The emotional impact of genetic testing and aspects of counseling prior to prescription of oral contraceptives

Abstract

Background: Oral contraceptives increase the thrombotic risk in women with factor V Leiden. Emotional aspects of genetic testing prior to the prescription of oral contraceptives (OC), aspects of counseling and referral patterns are widely unknown.

Study design: Two hundred forty-seven women with and 132 women without factor V Leiden were interviewed by questionnaire.

Results: One hundred sixty-one women (65%) with factor V Leiden and 63 (48%) with wild-type factor V responded. One hundred seventy-one women (76%) reported being emotionally disturbed by genetic testing. Eighty percent of women with factor V Leiden and 16% of women with wild-type factor V were discouraged from OC use. Three percent of women with factor V Leiden were encouraged to take OC. Forty-one percent of women with factor V Leiden used at least one hormone contraceptive method after diagnosis. Only 46 women (29%) with factor V Leiden were counseled about the relevance of the mutation in case of pregnancy.

Conclusions: Testing for factor V Leiden has considerable emotional impact. Recommendations after testing are not consistently driven by the test result.