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CION Cancer Clinics
Planning a family when you carry an APC fault | CION Cancer Clinics
Each child of a parent with an APC fault has a one in two chance of inheriting it. That does not mean you cannot have children. Many people with FAP do, and their children are tested and checked early. This page sets out the choices couples have, how testing in pregnancy and embryo testing work, and what to discuss before marriage or pregnancy. At CION Cancer Clinics, our oncologists explain what a gene result means for you and your family, and plan the checks that follow.
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Medically reviewed by Dr. Naresh GunduConsultant Medical Oncologist · MBBS, DNB (Internal Medicine), DM (Medical Oncology, AIIMS) · last reviewed September 2026, next review due September 2027
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On this page
- Will my children inherit my APC fault?
- What choices do couples with an APC fault have?
- How does family planning with FAP usually unfold?
- What do the family planning terms mean?
- How does testing in pregnancy compare with testing embryos?
- What this page cannot tell you
- Four things couples believe about FAP and children, and what is true
- Common questions about APC, marriage and children
The short answer
Will my children inherit my APC fault?
Each child of a parent with an APC fault has a one in two chance of inheriting it. Sons and daughters are equally likely, and it makes no difference whether the fault comes from the mother or the father. The chance is the same for every pregnancy.
What that chance does and does not mean
One in two is not a pattern that repeats neatly. A couple could have three children who all inherit the fault, or none who do. Each pregnancy is a fresh toss of the coin. A child who does not inherit the fault cannot pass it on to their own children.
Why this is a decision, not only a risk
FAP is a serious condition, but it is also a well-understood one. A child who inherits the fault and is checked from late childhood can usually have bowel cancer prevented by planned surgery. Many parents with FAP decide to have children naturally for exactly that reason. Others prefer to avoid passing the fault on. Both choices are reasonable.
No one at CION will tell you which choice to make. The counsellor's job is to make sure you know all of them.The routes open to you
What choices do couples with an APC fault have?
These options are listed in no order of preference. Some depend on the exact family fault being known first.
Conceive naturally, test the child later
The most common choice. The child is tested for the family's fault in late childhood, before bowel checks would need to start. A child who tests negative needs no extra checks at all.
Test during pregnancy
A sample from the placenta or the fluid around the baby is tested for the family's fault early in pregnancy. Couples then decide what to do with the result. The procedure carries a small risk of miscarriage.
IVF with testing of embryos
Embryos made through IVF are tested, and only those without the fault are placed in the womb. It avoids a decision during pregnancy.
Worth knowing
- Costly, and usually not covered by insurance
- Offered at a limited number of Indian centres
- Several IVF cycles may be needed
Other routes
Donor eggs or sperm, adoption, or choosing not to have children. Some couples consider these after talking it through. Each is a valid choice and none is a failure.
Not sure whether this applies to you?
Ask an oncologistStep by step
How does family planning with FAP usually unfold?
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Confirm the exact family fault
Testing during pregnancy or on embryos is only possible when the precise APC change in the family is known. If it was never found, this is the first job, usually through the affected relative.
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A counselling session before trying
Ideally both partners attend, some months before trying to conceive. The counsellor explains every option, the costs and the timing, so nothing has to be decided in a rush once a pregnancy has started.
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A check of your own health
If you have FAP yourself, your oncologist and surgeon look at your own bowel checks, any past surgery and any desmoid history before a pregnancy. Some surgery choices affect fertility, so timing matters.
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The chosen route
Natural conception, testing in pregnancy or IVF with embryo testing each follow their own path from here. Your counsellor stays involved and can coordinate with the obstetric or fertility team.
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Testing the child, if needed
For children conceived without prior testing, the family fault is checked in late childhood. Your counsellor will explain the right age and how to talk to your child about it.
Words you will hear
What do the family planning terms mean?
- Dominant inheritance
- One faulty copy of the gene is enough to cause the condition. This is why each child has a one in two chance.
- New fault
- A fault that appeared for the first time in one person, with neither parent carrying it. From that person onwards it is passed on in the usual way.
- Chorionic villus sampling
- A small sample taken from the placenta early in pregnancy and tested for the family's fault.
- Amniocentesis
- A small sample of the fluid around the baby, taken a little later in pregnancy for the same purpose.
- PGT-M
- Testing of IVF embryos for one known family fault before an embryo is placed in the womb.
- Predictive test
- A test on a well person, often a child, to see whether they carry the family fault already found in a relative.
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Side by side
How does testing in pregnancy compare with testing embryos?
Testing in pregnancy
Testing embryos through IVF
Natural conception, no fertility treatment
Needs IVF, with its own injections and procedures
Result comes during an ongoing pregnancy
Decision is made before a pregnancy begins
Small risk of miscarriage from the procedure
No procedure on the pregnancy for this purpose
Lower cost
Much higher cost, rarely covered
Being straight with you
What this page cannot tell you
It cannot tell you what to do. Family planning with an inherited fault is a personal decision shaped by faith, family, money and your own experience of FAP. A counsellor lays out the options without steering you. What your specific variant means is a question for the counsellor who ordered the test.
It cannot settle the law for your situation
Indian law allows testing in pregnancy and on embryos for a known genetic condition, under strict rules. Using any test to learn or choose the sex of a baby is illegal. The fertility centre and your counsellor will explain what applies to you.
Who this does not apply to
This page is for families with a confirmed APC fault that causes FAP. It does not apply to the low-risk APC change called I1307K, which does not cause polyposis and is not usually a reason for testing in pregnancy. It also does not apply to MUTYH polyposis, which is inherited quite differently.
If your APC report is unclear about which kind of change it found, ask before making any family planning decision.Commonly believed
Four things couples believe about FAP and children, and what is true
"If our first child has it, the next one will not."
The chance does not balance out. Every pregnancy carries the same one in two chance, whatever happened in the pregnancies before it.
"Only the mother can pass it to the children."
A father with an APC fault passes it on exactly as often as a mother does. Sons and daughters are equally likely to inherit it.
"A person with FAP should not have children."
Many people with FAP have children and raise them well. With testing and planned checks, a child who inherits the fault can usually have bowel cancer prevented. The choice belongs to the couple.
"Our baby should be tested at birth to be safe."
Testing a newborn usually changes nothing, because bowel checks do not start until later childhood. Waiting keeps the test close to when the result is actually used. Your counsellor will explain the exceptions.
Questions we are asked
Common questions about APC, marriage and children
Should I tell the family I am marrying into?
That is your decision, and families handle it very differently. Many couples find it easier when the partner knows before marriage, because it affects future children and health costs. A counsellor can help you plan the conversation and can meet both of you together to explain the facts calmly.
Does bowel surgery for FAP affect a woman's fertility?
Some operations that involve the pelvis can reduce fertility, while others affect it much less. If you hope to have children, say so before surgery is planned. Your surgeon can weigh the type and timing of the operation against your family plans and your polyp findings.
Is it safe for a woman with FAP to be pregnant?
Most women with FAP have safe pregnancies. The main concern is that pregnancy can make a desmoid grow, especially in women who have had one before. Plan the pregnancy with your oncologist and obstetrician together, and keep your bowel checks up to date.
Can we choose a boy or a girl to avoid FAP?
No. FAP affects sons and daughters equally, so choosing the sex of a baby would not help. It is also illegal in India to use any test to find out or choose a baby's sex. Testing is allowed only for the family's known APC fault.
How much does IVF with embryo testing cost?
It is much more expensive than natural conception, because it combines IVF with laboratory work designed for your family's fault. Several cycles may be needed. Ask the fertility centre for a written estimate covering the whole process, and check what your insurer will and will not pay.
At what age should our child be tested?
For FAP, testing usually happens in late childhood, shortly before bowel checks would begin. This is one of the few inherited cancer conditions where children are routinely tested, because the checks genuinely help. Your counsellor will give you the timing that fits your family.
Neither of us has FAP, but our child does. How?
Some APC faults appear for the first time in a child, with neither parent carrying them. Parents are usually offered testing to confirm this. If neither carries the fault, the chance for another child is low, though not zero. The affected child will pass it on in the usual way.
Can counselling be done in Telugu?
Yes. Family planning conversations are easier in the language you think in, and it helps when elders are part of the decision. Ask for counselling in Telugu when you book, and bring whichever family members you want in the room.
Your Specialists
Meet CION's oncologists. Bring your family history or genetic report to them.
Our medical oncologists see people with a strong family history of cancer, arrange genetic counselling and testing where it fits, and plan the checks that follow.
Medical Oncologist
Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
Medical Oncologist
Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
Medical Oncologist
Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
Medical Oncologist
Medical Oncologist
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Sources
- GeneReviews (NCBI) — APC-Associated Polyposis Conditions
- MedlinePlus Genetics — Familial adenomatous polyposis
- MedlinePlus Genetics — What are the different ways a genetic condition can be inherited?
- MedlinePlus Genetics — What are the different types of genetic tests?
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Testing the family for APCWho is tested, in what order, and when children are includedTelling children they may have FAPHow to start the conversation at the right ageDesmoid tumours in APC carriersWhy pregnancy is planned with your teamDeciding the timing of preventive bowel surgeryHow surgery choices and family plans fit together
Talk to us
Planning a pregnancy and unsure where to start?
Tell us about the APC result in your family and what you are hoping for. We will arrange a counselling session, in Telugu if you prefer, where both of you can ask anything. One helpline serves every CION centre.