Meet Your Genetic Counselor: Lauri Black
Having grown up in the Pacific Northwest, I have been a transplant to the Bay Area ever since starting graduate school in 1996. I remained in the area for the fabulous professional opportunities. It was here I met my husband and now am also blessed with a son. I have always had a deep appreciation and love of nature. Living in the Bay Area has allowed me to nurture this passion in the form of surfing, sailing and most recently snowshoeing.
As a genetic counselor, I am a health care professional trained in human genetics and counseling. I have a Master of Science in Genetic Counseling and in 1999 was certified by the American Board of Genetic Counseling. Genetic counselors practice in several subspecialty areas of genetics, including assisted reproduction technologies, infertility genetics, and prenatal diagnosis. My job is to help you understand the complex information regarding your situation and enable you to make an informed decision as to what’s best for you.
The most common reason your infertility doctor would refer you for a consultation is to discuss the testing of embryos. There are two basic types of testing. Preimplantation genetic diagnosis (PGD) is the testing of embryos for a specific genetic disease known in the family. Preimplantation genetic screening (PGS) is the testing of embryos for general chromosome abnormalities such as Down syndrome.
The two main objectives in a genetic consultation for PGD/S are family history review and informed consent. During the review of family history, I take at least a three generation family tree (pedigree) to identify any additional genetic risks. This process helps to clarify the correct type of PGD/S being offered, as well as to identify any additional testing that might be appropriate. Medical records may be requested for review if there is a significant family history or to document familial mutations for PGD. This part of the consultation is typically less time consuming.
The informed consent portion of the consult includes an in depth discussion of the PGD/S process, from beginning to end, and a review of the information in the consent form. For those who have already had IVF treatment, some of this explanation may be familiar. However, as complex as the process of IVF is, embryo testing adds yet another layer of complexity. In addition to the steps in the IVF process, there are the biopsy procedures, the testing of a single or more cells for specific chromosome abnormalities, DNA markers, and/or gene mutations, and then the review of the PGD/S report results prior to embryo transfer. My job is to guide you through this process mentally, prior to the actual cycle, so hopefully there are no unanticipated outcomes for you. Even more critical is the consent form review before signing. Consent forms are designed to inform and protect patients. Important information is contained in the consent form, including risks and limitations of PGD/S, as well as the purpose of the procedure and the diagnostic technique. The informed consent portion of the consultation is typically the more in depth part of the discussion and is intended to address all of your questions about this option prior to your cycle start. I am available to answer these questions and witness your signature. The entire consultation usually lasts one and a half to two hours depending on the type of testing being discussed and the number of questions you have.
I also work with the PFC Egg Donor Agency to provide genetic risk assessment for all prospective ovum donors. The EDA has implemented this protocol to ensure that their donors have been screened in accordance to the American College of Obstetricians and Gynecologists guidelines. Any genetic risk from family history is addressed. This screening is just one of the ways the EDA works to optimize your pregnancy outcome when using an ovum donor.
In addition, I am available on request to provide a genetic risk assessment for you, even if there is no embryo testing or ovum donor included in your treatment cycle. Some of you may have questions concerning conditions in your families, and want to discuss what impact that history may have on your or your children’s future health. Discuss these concerns with your infertility doctor, so they may determine whether a genetic risk assessment consultation is appropriate for you.
I am grateful for the opportunity to work directly with PFC. I wish all of you the best in your family building pursuits.
Lauri Black, MS, CGC
Certified Genetic Counselor