Genetic testing before planning a pregnancy

Many women diagnosed with breast cancer at a young age, or with a strong family history, triple negative cancer, or certain other features, are offered genetic testing for inherited gene changes such as BRCA1, BRCA2, PALB2 and others. If you are planning a pregnancy, knowing your genetic results can be valuable for several reasons. First, a mutation in a gene such as BRCA1 or BRCA2 can affect decisions about timing, because women with these mutations are often advised to consider removing their ovaries and fallopian tubes once their family is complete, to lower ovarian cancer risk. Second, each child of a parent with such a mutation has a one in two chance of inheriting it. Some couples choose preimplantation genetic testing, known as PGT-M, during IVF to select embryos without the family mutation, where available and legally permitted. Others choose natural conception and may consider testing during pregnancy or testing the child later in adulthood. Many choose not to test embryos at all. Third, results may matter for your partner and relatives, and some couples also consider testing the partner. Genetic counselling before and after testing is essential, because results can raise complex medical, emotional, ethical and financial questions, and a trained counsellor can help you understand all options without pressure.

Testing is a personal choice

No one should feel pressured to test or to use embryo testing.

Counselling comes first

A genetic counsellor explains what results mean before you decide.

Relatives may benefit

Your results can help family members make informed choices.

Genetic counselling helps you understand testing and results before making decisions.

Family history

The counsellor draws a family tree, including cancers on both sides of the family.

Explaining tests

You learn which genes are tested, possible results and what they could mean.

Discussing implications

Implications for your cancer care, pregnancy plans, children and relatives are discussed.

Consent

Testing is only done with your informed consent.

After results

A follow-up appointment explains results and next steps.

Your results may help relatives understand their own risk.

Who may benefit

Parents, siblings, children and other close relatives may be offered testing.

How to share

Genetic counsellors can provide letters to help explain results to family members.

Respecting choices

Some relatives may not want to know. Their choice should be respected.

Genetic results can raise deep questions about family and the future.

Take your time

Unless timing is urgent, allow yourselves weeks to think and talk.

Consider each other's values

Religious, cultural and personal beliefs can shape views on embryo testing, donor use or testing children. Respecting these differences helps couples reach choices both partners can live with.

Think about extended family

Decide together how and when to share results with parents, siblings and in-laws, as genetic news can affect the wider family.

Seek support if you disagree

If you and your partner see things differently, a genetic counsellor or psychologist can guide calm conversations without taking sides, helping each person feel heard.

Remember timing

If your oncologist has advised a particular window for pregnancy, factor this into how long you take to decide about testing.

Look after your wellbeing

Genetic decisions can feel heavy. Rest, exercise and time with loved ones help you think clearly.

Use trusted sources

Rely on your counsellor and reputable medical sources rather than forums.

Write down questions

Bring them to your genetic counsellor so nothing is missed.