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Conception options

Some people simply accept the possibility of having a child with hemophilia. In countries where quality care with safe clotting factor concentrates is available, hemophilia is often seen as a manageable disease.

Where adequate care is not available, this is a more difficult decision. Some families choose to adopt or foster a child, or to use other conception options to eliminate the risk of having an affected child. However, these options are not always available or can be unacceptable for religious, ethical, financial, or cultural reasons.

ProcedureHow it's doneThings to consider

In-vitro fertilization (IVF) with pre-implantation diagnosis (PGD)

The woman’s eggs are retrieved and fertilized in the laboratory with the sperm from the woman’s partner. This is called in-vitro fertilization (IVF).

When the embryos are at a very early stage of development, a test is done to determine whether they carry the altered hemophilia gene. Only those that do not contain the altered gene are implanted into the mother’s womb.

This procedure is expensive and not available in many parts of the world.

The success rate for a pregnancy with IVF is approximately 30 per cent per cycle.

CVS or amniocentesis is still recommended to confirm that the fetus does not carry the altered gene.

IVF with egg donation

Using donor eggs from a fertile woman who is not a carrier of hemophilia ensures that the child would not be at risk of inheriting the hemophilia gene from the mother.

Again, IVF is expensive, with a success rate for pregnancy of approximately 30 per cent per cycle. The success rate is best when the donor is young. 

 Sperm sorting

Only sperm carrying an X chromosome is used. This ensures the birth of a female child.

The female child may still inherit the altered gene and be a carrier of hemophilia. She could experience bleeding symptoms, and may pass the altered gene on to her children.

This method is only available in specialized centres as a research tool and it is still under evaluation.

   Source: Adapted from All About Carriers, Canadian Hemophilia Society.