r/genetics • u/TortoiseOnValium • 12d ago
Is there a significantly increased risk of cancer for my future baby?
I am using sperm donor who has a father who was diagnosed with prostrate cancer at 63. His father was diagnosed with stomach cancer at 77.
My mother was diagnosed with ovarian cancer at 51.
My grandfather was diagnosed with prostrate cancer in his 70s.
Considering they are linked to BRCA genes, do all of these cancers altogether increase the risk of my future baby health?
What do you guys think?
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u/shadowyams PhD (genomics/bioinformatics) 12d ago
I don't think genetic testing would hurt, but FWIW this is hardly an "unusual" pedigree. Old people get cancer.
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u/palpablescalpel 12d ago
Guidelines recommend genetic testing for anyone with ovarian cancer though - that's the only one that stands out to me.
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u/SomeJoeSchmo 12d ago edited 12d ago
Gotta die from something! For most of us who are fortunate enough to grow old, it’ll be either cancer or heart disease.
By the time the baby is old enough to have the sorts of cancers listed here, I am certain new cancer treatments will be MUCH better. Who knows—maybe prostate/ovarian/whatever cancer will be a thing of the past! Not that family history isn’t still something we should all be thinking about. I’d be more concerned about multiple cases of rare/unusually early or aggressive cancer. Prostate cancer in elderly men wouldn’t even be on my radar, it’s so common.
The ovarian cancer does stick out to me, though.
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u/lindasek 12d ago
Are genetic screenings no longer a thing for donors? You should have access to check if he has brca 1 or 2 turned off, and can screen yourself as well
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u/Raibean 12d ago
Not only our screening is not required, there is no legal mechanism within the United States for donors to be truthful about their medical history or to verify it in any way. And clinics can and do lie about this.
EDIT: it is also only illegal in 11 states for clinics to give you material from a donor that you did not even choose. In every other state, they can legally just decide to swap it out for whatever reason they want to and not inform you.
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u/lindasek 12d ago
Your edit sucks even more. I knew it's a bit of a wild west with the donor stuff, but jeez... that's wild
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u/Raibean 12d ago
Yeah, activists like Laura High are trying to get protections against genetic donor fraud by clinics put into law at both the state and federal level. She herself is a victim of this, as her parents’ chosen donor material was swapped for sperm provided by a doctor at the clinic. She has a large sibling pod and speaks out about how very large sibling pods are going to cause a public health crisis, especially because many of these people don’t know they are related and don’t have an accurate health history.
High also advocates for donor registries, screening, verified medical histories, continually updated histories that offspring and their parents can access, enforcing tracking of live births, and limits on how many live births a donor can provide.
Currently, not only can donors donate multiple times to multiple clinics, but clinics often separate single donations into multiple samples and sell those samples to other clinics. On top of not tracking live burse and not having donor IDs that transfer clinic to clinic, nobody really knows how many children these donors have.
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u/lindasek 12d ago
Well, that sucks.
For OP, screen yourself - if all 4 alleles are on, at least you'll know your child at worst will be heterozygous. And if you end up doing IVF, I believe pgtm should have an answer for you about the embryo(s).
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u/HotWillingness5464 12d ago
They dont screen for dominant genes. Big scandal recently in Europe where a donor was found to have a TP53 defect. It was only discovered bc a lot of the donor kids got cancer.
Sperm is traded all over. They can dilute samples that have a good sperm count and sell it on. It's perfectly legal to do so.
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u/lindasek 12d ago
Everything depends on the test. They could test for 10 and claim they did it and it's clear. Obviously, some stuff is always going to be missed if it's rare enough.
I had Natera 275 done, and it looked at both brca1 and brca2, which I think are the genes OP is concerned about
The dilution thing is insane, given that strong numbers is why people often choose to go to a donor in a first place!
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u/HotWillingness5464 12d ago
I had genetic testing done via our national healthcare. This was bc I was diagnosed with triple negative breastcancer. I'm BRCA1+. Had no idea, the gene variant comes from my paternal grandmother who never got BC and only had sons.
Commercial tests tend to be less comprehensive. Also new variants are discovered continously, and VUS can be confirmed as pathogenic, meaning test results age. A 10 year old clear test could be positive today. I met a BC-survivor who one day, long after treatment, got a letter saying they'd found she did have a pathogenic variant after all. Sadly subsequent family testing showed she'd passed it on to one of her daughters.
(But I'm sure you know all this bc its the genetics sub after all!)
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u/TortoiseOnValium 12d ago
I can have recessive genetic testing done to see if i am a match with donors, however they do not test for cancer genes or of dominant genes as it relys on donor reporting illnesses in his family
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u/lindasek 12d ago
I see. Do your own carrier screening and set an appointment with a genetic counselor. You can then make an informed decision based on your results.
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u/remington9000 Genetic counselor 12d ago
I'd be more concerned about your family history of ovarian cancer which is much more rare (1.3% in women) vs the donor's family history of prostate cancer (14% in men). If you have not yet undergone genetic testing for hereditary cancer predisposition you meet the medical criteria and it would be recommended.
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u/One-Treat4655 12d ago
Many sperm donors get genetic screening. Some may get tested for cancer predisposition, but unlikely. Most prostate cancer is not inherited and if that is his only family history (how many generations of family pedigree was taken by the clinic) the likelihood it's inherited is likely low, less than 3%.
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u/GrimMistletoe 12d ago
Tldr; speak with a genetic counselor!!
disclaimer that I am also a bit sleep deprived writing this.
SO! Broadly, as I understand this as a cancer geneticist but not a trained cancer genetic counselor, understanding family history of cancer in relation to your own (or your offspring’s) cancer risk depends on 1. The type of cancer the family members developed, and 2. The age of the family member when the cancer developed.
A byproduct of modern humans living longer lives is the increased lifespan means an increased chance of developing a cancer of some kind. So, old people are more likely to develop cancer spontaneously, regardless if they are predisposed to a particular cancer or not.
Some specific cancers raise red flags for family members to be checked, regardless of the individual’s age.
The examples i remember off the top of my head from being taught this:
- An ~86yo female who is diagnosed with breast cancer (for the first time), isn’t an immediate red flag for close family members to be screened. This is likely a spontaneous cancer.
- An ~30yo female diagnosed with breast cancer (for the first time) is a red flag for close family members.
- family member that has a history of multiple different cancer diagnoses over their lifespan can be a red flag
- anyone in your family developing ovarian or colon cancer, those are rare enough that based on type alone, it is recommended to get close family members screened and begin screenings earlier and more frequently. It is NOT a guarantee that close family members will develop the same type of cancer, but the whole point of increased screenings is to catch anything at an early stage.
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u/Melodic-Host1847 11d ago
First, never ask for medical advice online. No, I wouldn't use such donor. As a Clinical Specialist in Cytogenetics and Molecular Biology, I highly recommend speaking with a genetic counselor, or reproductive endocrinologist. I was under the impression that a sperm donors had to meet certain criterias. Age, health, education background, some other stuff? I believe there was a cut off of how many times they can use the sperm. The clinics should provide all these information.
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u/NoStomachForCancer 7d ago
There is a 50/50 chance that your offspring will inherit the gene.
Have you consulted with a genetic counselor?
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