Medical Oncologist
CION Cancer Clinics
Genetic counselling for couples deciding about children | CION Cancer Clinics
If one of you carries an inherited cancer gene fault, a couples session with a genetic counsellor is the place to decide how to have children. You both hear the same facts, together, from someone who does not take sides. This page explains what the session covers, how it runs, and what to do when the two of you do not agree. At CION Cancer Clinics, our team helps carriers and their families plan checks, next steps and support after a genetic result.
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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
- What does a couples session add when one of you carries a gene fault?
- What a couples session usually covers
- How the process usually runs
- The terms used in the session, in plain language
- What if we want different things?
- What this page cannot tell you
- Four things couples tell us, and what is actually true
- Common questions about couples counselling
The short answer
What does a couples session add when one of you carries a gene fault?
A couples session is a genetic counselling appointment you attend together, before you decide how to have children. Both of you hear the same facts at the same time, from someone who does not take sides. The counsellor explains the chance of passing the fault on, lays out every option, and helps you find the choice you can both live with.
Why both of you need to be in the room
When only the carrier attends, the partner at home hears a second-hand version, often softened or muddled. Questions go unasked. Fears grow in the gap. Sitting together means the partner without the fault can ask what they actually want to know, and the carrier does not have to act as the family's translator on top of everything else.
What the session is not
It is not marriage counselling and it is not an exam. Nobody is judging whether you should have children. The counsellor will not approve or refuse any plan, and will not tell your families what was said. Their job is to make sure the decision you reach is an informed one, made by the two of you.
When to book it
Ideally before you start trying for a pregnancy. Some options, such as embryo testing, take time to arrange, and a few depend on a test being designed for your family's exact fault first. Coming early keeps every door open.
A gene fault in one partner does not decide your family's future. It adds a set of choices you are entitled to hear about.Inside the session
What a couples session usually covers
Every session is shaped around your family, but most cover the same four areas. You can ask to spend longer on any one of them.
The chance of passing it on
For most inherited cancer genes, each child of a carrier has a one-in-two chance of inheriting the fault. That chance resets with every pregnancy. The counsellor will also explain what inheriting it would mean for that child in adult life, which is a raised risk and not a diagnosis.
Every option, laid out evenly
The choices are explained side by side, with no ranking.
- Conceiving naturally with no testing
- Testing embryos through IVF
- Testing during a pregnancy
- Using donor eggs or donor sperm
- Adoption, or choosing not to have children
The other partner's family
The partner without the known fault is asked about their own family history too. A few rare conditions appear only when both parents carry a fault in the same gene. This matters more when partners are related by blood, which is common in many Telangana families and is asked about without judgement.
What each path costs you
Money, time, travel and physical strain differ enormously between the options. Embryo testing is usually paid for privately. Talking about cost openly in the room is normal and expected.
No option is the right one by default.Not sure whether this applies to you?
Ask an oncologistFrom first call to decision
How the process usually runs
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Gather what you already have
Bring the carrier's genetic report, the family letter if there is one, and a rough family tree from both sides. A photo of the report on your phone is better than nothing.
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The first joint session
The counsellor checks the result, explains the chance of passing it on, and walks through the options. Most couples leave with more questions than they arrived with. That is expected.
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Time apart to talk
You go home and talk it through, on your own terms. There is no deadline set by the clinic. Write your questions down as they come up.
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A second conversation
You return with your questions. If you are leaning towards an option, the counsellor explains what the next step involves and who you would be referred to, such as an IVF clinic or a fetal medicine unit.
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Coming back when life changes
A new pregnancy, a new diagnosis in the family or a change of heart are all good reasons to book again. The door does not close after one decision.
Words you will hear
The terms used in the session, in plain language
- Carrier
- Someone who has an inherited gene fault but does not have cancer. Being a carrier is not an illness.
- Dominant inheritance
- One faulty copy of the gene is enough to raise the risk. Most inherited cancer genes work this way.
- Penetrance
- How often a fault actually leads to cancer among everyone who carries it. It is never all of them and it differs by gene.
- PGT-M
- Testing embryos made through IVF for the family's known fault, so that an unaffected embryo can be chosen for transfer.
- Prenatal diagnosis
- Testing a pregnancy that is already under way, using a sample from the placenta or the fluid around the baby.
- Non-directive
- The counsellor's working rule. They give you the facts and help you think, but do not steer you towards any particular choice.
When you do not agree
What if we want different things?
What couples often say
What the counsellor can help with
One of us wants embryo testing, the other does not
Separating the facts from the feelings, and naming what each of you fears
The carrier feels guilty and wants to step back
Reminding both of you that nobody chose the fault
Our parents are pressing for a particular answer
Keeping the decision with the two of you, and planning what to tell family
We cannot afford the option one of us prefers
Setting out realistic costs and the options that remain
We keep having the same argument at home
Referral to a couples or family therapist alongside genetic counselling
Leave a number, we will call you
One field. No form to fill in, and no charge for the call.
Being straight with you
What this page cannot tell you
It cannot tell you which option is right for the two of you. That depends on the exact gene, how it has behaved in your family, your ages, your beliefs and what you can afford. What your specific variant means is a question for the counsellor who ordered the test, or one they refer you to.
It cannot predict how you will feel later
Couples are often surprised by how their views shift over months. A plan that felt certain before marriage can feel different once a pregnancy is real. Coming back to talk again is part of the process and not a sign that something went wrong.
Who this does not apply to
Most couples do not need this session. If neither of you has a confirmed inherited fault, reproductive options are not usually offered on family history alone. The same is true of a variant of uncertain significance, a spelling change whose meaning is not yet known. A fault found only inside a tumour cannot be passed to a child at all; that testing belongs to targeted therapy.
If you are unsure whether your result qualifies, call the helpline and ask. Someone will tell you honestly.Commonly believed
Four things couples tell us, and what is actually true
"The counsellor will tell us what we should do."
They will not. Genetic counselling is deliberately neutral. You will get honest facts and help thinking them through, and the decision stays with you.
"This is the carrier's decision, so the other partner should stay out of it."
Any child is both of yours, and so is the choice. Partners who are left out often carry doubts for years. Counsellors prefer to see you together for exactly this reason.
"If we conceive naturally, we are being irresponsible."
Having children without testing is a legitimate choice that many carriers make. A child who inherits the fault can be told in adult life and watched closely from then on.
"Our elders need to be in the session for it to count."
You can bring anyone you want, but you do not have to. Many couples find it easier to decide privately first and then choose what to share with parents and in-laws.
Questions we are asked
Common questions about couples counselling
Do we both have to come to the appointment?
It is strongly encouraged but not required. If one partner works away or lives in another district, a video or phone link for part of the session is often possible. What matters is that both of you hear the options first-hand rather than through each other.
Can the session be held in Telugu?
Ask when you book. Hearing difficult information in your first language makes a real difference, and it helps the partner who is less comfortable in English ask their own questions. If a counsellor who speaks Telugu is not available, an interpreter can usually be arranged.
Will the counsellor tell our families what we decide?
No. What you discuss is confidential. The counsellor may encourage the carrier to let blood relatives know about the fault so they can be tested, but your reproductive decisions are yours to share or keep private.
We are engaged but not yet married. Is it too early?
No. Many couples find this the easiest time to talk, before pressure from a pregnancy or from family. It also lets the partner without the fault understand what they are joining, which tends to build trust rather than damage it.
Can we come if we already have children?
Yes. Couples often come after a result arrives with children already at home, asking about a future pregnancy and about the children they have. Testing of existing children for adult-onset genes usually waits until they are adults themselves.
Is couples counselling covered by Aarogyasri or insurance?
Coverage varies, and it changes. Genetic counselling may be billed as a consultation, while embryo testing and IVF are usually paid for privately. Ask the billing desk before the appointment so the cost does not come as a surprise.
What if one of us becomes very upset during the session?
That is common and it is fine. Counsellors are used to pausing, leaving space or finishing another day. If distress continues for weeks, they can refer either of you to a psychologist who works with families facing genetic results.
How do we start?
Ask the doctor who arranged the genetic test for a referral, or call the CION helpline and say you want to discuss family planning after a result. Have the report ready, and mention if you would like the session in Telugu.
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
- MedlinePlus Genetics — What is genetic counseling?
- National Cancer Institute — Genetic Testing for Inherited Cancer Susceptibility Syndromes
- Human Fertilisation and Embryology Authority — Pre-implantation genetic testing for monogenic disorders (PGT-M) and Pre-implantation genetic testing for chromosomal structural rearrangements (PGT-SR)
- NHS — Predictive genetic tests for cancer risk genes
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
Your reproductive options explainedEvery path to a family, side by sideFamily planning with a cancer geneWhere to start once a result is in handTelling a future spouse about a genetic resultHow and when to raise it before marriageHaving children anywayWhy conceiving without testing is a legitimate choice
Talk to us
Want to talk through your options together?
Tell us about the result and where you are in your plans, and we will arrange a joint session with a genetic counsellor, in Telugu if you prefer. One helpline serves every CION centre.