What reproductive options are available for hereditary cancers beyond PGT-M?

• A. Prenatal options include prenatal diagnosis (invasive testing) and counseling; noninvasive options exist but may have limited gene-level resolution for some syndromes.
• B. Only PGT-M is available.
• C. Prenatal options are illegal.
• D. No prenatal options exist.

Answer: (B)

The main point here is how to prevent passing a hereditary cancer variant to offspring. The approach that directly removes the risk before pregnancy is achieved is preimplantation genetic testing for monogenic disorders (PGT-M), which screens embryos for the specific pathogenic variant and allows selecting unaffected embryos for transfer. This preimplantation step is the most proactive way to ensure a pregnancy without the familial mutation.

Prenatal testing after conception, such as invasive diagnostic testing during pregnancy, can reveal whether a fetus carries the mutation, but it doesn’t prevent the birth of a child with the risk variant and often leads to difficult decisions mid-pregnancy. Noninvasive prenatal testing currently lacks reliable, gene-level resolution for many single-gene cancer predisposition syndromes. Because these options do not provide the same preimplantation guarantee of an unaffected pregnancy, the scenario in this question treats PGT-M as the primary, targeted reproductive option beyond simply diagnosing the fetus during pregnancy.