Preventing HLA-B27 Gene Transmission: Options for Future Generations

How to prevent the inheritance of the HLA-B27 gene to the next generation?

Hello Doctor, I am a 26-year-old male who has been suffering from ankylosing spondylitis since I was 17.
I am concerned about the HLA-B27 gene being passed on to my future children, which could cause them to experience the same suffering.
I have heard that: 1.
Chorionic villus sampling (CVS) or amniocentesis can be performed after pregnancy to determine if the fetus is a "carrier" of ankylosing spondylitis; 2.
In vitro fertilization (IVF) can be done along with preimplantation genetic screening (PGS) and ultra-rapid preimplantation genetic diagnosis (Ultra PGD) to select embryos free of the disease, preventing ankylosing spondylitis from being passed down through generations.
I would like to ask: 1.
What methods are available to prevent the inheritance of the HLA-B27 gene to the next generation? 2.
Can chorionic villus sampling or amniocentesis accurately test whether the fetus carries the HLA-B27 gene associated with ankylosing spondylitis? What is the accuracy rate? 3.
Is it truly feasible to avoid having a "baby carrying the HLA-B27 gene" through PGS and Ultra PGD? Thank you for your assistance!

Wenwen, 20~29 year old female. Ask Date: 2023/11/28

Dr. Zeng Guosen reply Internal Medicine

1.
Currently, there is no method to prevent the inheritance of the B27 gene to the next generation.
2.
Techniques such as chorionic villus sampling or amniocentesis, along with PGS and Ultra PGD, may be able to address the presence of a baby with the HLA-B27 gene.
This involves technical and legal considerations, so it is advisable to consult with the institutions that perform these techniques.
Thank you for your question.

Reply Date: 2023/11/28

More Info

Hello! Thank you for your questions regarding the HLA-B27 gene and its implications for future generations, especially in the context of ankylosing spondylitis (AS). As someone who has been living with this condition since the age of 17, your concerns about genetic transmission are completely valid. Let’s address your questions one by one.

1. Ways to Avoid HLA-B27 Gene Transmission: Currently, there are no guaranteed methods to prevent the transmission of the HLA-B27 gene to future generations, as it is inherited in a Mendelian fashion. However, there are several reproductive options that can help you make informed decisions. Preimplantation genetic testing (PGT) during in vitro fertilization (IVF) is one of the most effective methods. This allows for the selection of embryos that do not carry the HLA-B27 gene before implantation. Additionally, genetic counseling can provide valuable insights into the risks and implications of passing on genetic conditions.

2. Chorionic Villus Sampling (CVS) and Amniocentesis: Both CVS and amniocentesis are prenatal diagnostic procedures that can provide information about genetic conditions in the fetus. However, it is important to note that while these tests can identify the presence of the HLA-B27 gene, they do not definitively indicate whether the child will develop ankylosing spondylitis. The presence of the HLA-B27 gene is associated with a higher risk of developing AS, but not everyone who carries the gene will develop the disease. The accuracy of these tests in detecting the gene is generally high, but the interpretation of results should be done in consultation with a genetic counselor or specialist.

3. PGS and Ultra PGD: Preimplantation Genetic Screening (PGS) and Ultra Preimplantation Genetic Diagnosis (Ultra PGD) are advanced techniques used in conjunction with IVF. PGS screens embryos for chromosomal abnormalities, while Ultra PGD can specifically test for single gene disorders, including the HLA-B27 gene. By using these methods, you can select embryos that do not carry the HLA-B27 gene, thereby significantly reducing the risk of having a child who may inherit the predisposition to ankylosing spondylitis. However, it is essential to consult with a fertility specialist who is experienced in these procedures to understand the success rates, costs, and ethical considerations involved.

In summary, while there are no foolproof methods to prevent the transmission of the HLA-B27 gene, advanced reproductive technologies such as IVF combined with genetic testing can provide options to help reduce the risk of passing on the gene. It is crucial to work closely with healthcare professionals, including genetic counselors and fertility specialists, to navigate these options effectively. They can provide personalized advice based on your specific situation and help you make informed decisions for your family's future. Thank you for your thoughtful questions, and I wish you the best in your journey ahead!

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