Alyse Scarfe from Hastings, who lives with a BRCA1 gene mutation, conceives naturally.
Hastings woman Alyse Scarfe always wanted to be a mother, but the moral dilemma over how and if she should do it sparked not just a lounge-room debate but a national debate.
Now Scarfe, 28, is 33 weeks pregnant by natural conception and expecting a baby boy next month.
Herroad to this point has been filled with ethical challenges, disappointments - and sheer delight.
Scarfe, nee Aldridge, inherited a gene known as BRCA1 from her father, which makes her highly susceptible to breast and ovarian cancer.
BRCA stands for BReast CAncer, and all of her family carry the two BRCA genes, BRCA1 and BRCA2, a gene mutation that makes her, and potentially her children, highly susceptible to cancer.
In 2019 Scarfe spoke to Hawke's Bay Today and appeared on TVNZ show How Not To Get Cancer after finding out more about the Preimplantation Genetic Diagnosis (PGD) procedure.
Scarfe detailed how she was grappling with whether to have a PGD procedure, which genetically tests her embryos and safeguards her future children from inheriting the gene.
The PGD procedure involves creating an embryo via in vitro fertilisation (IVF).
One or two cells are removed when the embryo is at the six- to 10-cell stage (usually on the third day after fertilisation) and are tested for particular genetic conditions or chromosomal abnormalities.
Alyse Scarfe says while PGD procedure wasn't for her, other women should make their own choices. Photo / Paul Taylor
Unaffected embryos are then transferred to a woman's uterus and, if all goes well, a pregnancy results.
But it's also a process that - had her parents known about it and gone through it - would likely have meant Scarfe would never have been born.
"With the procedure, the embryos that have the gene would have been discarded," she told Hawke's Bay Today.
"I'm kind, confident, I contribute to society, I am a good person. Those embryos would be just like me."
When the cameras left and talk about the show died down, Scarfe and her husband Oakley decided after lockdown last year to try for a natural conception.
She's proud of that decision, and accepts that it's not always going to be the right one for other women.
"PGD wasn't for me, but other women should make their own choices," Scarfe said.
"I always wanted to be a mother, and shortly after lockdown we started trying for a baby. We fell pregnant quite quickly but sadly lost that one in August last year. In December I found out I was pregnant again."
There's a 50/50 chance her baby boy will have the BRCA1 gene, but the couple don't fear that.
They're looking forward to life ahead.
Alyse Scarfe has a BRCA1 gene mutation and is expecting her first baby and very excited about it. Photo / Paul Taylor
"We got married last year on June 24 and my husband is really excited to be a dad. From his point of view it was always going to happen the good old-fashioned way."
According to the Breast Cancer Foundation the risk of getting breast cancer is now thought to be approximately 57 per cent for BRCA1 mutations, and 49 per cent for BRCA2.
About 40 per cent of women with a BRCA1 mutation develop ovarian cancer by age 70 and 18 per cent with BRCA2.
This compares with a lifetime risk of approximately 12 per cent for non-inherited breast cancer and 1.3 per cent for ovarian cancer in the general population.
BRCA1 and BRCA2 genes normally produce tumour suppressor proteins that protect against cancer development, but when they become altered or mutated they can no longer repair DNA damage.
As a result, cells accumulate more genetic damage, which can lead to cancer.
Apart from this year because of her pregnancy, Scarfe still gets tested regularly with a breast screen and ovarian scan.
