Genetic Diseases- would you risk children?

[Pandora II]

Date: 4/26/2009 4:50:30 PM
Author: naeem
Consider adoption. It can be a great alternative.
Find out more about this disease. There must be more than you know now.
I studied genetics in college. Some traits skip generations. Maybe your issue does do.
Your parents or his parents might have had it but it would skip you and your husband and go to your kids, so you would not want this. If your mother or your husbands mother passed it to one of their children, then the grandkids could be safe.
Talk to a genetic expert at a major research center.
Consider an egg donor or sperm donor, this way your child is at least half yours or your husband''s and this might be better than adoption.
Adoption you would be taking a child who needs parents.
Having your own and risking the disease is again like adoption, it''s a call from God.
If God gives you a child that has the disorder, then he chose YOU and your husband for a reason. Would you reject your own child because of the disorder or give the child every ounce of your love for as long as you or the child shall live?
Maybe God wants you to adopt a child.
Talk to God, speak to a genetic expert, etc.

PKD is autosomal dominant therefore it does not skip generations - you either have it and have the possibility to pass it on or you don''t have it and it has burnt out as far as your descendants are concerned.

I notice a lot of people mentioning adoption - in the UK you cannot adopt if you have an illness that will significantly impact on your health or risk of dying young - even conditions like obesity will rule you out - let alone a condition like PKD. Are the rules much more lenient in the USA?

 

[icekid]

Date: 4/26/2009 7:18:28 PM
Author: neatfreak

Date: 4/26/2009 6:31:24 PM
Author: cara

Date: 4/26/2009 4:36:05 PM

Author: MCI don''t understand the adoption alternative because by adopting a baby, there is still a chance that he/she will have some sort of genetic disease that will be discovered at some point.


I''m not sure what I would do with PKD because aside from your post here, I know absolutely nothing about it. While pregnant with my first son, I developed Gestational Diabetes and discovered that diabetes runs in my family and that my children would be at risk. I still decided to have a second child so yes, I did have a child knowing of risk. Both of my kids are fit and active, so hopefully they never become sick with it.

Its a matter of the level of risk (say 5% versus 50%) and a matter of choosing to bring into the world a child with a known, high risk of having a certain disease. For couples with very bad odds on the genetics of their biological children, it might be that an adopted child of unknown genetics is at much lower risk of having *any* serious genetic disease than a biological child of the couple. But secondly, someone else made the decision to bring the adopted child into the world. That child exists already, so whether or not it has an unfortunate genetic disease is already determined and not the result of any action taken by the potential adoptive parents. If those parents were to have a biological child knowing that their genes are likely to cause the child to have a horrible disease, I think that is a qualitatively different decision than adopting a child, even if the child ends up having a horrible genetic disease.


As far as your decision to have biological children with a known higher risk of diabetes, I think that was an understandable decision given our understanding of diabetes genetics, treatment, and progression. While diabetes has a genetic component, it is not clear that the genetics is simple and genes are not perfectly predictive of whether or not one will get the disease - there are identical twins (same genes!) where one gets diabetes and the other does not. Also diabetes is a serious disease with lifelong consequences, but still not as bad as many other diseases out there. Would you have made the same choice if, say, you and your husband were carriers for TaySachs and any child you produced together had a 25% chance of dying a horrible death in early childhood? Maybe you would have, but it certainly gives most people pause to consider it.


In case of the OP, the genetics is simple and known, and the odds of passing on the PDK disease are quite high (50%), and the disease sounds bad but not quite as bad as some others (Huntingtons, Tay-Sachs, Cystic Fibrosis). Its a tough situation.

Exactly Cara. A child you adopt is ALREADY born. They are in this world and they need love and support. IF they happen to develop a genetic disease down the line then they do. But it''s very different IMO than knowingly birthing a baby that has a 50% chance of having a potentially fatal genetic disorder. Very different.

I agree!! No genetic problems within our families, as far as I know. If there were, I would definitely adopt (which I plan to do anyway.)

 

[E B]

Date: 4/26/2009 6:31:24 PM
Author: cara

Its a matter of the level of risk (say 5% versus 50%) and a matter of choosing to bring into the world a child with a known, high risk of having a certain disease. For couples with very bad odds on the genetics of their biological children, it might be that an adopted child of unknown genetics is at much lower risk of having *any* serious genetic disease than a biological child of the couple. But secondly, someone else made the decision to bring the adopted child into the world. That child exists already, so whether or not it has an unfortunate genetic disease is already determined and not the result of any action taken by the potential adoptive parents. If those parents were to have a biological child knowing that their genes are likely to cause the child to have a horrible disease, I think that is a qualitatively different decision than adopting a child, even if the child ends up having a horrible genetic disease.

Exactly. Well said, cara (as usual

).

 

[Italiahaircolor]

No, I don''t think I would. Sorry.

 

[fisherofmengirly]

I think that everyone has the potential of passing on some form of something that is considered less than ideal (as some others have mentioned: diabetes, a disposition towards heart issues later in life--which can be effected by lifestyle, high blood pressure...) and while that's not something you would *wish* on your child, there is no such thing as perfect DNA or genetic make up.

I suppose it is different when considering life debilitating diseases, however. *If* we had any family members with any of these issues, we would talk more in depth about it, I'm sure. Happily, that's not the case and we're not of any of the ethnic make ups that are of a higher disposition to some of the really detrimental diseases you so often hear people testing for. If we were, I can see how we would possibly do some testing, but again, with it not being in our lineage, I don't know that we would.

We are of the mindset and belief system that children are created for a reason, one of which being to be born, not to be terminated if they're not the world's idea of perfect. HOWEVER, that's not to say that adults shouldn't take into consideration the likelihood of having a child with severe disabilities, and perhaps make choices to be parents by means other than conception if there are red flags.

It's a very delicate issue, and I'm very proud of you and your guy for thinking about it so early into your relationship. It's something some people never consider. (Not knowing any thing more than what you've posted about PKD, I've not spoken to that topic specifically.)

 

[fisherofmengirly]

Date: 4/26/2009 7:28:08 PM
Author: Pandora II

Date: 4/26/2009 4:50:30 PM
Author: naeem
Consider adoption. It can be a great alternative.
Find out more about this disease. There must be more than you know now.
I studied genetics in college. Some traits skip generations. Maybe your issue does do.
Your parents or his parents might have had it but it would skip you and your husband and go to your kids, so you would not want this. If your mother or your husbands mother passed it to one of their children, then the grandkids could be safe.
Talk to a genetic expert at a major research center.
Consider an egg donor or sperm donor, this way your child is at least half yours or your husband''s and this might be better than adoption.
Adoption you would be taking a child who needs parents.
Having your own and risking the disease is again like adoption, it''s a call from God.
If God gives you a child that has the disorder, then he chose YOU and your husband for a reason. Would you reject your own child because of the disorder or give the child every ounce of your love for as long as you or the child shall live?
Maybe God wants you to adopt a child.
Talk to God, speak to a genetic expert, etc.

PKD is autosomal dominant therefore it does not skip generations - you either have it and have the possibility to pass it on or you don''t have it and it has burnt out as far as your descendants are concerned.

I notice a lot of people mentioning adoption - in the UK you cannot adopt if you have an illness that will significantly impact on your health or risk of dying young - even conditions like obesity will rule you out - let alone a condition like PKD. Are the rules much more lenient in the USA?

Slight Thread-Jack:

Pandora,

I''ve noticed you mentioning this in past posts, as well. I have been looking into it, since it was so surprising to me when you were talking about all the rigorous steps involved in adoption in the UK. I think that in the US, it can be less of a struggle, but it depends on how you go about adopting. In the UK, is it all through the Gov? Here, there are tons of private adoptions, and those *can* be less rigorous. A ton of US adoptions are actually through the means of adopting children from other countries. The majority of US adoptions of US children happen by way of the Children Protective Services, and those typically are not of newborns (which sadly is the preference). I cannot speak to what the steps are in private adoptions, but in the state of GA, you have to have a clean record (criminal), you have to have a home that is considered fit and safe and with enough room to add a child into the home, and you have to be monitored by the State with the child in the home for several months, you have to have a home study (they visit unannounced, call family members not living in the home, look at your work life, check your financial stability, all that kind of thing), and you have a medical and medicinal history completed. They also look at the stability of the marriage (or any other such relationship a person/people are in when looking to adopt), and from what I''ve noticed, this is the *biggest* reason families are not chosen as candidates of adoption here. Obesity has never been an issue I''ve heard of for a parent not being able to adopt. I suppose that in extreme cases (mobility issues, etc.), it could be considered, but the the typical overweight person wouldn''t be ruled out from being a parent to a child in State custody based on that. Mental health issues is something that is a red flag, as so many people with MH issues don''t always follow up with care and think that they''re just healed out of nowhere. Obviously you need to be in good health, but it sounds like the UK is *much* more strict as to who can adopt their children than the US tends to be. Again, the US has certain standards that all states must follow, but it''s typically left to the State for the fine lines. In Georgia, most people have to be foster parents before they can adopt, and that entails a lot of home studies, random visits at random times, and multiple classes on parenting, CPR, dealing with difficult children (most children adopted through this means have been abused of some sort to some degree), etc. Hope that helps!

End Thread-Jack.

 

[swimmer]

Can you get an appt with a genetic counselor? DH and I went when tests revealed that I am a carrier for several things. It turns out that DH is a carrier for other chronic conditions, but we aren''t carriers for the same ones. That helped us to make our decisions. Getting real statistical data is important, life is full of surprises but information is power.

 

[Hudson_Hawk]

My family has a very deep gene pool (LOL) with lots of issues (Cystic Fibrosis and Osteogenesis Imperfecta to name a few). We will most DEFINITELY have genetic testing/counseling done prior to TTC and will base our decisions on the outcome of that. If I were to become pregnant prior to that and we discovered that the baby had OI or something else horrible like that I would not carry to term for the child''s sake, not my own.

I''m 100% resigned to the fact that my children will most likely have Celiac Disease. I have it, my brother has it, my paternal grandmother has it and a maternal cousin has it. It''s very dominant on my side. That being said, it''s a condition that can be managed and it''s probably one that can be managed on the family-level easier than on the individual-level.

 

[MichelleCarmen]

Date: 4/26/2009 6:31:24 PM
Author: cara

Its a matter of the level of risk (say 5% versus 50%) and a matter of choosing to bring into the world a child with a known, high risk of having a certain disease. For couples with very bad odds on the genetics of their biological children, it might be that an adopted child of unknown genetics is at much lower risk of having *any* serious genetic disease than a biological child of the couple. But secondly, someone else made the decision to bring the adopted child into the world. That child exists already, so whether or not it has an unfortunate genetic disease is already determined and not the result of any action taken by the potential adoptive parents. If those parents were to have a biological child knowing that their genes are likely to cause the child to have a horrible disease, I think that is a qualitatively different decision than adopting a child, even if the child ends up having a horrible genetic disease.

In case of the OP, the genetics is simple and known, and the odds of passing on the PDK disease are quite high (50%), and the disease sounds bad but not quite as bad as some others (Huntingtons, Tay-Sachs, Cystic Fibrosis). Its a tough situation.

Thanks for answering, Cara. What you said makes sense. . .

Later yesterday I was thinking again about the OP's question and decided I would not have a baby knowing he/she had a 50% chance of a needing a transplant.

Oh, and someone I know has Huntington's. Her mom and other relatives have it (grandma, mom and/or aunt) and she went ahead and decided to have a baby. A little girl. Wikipedia says a test can be preformed pre-birth and obviously "raising various ethical issues and heated debates."

 

[mayachel]

From purely a cost perspective, though IVF is expensive, I don''t believe it is possibly more expensive than the total years of care and medication required for dialysis and transplant. While a kidney is one of the "easier" organs to get, it still makes a huge assumption that one will be available, and that the potential complications of major surgery will be minimal. In terms of thinking about the potential child first, I believe if it is an either/or choice (and it never is that simple) selective IVF is much more compassionate and cost effective.

 

[SarahLovesJS]

Honestly? This is a really difficult situation, but I would adopt and not have children of my own if I confirmed the risk of our children having the disease was great. Granted, I have a personal situation here in that my Grandpa went through kidney failure (not due to this disease, but he did have a horseshoe kidney which meant he only had one to start with) and he died within a few years of kidney failure at the age 60. Watching the dialysis was terribly painful...I am sending prayers to your FI and his family and of course you.

 

[zhuzhu]

Genetic testing can be done during pregnancy to determine if the baby is affected with autosomal dominant polycystic kidney disease (ADPKD), although it is not recommended for several reasons:

* The test is not perfect and may falsely identify the baby as having ADPKD when it does not
* The test may fail to identify ADPKD when it is present (too many possible variation within the genes to screen them all)
* Some people with gene mutations will never develop symptoms of ADPKD
* ADPKD does not cause symptoms until middle age in most people (by which time there may be effective therapy to prevent cyst growth).

There are a lot of other medical conditions that can result in ESRD. Hypertension and Type 2 diabetes are 2 of the most common risk factors. We are all at risk for SOMETHING. It is really up to you and your DH as it is a deeply personal decision. I agree that you should meet with genetic counselor together to get as much information as you can.

 

[cara]

Zhuzhu, I''m not sure where you got your information, but I don''t think it is entirely applicable for the OP. It might be that routine prenatal screening for PKD is not recommended for the general population, but when a biological parent has been identified as having the disease and there is a family history then the circumstances are different. I personally would be interested in testing were I in that position, and would be very concerned with a blanket recommendation against prenatal screening for couples with a 50 % chance of passing it on to their child.

I am not an expert on PKD or genetics, but my husband works on an autosomal dominant heart condition with roughly similar prevalence and severity, and some families do opt for pre-natal genetic screening. So these are my thoughts:

* The test is not perfect and may falsely identify the baby as having ADPKD when it does not

Yes, but at what rate? False positives are very important if this test were to be recommended for blanket screening of the general population, because the true positive rate would be so low. For example, if the disease has a prevalence of 1:500 in the general population, then if the false positive rate were also 1:500, screening the general population would result in an equal number of true and false positives. Not so good. But when the true positive rate is expected to be 50% as is the case for the OP and her FI, I am hoping the test would have a low enough false positive rate to be quite useful and reliable.

* The test may fail to identify ADPKD when it is present (too many possible variation within the genes to screen them all)

For one, I am assuming that the OP''s fiance has been genetically tested. That means a specific PKD-causing mutation has been identified for this family and there is a test for it, so that is the one mutation you would look for in a fetus. If by chance they have not identified the exact mutation (and the OP''s fiance has received his diagnosis on the basis of medical symptoms rather than a genetic screening), this would be an appropriate place for a family-wide genetic test to help determine the mutation. It is much cheaper than testing many individuals separately, and it seems enough people are affected in this family to make it worthwhile if the OP (or others in her fiance''s family) are interested in pursuing genetic testing either for pre-natal purposes or to know whether they have the gene or not.

Of course it is possible that the fetus could have a random PKD-causing mutation distinct from the one his father has, but the odds of that are comparable to the odds of a random fetus having a spontaneous PKD-causing mutation without a family history of the disease (ie. very low.)

* Some people with gene mutations will never develop symptoms of ADPKD
and * ADPKD does not cause symptoms until middle age in most people (by which time there may be effective therapy to prevent cyst growth).

True, the course of the disease is variable and treatment options may improve in the future. But according to the PKD website about 60% develop end-stage renal failure. And it seems that there are other serious risks from the disease. Certainly evaluating the severity of the disease and the likelihood of treatment improvements in the future is part of the analysis.

But here is my worry. It might be that the OP and her fiance get to watch his mother deal with this disease, hopefully for many years, and then, in a few decades, deal with the FI having the disease. It gets wearying. If I were in a position, now, to end the cycle and spare my children this particular future, I would want to do that. Of course if I already had children or were blissfully ignorant of the genetics, then what will be will be and you make the best of it. And another person might think long and hard about the odds and factors and make a different choice.

 

[curlygirl]

Date: 4/26/2009 1:51:52 PM
Author: neatfreak
I''d do pre-screened IVF or adopt personally. But that''s just a personal choice that only you can make for yourself.

I agree. I have a friend who is a hemophilia carrier and she did IVF with PGD and was able to give birth to a daughter who doesn''t carry the hemophilia gene. She also has some frozen embryos that are also not carriers in case she wants to have more children. It''s definitely expensive so it may not be an option but I think that would probably be my first choice and if that wasn''t feasible for one reason or another, I would look to adoption. Very tough choice, I wish you all the best as you make this decision.

 

[zhuzhu]

Thank you Cara, for the additional information and clarification. Yes, the summary points I posted were taken from an educational organization addressing "population-based screening" feasibility. I did not take into account that her fiance had already been tested for family-specific mutations. If it is known, yes then it is important to look for the same risk markers to assess the risk profile. Here is is a paragraph on linkage analysis, applicable for genetic screening on families with history of ADPKD. It is taken from a review article by Pei in Clin J Am Soc Nephrol 1: 1108-1114, 2006.

"DNA linkage analysis requires both the genotype and the clinical information from multiple affected and unaffected family members, as well as from the at-risk individual being tested. By typing multiple polymorphic DNA markers that flank the PKD1 and PKD2 loci in the study subjects, linkage analysis seeks to identify a segment of the chromosome at either the PKD1 or the PKD2 locus that completely co-segregates with the disease. For clinical testing, Bayesian statistical algorithms are used to provide a probability estimate of linkage of the family to a disease locus. When the flanking polymorphic markers are informative, the prediction of disease in an at-risk individual can be highly accurate with an error of
For the general population with no known family history of the disease, the genetic screening is commercially available but expensive, and with unfavorable sensitivity and specificity profile.

"Gene-Based Mutation Screening
..Despite the challenges that are imposed by the genomic complexity of PKD1, mutation screening of the entire PKD1 and PKD2 coding sequences and their splice junctions from DNA templates now have been developed, allowing for comprehensive screening of these genes. To date, approximately 200 different PKD1 and >50 PKD2 mutations have been reported, with most of them predicted to truncate the mutant protein (as a result of frameshift deletions and insertions, nonsense mutations, or splice defects). Most mutations are unique to a single family and scattered throughout these genes with no clear "hot spots". Therefore, exon-by-exon screening of these genes is required to ensure a high sensitivity in detecting disease-causing mutations.

To define the sensitivity of the gene-based diagnosis of ADPKD, mutation screening of both PKD1 and PKD2 by denaturing HPLC followed by sequencing of PCR fragments with altered elution profiles was performed in a recent study of 45 patients with genetically uncharacterized ADPKD. In general, there was a high rate of missense mutations detected in PKD1, with an average of five per patient. By contrast, only two PKD2 polymorphisms were detected in the entire patient cohort. Despite comprehensive screening of both genes, protein-truncating mutations in PKD1 and PKD2 was found in 26 patients and three patients, respectively. Therefore, the overall sensitivity for detecting a definitive mutation was 64%(29 of 45). The reasons for this relatively low mutation detection rate in this patient cohort are unclear. It is possible that some of the missense mutations identified in fact may be pathogenic. However, in the absence of a valid functional assay, it is difficult to differentiate the disease-causing missense mutations from benign polymorphisms. In addition, mutations in the gene promoter region, which may affect gene expression, have not been screened. Gene-based diagnosis of ADPKD is available commercially (Athena Diagnostics, Worcester, MA; http://www.athenadiagnostics.com). The main advantage of this test is that only a blood sample from the test subject is required. However, it is expensive, and although the sensitivity data for detecting a definitive mutation have not been published by the company, a definitive mutation likely is found in no more than approximately two thirds of the test subjects. Therefore, this screen is useful only when it is positive."

 

[zhuzhu]

Latte, I would like to clarify that I am no advocating "for" or "against" genetic testing in your case. In fact I am not comfortable providing suggestion on if you should get pregnant or not (or what I would do personally, as it may indirectly influence your decision) - because I do not know you on the personal level. Unless I know what your stands are on abortion, response to stress, and tolerance for health risk..etc; it is impossible for me to make unbiased recommendations that will be beneficial to your specific case. I believe professional genetic counseling is your best place to start, as counselors are trained to take data specific to your family into account, and to help you formulate your own decision.

 

[movie zombie]

short question, short answer: no.

mz

 

[Black Jade]

I think you answered your own question when you said that you were so glad that your fiance''s mother decided to have him.
You would rather have him even knowing he has this disease (since you have not cancelled the wedding). Why not give some other person the chance to make the choice you are making in the future?

I don''t think we as humans know enough to decide who has quality of life and who doesn''t. I know people with Down''s syndrome children, people with hemophiliac children, I myself have a bipolar child--these things are not easy but the child who has them is still a valuable human life. I had a brother who had cerebral palsy and lived two years. My parents are from a third world country and there were no social services, and poor medical care. My mother didn''t even have running water in the house! The cerebral palsy was so severe that he was never even able to lift his head up. Yet my mother says that having him for those two years was very, very important in her life, stretched her and grew her and it was a an experience she''s glad she didn''t miss. She gave me good advice when I was pregnant with my child and the doctors suggested an abortion because they believed that he had a disease where he had a spine, but no brain. They said that he would just suffer and suffer and die in a couple of days anyway. It turned out that this was not true--they had made a medical mistake. But I would not have had an abortion in any case.

We all want to avoid suffering, yet it''s through suffering very often that there is growth and change. Just like a diamond would remain a piece of carbon without heat and pressure, and remains an rather ugly rock without the painful process of being faceted, so we too can remain stunted if we spend our lives avoiding all possible pain (or try to avoid pain for our children).

You have to be very careful--when you say, I would have never have a child with such-and-such a disease because I wouldn''t want them to have to go through that, it''s selfish. Often what you really mean is that YOU are afraid to go through whatever it is, and YOU are afraid to watch them suffer.

And when does it end? Few children with Down''s syndrome are not allowed to be born in this country. Leaving all discussion of her politics aside, it is a fact that Governor Palin took a tremendous amount of flack last year just for being the mother of Down syndrome baby that she had chosen not to abort. I heard health services people saying how selfish she was to do that and what a bad example she was setting. A little further along this road, in England it came out last year that children were being aborted in the womb for having harelips, which an operation will easily fix. But the mother''s don''t wish for that inconvenience. In India now in certain provinces, the mother''s don''t want to bear baby girls. You have to pay a dowry to marry a daughter off eventually, so they abort them to avoid this in the future. There are whole provinces where there are severe boy-girl imbalances.

I just think that we need to be careful. I have brought up extreme cases here. You of course are not contemplating an abortion or something of that nature, but contemplating deciding not to have children, which is a right you should have, but I think you''d miss a lot if you decided not to have children for this reason. I have a friend, she has a sister who is psychotic (delusional); has Asperger''s abd severak mental illnesses and is in and out of mental hospitals, plus has struggled with homosexuality and other issues. My friend was very concerned and did not wish to have cihldren (this was not the only mentally ill person in her family). She was married almost twenty years ago and was SURE she would not have children and her husband agreed with her. Five years ago she got pregnant accidentally in spite of her precautions (which happens, unless you''re actually sterilized). She had a miscarriage--but saw at that time how excited her husband was and decided to have a child. She has two children now and both seem fine and are a delight. Of course, she is not home-free. My son''s bipolar did not show up until he was twelve. Since then we have struggled with it. But he is worth it.

My friend''s sister, by the way, is also a delight. She is about forty now and has many many struggles. Sometimes things are very bad. But sometimes they are very good. She can''t always take care of herself and has been hospitalized several times since I have known them, sometimes under not very good circumstances at all. But she is highly intelligent, very gifted artistically, wonderful with children and is leading a valuable and fulfilling life. She has given her parents grief and worry and she has also given them great delight. She has become my close friend also; I have learned a lot from her and am proud to know her. And she is the greatest aunt ever.

 

[zhuzhu]

I am sorry, Black Jade, to hear about your struggle in taking care of your bipolar son. You are a very brave and loving parent.

While I agree with you that people should not rule out having children just because of the presence of the genetic diseases, I don't think it is selfish to no have them either. You said "You have to be very careful--when you say, I would have never have a child with such-and-such a disease because I wouldn't want them to have to go through that, it's selfish. Often what you really mean is that YOU are afraid to go through whatever it is, and YOU are afraid to watch them suffer."

Of course it is the parents who are afraid to watch their children suffer, but how is that selfish to not want your loved ones to suffer? If the "child" has not even been conceived yet, what kind of damage can you actually do to a "theoretical baby" by not having it?

I admire your strong belief in pro-life, and your strength/abilities to manage all difficulties associated with caring for the children with medical issues (BTW, I don't think homosexuality is a medical issue, and I am not sure what you meant by "she has struggled with homosexuality"}; however not all want-to-be parents have the resources you have. If they are facing an important decision like having or not having baby because of potential disease of strong genetics factor, I say it is better to let professionals to guide them through what that best decision is.

 

[MakingTheGrade]

I think for something like that I would try for IVF/fetal screening. Even if that were not an option, something like this which doesn''t manifest until your 40''s and is treatable, I think I might be willing to roll the dice for a few reasons, one of which being the progress in medical technology. Who knows what new breakthroughs will be made in the area of transplantation in 50 years? There is research currently from all directions (gene therapy, stem cell, organ growing, better immunosuppression) that may result in a much better standard of life in the future, if not an outright cure. Of course, that might not happen in their life time, but again, it''s treatable with dialysis, and as hard as that is on a person, it''s not a death sentence.

But that''s just me personally, you have to do what''s right for you!

 

[MonkeyPie]

Short answer: no.
Longer answer: Why anyone would bring a baby into the world when there was a 50% or more chance that they would have a long, hard, difficult life is beyond me.