Can Hemophilia women plan pregnancy?

Hemophilia is a bleeding disorder; in this the blood doesn’t clot properly. It is caused when blood does not have enough clotting factor. If a woman is a carrier of hemophilia gene or suffers from the condition, there are chances that she might deliver a baby who also suffers from the same condition. But proper planning and precaution can help avert trouble. Here is what you can do before planning a baby:

• Carrier status should be confirmed prior to conception by proper history and confirmatory diagnosis. You should opt for prenatal counseling and if possible also opt for genetic counseling.
• These patients should be managed in a tertiary hospital and it has to be a team effort comprising obstetrician and hematologist. This is important as if the child will be carrying the gene, complications can happen at the time of birth also.
• They have to accept a 50/50 risk. This explains that the child may or may not have the gene. Hence post conception it is advised that a prenatal genetic counseling be done.

Following reproductive options are available:

• Conducting Invitrofertilisation with donor egg and if available pre implantation genetic diagnosis (this technique involves IVF with identification and selection of non affected embryos for transfer back to the uterus.
• Natural conception without prenatal diagnosis and accepting the risk and consequence of hemophilia in offspring.
• Natural conception with prenatal diagnosis by CVS (chronic villus sampling or amniocentesis) and termination if fetus is affected.
• Discuss normal delivery/ caesarian options with your obstetrician.
• Investigating the baby after birth and management accordingly.

Though a genetic disorder like hemophilia cannot be prevented but taking requisite steps can ensure a good outcome. Moreover it is essential to the risks and be prepared for the future.