because this topic deals with the health of children, it is particularly difficult to land on a definite opinion of what should happen with genetic testing. Despite the fact that it is more difficult because I am not only considering the well being of the person being tested but of their potential offspring, I still land on the opinion that no one should be forced to undergo genetic testing against there will. That being said, however, I do think that any man with any history of ALL in his family should be strongly encouraged to undergo genetic testing. In a selfish way it is easy to say “well I don’t want to know that information”, but when considering a child’s life I believe it is always better to be more informed.

    I would not ever consider leaving my partner if I found out he had this mutation in his sperm and I certainly don’t think this genetic testing should be encourage for anyone who is not currently considering having a child. This should not be something that men have to walk around with as a factor of their eligibility to be a potential mate. This is just ridiculous and Sarah Ghabbour couldn’t have said it better when she said it was like the plot of a science fiction movie. We aren’t breeding machines searching for the perfect specimen of human to narrow the human race into one “ideal” genotype. This is just absurd to me. I would certainly reconsider my options with how to have children if I was concerned my child could become ill at such a young age, but I would not base my choice of a partner on this information.

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  35. I agree with many people that ALL should not be treated any differently than other heritable genetic mutations and diseases. I think that if the disease runs in the family, then it would be a good idea to get tested because there is a greater chance you may have the rare mutation. However, if there is no such history, then a man should not be required to get his sperm tested. The article also states that even if the mutation is inherited, it doesn't necessarily mean that the child will definitely get leukemia. The article says that inheritance is only one of many factors that probable play into the development of the disease. Therefore, why require all men to get tested? This process could be very expensive, emotional draining and stressful, especially when such a small population actually will have the variation. And even if they do have the mutation, the mutation does not equate to definitely having a child with leukemia. I think that a male should be able to make an informed decision about whether to get tested or not. He should also be prepared financially and emotionally to care for a child with ALL if he tests positive and plans on having children.

    As a woman, I would not leave my partner if he discovered he had this variation. I think we would thoroughly discuss it and make sure we were ready to have children. I also think that there are so many other genetic diseases that are inheritable, so why worry/focus so much on this one in particular when there is the potential for my child to develop a series of other conditions as well? I think that before you decide to have children, you need to discuss with your partner the possibilities of the child developing different conditions/diseases (especially if there are any that run in the family), and make sure you both will care and support the child through whatever obstacles may arise.

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  36. Personally, I think I would want to know if my child would be at risk for ALL. However, I do not think that this would affect my decision to want to have children. Just because a child is at risk, doesn't mean they are necessarily going to be born with this disease. In making a decision to have a child, a couple must consider many things, the most prominent being socioeconomic factors. Raising a child is costly and this is a big deterrent for most people. Many people can have trouble affording to raise a child, never mind paying for some possibly unnecessary, costly genetic testing. This is why I feel that a program should be put in place in order to educate people about the possible risks of this disorder, but I don't see large-scale testing being available in the immediate future.

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  37. I believe that genetic testing for illnesses such as ALL should be not forced upon anyone and it should be up to the parents to decide if it's actually worth it. There seems to be a lot of indecisiveness around how high the risk of actually developing the disease is, therefore I do not see it to be something of absolute importance to be screening for in all men.

    I think that people should definitely NOT be deciding to not have children for something as improbable as the development of ALL through hereditary means. I think it would be a scary world if everyone decided not have children because of the small risk of them inheriting some type of illness. It reminds me of eugenics in that we would be deliberately trying to perfect our race by weeding out those with genetic mutations, even if the risks are very small. I think it quickly becomes a slippery slope that should not be meddled with.

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  38. Like many people are saying, ALL should not be treated any differently than other heritable genetic mutations or diseases. I believe that if genetic testing is easily accessible and inexpensive, everyone should consider this option. Men who are looking to have children should get their sperm tested to avoid future problems and so they could prepare accordingly. They still have a choice so they don't necessarily have to be forced, but I find it very beneficial. If I had this variation, I would be a little discouraged in having children, but I would still consider other factors and possibilities.

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  39. I do not think this article presents enough evidence to say that all men should get their sperm tested. A possible linkage is presented for an increased risk.. that doesn't sound too solid to me. I think these results need to be taken futher to find what the true genetic link actually is. In the fufture I could see it being normal and helpful for men to get their sperm tested for ALL, but right now I don't think all men need have this done. If ALL runs in the family or the man himself has it, I would suggest testing. Although it doesn't give a definite answer, the risk can be taken into account when deciding whether or not to have a kid. And if someone thinks men should test their sperm, I think women would also have to look at their eggs. This can be inherited from egg or sperm, so this does not all lie on the man.

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  40. Like most things in modern medicine, tests and procedures should never be an assumed thing, and a decision made for patients without proper education and consent. Although is it is tempting for people in the medical profession to use their knowledge and experience to dictate the path their patients should make, the decision is ultimately up to each individual patient. Like screening for cancer, the yearly flu shot, and other widely accepted and endorsed, yet non-mandatory health practices, the autonomy of patients, and their preferences/knowledge of their personal situation, and views prevails. This can be a frustrating situation for providers, but it only makes sense that individuals should have the final say in what is or isn’t done in the interest of their health.
    That being said, doctor in Latin means teacher, and I think that in order for a doctor to completely fulfill his job description he/she should present all the information and possible courses of action to their patients. This means making them aware of a test that can expose risks, or add piece of mind, and ultimately add insight into the decision making process of whether or not to have children. Since 75% of children with ALL come from families where this atypical gene is present, it is well worth the consideration. My initial reaction was to think ignorance is bliss, and that I would not want to know if I had this atypical gene, but avoiding the issue would do nothing especially if I had the gene and my child was affected. It is a scary concept, but something that should be thought about while contemplating having a family. After all, there are other ways of conceiving as well as adoption.
    I would like to think that the presence of an abnormal gene would not lead to someone cutting off a relationship, but that is a personal decision that can change from relationship to relationship. I think I would be less likely to have children if I knew I had this abnormal gene, but I would also seek out other ways of becoming a father such as IVF or adoption. It wouldn’t be the same, but I think it would be well worth it to not have to watch my child struggle with cancer as a result of my genetics. I can’t imagine what that would be like.

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  41. People should never be forced to do anything that they don't want to do. People should be able to make their own decisions and if it is a risky decision, they should be ready for any potential consequences. Men who are aware of ALL and would not want a child with the disease should be able to make the choice to get tested. If a man wants a child regardless of what the child could be born with, then he should be able to have children and not be forced into genetic testing. There are always going to be supporters and protesters of testing, so it should remain a personal option. Though it is sad to know that your child could potentially be born with leukemia, having children is something that many people look forward to and cannot picture their life without, and those parents are the type to raise a child no matter the hardships. Personally, I'd be hesitant about having children with a carrier of the ALL genetic mutation but I wouldn't leave my partner because of it. Even so, there is still a chance that my child wouldn't develop ALL at all. I feel like I would still be willing to have children.

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  42. I do not think it should be protocol for all men to test their sperm because people are allowed to choose if they want to seek preventative treatments. I compare it to STI testing, in a sense. If a man wants to get tested to see if he has HIV, he can choose to go or not to go. If he transmits HIV to his partner, it is not illegal. In the same way, if a man passes along sperm carrying a risk for ALL, it is not necessarily "wrong" of him.
    With any risk, there is always a side of non contraction or not getting the disease. Even men who test positive for carrying the disease may have children without ALL. If this was my husband, I would most likely still have children. It is not his fault for carrying something and who knows, I am probably carrying something else that has not been discovered yet. I would never leave someone who was a carrier and I would probably also seek adoption (something that I have already decided I will most likely do).

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  43. I find this topic very hard to discuss because I understand both sides of the argument and don’t know which side I fall on because there is so much to consider. I understand why men would want their sperm tested because having a child with a serious condition, like Acute Lymphoblastic Leukemia, can be very detrimental for the family. Knowing that you have a genetic mutation carried in your sperm, may make some people reconsider having children because people don’t want to bring a child into the world knowing that he/she will suffer. However it is hard to draw the line of what conditions cause suffering that outweigh the benefits of life which makes this topic so complicated. If we tested everyone’s sperm before they have children, will that deter too many people from having children because of knowing their risks? By doing these tests, we are creating a fear factor that will take away from the natural joy of having children. If I knew that my partner had a mutation, I think I would want to discuss other options with him than having our own children. However, without knowledge that he had a mutation, I would not make a partner get tested for these genetic variations.

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  44. I believe that having genetic testing should be up to the individual. Acute Lymphoblastic Leukemia (ALL) is a tough one to consider because if a mutation is found it does not directly cause ALL to develop. For something that is inherited such as a breast cancer gene HER2, that will most likely predispose the person to breast cancer, that is something that I would want to be tested for. This way the necessary precautions can be taken place to hopefully reduce the risk of it occurring. Such as a mastectomy. With ALL you are not sure that this mutation directly causes it. I think it would be good for men to have their sperm tested for this genetic variation just to see if it is a possibility. But then again would I love my child any less if they did have this gene, no. In addition, if I did know that the sperm has this genetic variation it could bring about a lot of unneeded worry if the child does end up being fine. With a disease such as ALL I think that it is no reason to not stay in a relationship with your partner. You are in it together and if your child does have ALL then you take the steps to help them be healthy and help find a cure. I don’t think it’s a reason for men to not have children, the mutation is not a direct result your child will have it and we should love our children no matter what.

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  45. I don't think men should have to have their sperm tested, but I do think there should be some sort of program to educate people about the mutation. Informed consent is absolutely necessary, and that is why the educational program would work. Personally, I would like to be tested for the mutation. If I knew that I had the mutation, it would not deter me from having children. It would, however, cause me to change my lifestyle and really prepare for the worst case scenario. Diseases such as Leukemia are extremely pricey, so I would be very conscious with my money and look at various healthcare providers that would be the best if my child were to have cancer.

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  46. I believe that any two people thinking about having a child should consider genetic testing. However, I don’t think it should be mandatory and I don’t think it’s wrong if people choose not to. I would just hope that there would be some discussion about it between the two people and their health care provider. I believe that context matters in a situation like this, and there is no right answer for everyone; this decision would have to be made on a case-by-case basis. If my partner and I were trying to conceive through “standard” means, I might be less likely to have children with them but no more or less likely to stay in a relationship with them. I can understand how someone might want to have children regardless of the fact, and I can also understand how someone might choose to leave the relationship. However, if my partner and I were trying to conceive through other means such as a sperm donor or IVF, I would be less likely to accept the sperm of a donor that carries a mutation.

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  47. We have come a long way in the field of genomics and genetic testing. We are now able to analyze our DNA sequence, see detrimental mutations in our genes (if any), and determine if we may be predisposed to certain diseases. Advancements like these in the field of genomics bring up the important question of, “just because we can possess this knowledge, does it necessarily mean that we should?” In this article, we can see that Acute Lymphoblastic Leukemia (ALL) is a disease that can be detected by a faulty gamete that is inherited from the parent through genetic testing. This brings up the issue of whether we should test for it before people consider becoming parents. This reminds me of the debate brought up in my medical ethics class about testing for Huntington’s disease. Children of patients who have Huntington’s disease are highly susceptible to developing it themselves (about a 50% chance). Since there is no cure for the condition, the presence of Huntington’s disease causes people to question whether they should start a family and risk passing this off to their children. In both cases, I would not be opposed to having children knowing that I have a condition like this. I’d definitely talk to my partner and discuss all of the options that are on the table before making the decision, but I don’t think that this condition will prevent me from having a child. Screening is an important tool for everyone to know and prepare for what can potentially harm us. I think screening for the condition would be a good idea, but I don’t think that it should be mandatory. I believe that if conditions like this are frequent in the family history, then it is important to get checked out. However, I think that screening anyone and everyone would end up being a waste of time and resources, as well as cause a potential financial burden for the family. Even if these conditions are not prevalent, I believe a physician should inform them about the issue and give people an option to participate in the screening.

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  48. These advancements in genetic screening is allowing us to choose options in the way we monitor our health. So far in our class discussions we have focused on what and how to deal with the option of having our genes tested to find out if we have any inherited genetic predispositions to genetically related disease. Naturally, if these inherited genetic diseases can be detected through genetic screening, it seems to make sense that genetic screening can be used to predict whether or not our children will also have the same genetic predispositions. With that being said, this also brings up a lot of controversies regarding privacy issues of both mother/father parties and relationship issues in dealing with what types of genetic predisposition each parent has that their children can possibly inherit.

    It seems to make sense that parents would want to know what types of genetic predispositions their child might have in regards to diseases and serious conditions/illnesses. Although as many pointed out that getting genetically tested won't deter their decision to have a child, it will give them a heads up to prepare for the worst--financially and emotionally. If a certain genetic disorder is common in the family history, the parents should consider genetic screening so they know what they are dealing with and perhaps mentally prepare themselves to what may lie ahead for the child's future. Unfortunately, not all inherited disease will affect a child. It's a 50/50 chance all dependent upon whether one or both of the parents carry a certain gene or whether if it is a dominant or recessive gene. With this "chance" patients should consider the potential emotional burden they might have--so with carefully explained informed consent, they parents should have the right to decide to have their sperm/egg screened for any disposition and prepare themselves the for worst case scenario. Personally, I wouldn't mind getting tested for certain mutations, because if I did have those mutations, I could consider other options in order to have a healthy child or start changing my lifestyle that may help lower the chances of my child inheriting certain genetic predispositions.

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  49. I would not choose my partner based on his genome, even if he could potentially have a mutation that would cause ALL in our children. I don't think anyone should select a partner based on genetics! I think it's a ridiculous notion that just because there is a risk of passing on disease in the family, everyone should be screened and know exactly their risk. Even if the screening test shows that the father has a high chance of passing the mutation to his child, that doesn't necessarily guarantee a poor outcome. A possible disposition to serious diseases is definitely a concern, but it’s not something that can be changed if it’s built within the genome. So in this case, some people would rather not know that they carry the gene. I can't imagine deciding not to marry someone because they might possibly someday pass on a genetic mutation to our children, then only to find out that they had a child with someone else who was perfectly healthy. I would be missing an opportunity to enjoy my life with the person I choose, in fear of something uncertain. I believe in living in the moment, without reservations on future possibilities. It's definitely better in the long run to just live your life without the burden of knowing all your health risks, because otherwise people would just worry all the time. Whether people should even be screened for such risks is a whole other issue.Though not an easy issue to deal with, it should not be a concern that consumes your life to the point of choosing a partner based on potential disease disposition.

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  50. If men and women are comfortable receiving genetic testing before having children and can afford it then I believe it would be a smart decision to do so. In this case you can at least be informed of any known risk for disease that your children could develop. You would not be as devastated if your child was to come down with something like leukemia and potentially could be prepared to pay for and treat the disease (that is if you are still willing to have children.) In the worst case scenario, you could seek a sperm donor or a surrogate mother. If I knew I had this genetic variation I would still want to have kids anyway as long as I had the finances to prospectively pay for my child’s treatment.

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  51. The decision to get tested for this particular genetic variation should be predicated on the likelihood that it will be expressed in the form of the disease in question. Potential parents should know the variation exists and the rate at which the disease manifests itself within the population. Only then can they make the most informed decision that would best suit their lifestyle. With that point being established, I cannot say whether or not I would want these test results, simply because I'm not as informed as I would like to be on the prevalence of the disease and the likelihood of the mutation becoming expressed. If it were very possible that any potential children I were to have would develop this form of Leukemia, I would be very hesitant to proceed to conceive children. However, I do not think it's necessary to end a relationship with someone over this mutation. There are plenty of children who would benefit from this particular situation if a couple who discovered the presence of the mutation were open to the idea of foster parenting/adoption.

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  52. I think it is smart for men to get their sperm tested if they are looking to have children. Cancer is a devastating disease, and causes a great deal of physical and emotional pain for the person suffering and for the families of the suffering person as well. I believe this sort of trauma should be prevented if possible. If I knew that my potential partner had the mutation for ALL in their sperm, I would need to find out more information about ALL and its heritability before making the decision of whether to have children with my partner. I would ask my doctor or genetic counselor about the likelihood of my potential child inheriting ALL. I would also try to find out more information about the penetrance of the disease. Penetrance is the proportion of individuals carrying a particular variant of a gene who also express an associated trait. In this case, the penetrance of the mutation for ALL would be the proportion of individuals with the mutation for who exhibit clinical symptoms after inheritance. If I found out that the penetrance for ALL was low, I would be more likely to have a child with my partner who had carried the mutation. It would be a tougher decision for me to make if I found out that it was quite likely this disease would significantly affect my child.

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  53. Men should only really have their sperm tested if there is strong evidence to suggest that they possess the mutation. Since this mutation is not directly linked to ALL, it shouldn’t become a routine test for men. Any type of genetic testing is going cause emotional stress, especially if a couple’s decision to have a child is contingent upon the results. This could put a lot of tension on the couple’s relationship. Also, if men are choosing to be tested, it is important that they have the resources to help them interpret the results correctly, and make the appropriate decision. Before getting tested they should take all factors and possible outcomes into consideration. For example, testing for one condition can expose another condition that the individual didn’t know they had. Ultimately, it is up to the individual to make the decision based on what they think is best.

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  54. Vanessa Merta

    I agree with most of my classmates here in that men should have their sperm tested if they are planning on having children. If we have these technologies I think it would be a waste to not use them. ALL is a terrible disease, and if there is a way to possibly avoid it, then parents should do all that they can. If anything, the potential parents should be prepared financially and emotionally for the possibility of having a child with this disease. Hopefully this wouldn't deter anyone from marriage, which some people had brought up. Parents should take this test for what it is, in the sense that their child could be fine even if the father has the genetic variant for ALL. Another option for those who don't want to take the risk after testing positive, would be adoption or sperm donors. So many children around the world need to be adopted every year, so in the parents misfortune, a orphan child could find a home. There are so many things that potential parents can do if they test positive, including still having a healthy child. This is why I think that men should have their sperm tested when they are planning on reproducing.

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  55. I dont know if genetic testing for ALL would make me reconsider having children with someone as if you successfully 'dodge' this condition, is it realistic that your child has an illness free life? Also the treatment options for ALL are very successful now and in modern society I don't think financial factors should come into it.

    I think the purpose of DNA analysis should be remembered and that 'designer babies' were never the end game. It is the pursuit of understanding disease and treating it, rather than preventing life. I think if we start to exclude partners on the basis of their genetic make-up, do we avoid the white male because of the high incidence of cystic fibrosis? Do we ignore the black male because of the high chance of my child developing sickle cell anaemia?

    I think if the likelihood of a devastating untreatable disease is very high, i.e retinitis pigmentosa, then I think the discussion about conception should take place. But with the advancements in medical treatment, the right to share the joy of a child - whatever the perceived 'difficulties' with the partner you love, should be exercised by ALL - no pun intended.

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  56. I think that all men or women interested in starting a family have an obligation to be screened for any genetic diseases that they could possibly pass on to their children. I don't think ALL should be any different. As a woman, if my partner had the mutation for this gene, it personally would not affect my relationship with him nor would it necessarily mean that I wouldn’t have children. In the article, it suggests that there are many other factors that affect whether or not the child would develop ALL. It is best to consider all the factors before making an important decision.

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  57. I believe that partners who intend to have children together should strongly consider genetic testing. Through being aware of certain risks, the parents and make an informed decision on whether or not they would like to have children, or if they are well-equipped to care for a child with a genetic disease. Although ALL is most common type of blood cancer in children, I think that it should be recommended not, required for men to have their sperm tested for the genetic variation for ALL. However, even genetic testing isn't a definitive answer to whether or not a child will develop ALL. I would not choose my partner based on his genetic information or mutation in his sperm. Hopefully, even in this new age of genetic testing and advancements in genetic technologies, individuals are still picking their partners on personal qualities and characteristics. I hope that genetic testing does not one day cause individuals to pick and choose future partner's based on their genetic material, this will ultimately remove the humanity and love that is behind relationships. Although I would consider asking my partner to get tested for mutations that may predispose our future child to certain illnesses, I would never decide to stay or leave my partner based on the results.

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  58. Knowing that this genetic mutation could contribute to a risk of your child developing ALL would be a motivator to get genetic testing before starting a family. It’s important to know the risks even though this would not necessarily change your decision to have kids. The article mentions that the presence of this mutation doesn’t guarantee that it will be passed on to offspring as with all mutations. It also mentions that this mutation itself would not be enough to cause cancer but that it would have an additive effect when combined with other mutations and environmental factors.

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  59. One thing that is unclear about the study is if the mutated sperm consists of all of sperm produced in the male, or only some of the sperm. If only a limited percentage of sperm is mutated, the likelihood of men testing their sperm is lower, because fertilization is random.

    I believe that eventually men will test for their sperms mutations. However, I do not think this will correlate to men less likely having children. Having children stems from human nature, and reasoning will not necessarily drive it away. Conversely, it could be possible that women would also begin considering sperm mutations when choosing a partner. However love also stems from human nature, and sperm mutations won't likely become a major factor in choosing ones relationship partner.

    Lastly, the article states that while sperm mutations increase chances of ALL, there still needs to be a second "kick". The fact that a mutated sperm is not a guaranteed cause of ALL makes the impact less significant.

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  60. I find it interesting that ALL is linked to a mutation in a male’s sperm. I don’t think that men should test their sperm for this genetic variation. Just because they carry the gene, doesn’t mean that their child will necessarily develop ALL. I wouldn’t be less likely to have children if I knew my partner had the mutation in his sperm. It may be risky, however, it wouldn’t prevent me from living my life and having a family. I think it would be silly to not have children because of the mutation when they may never develop the disease!

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  61. From my perspective, I think everyone should consider genetic testing before having children. I think it is a wise choice and it allows people to take advantage of the information that is out there today. I also recognize this is not feasibly possible for many people due to restrictions on health insurance. On the other hand, I recognize why someone may not want to get the genetic tests done. As this article points out and as we have learned from our many lectures on epigenetics, there is no guarantee that a gene will lead to a disorder. Environment, stress, and many other factors can determine the expression, so for some knowing the genetic information would be too much for them to lead a productive, happy life. I think, as I have stated before, that the decision should be in the hands of the parents/family. When it comes to disorders that have a much higher risk of being expressed if the gene is present, I believe it is the responsibility of medical professionals to convey this message to patients rather than scare them into getting testing.

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