Yes, people with Adrenoleukodystrophy (ALD) can have children. In fact, some individuals with ALD have already had children and will continue to do so.
ALD is an inherited disorder caused by the X-linked recessive gene, meaning males are usually more severely affected than females, but both can be carriers of the disease. For an individual with ALD to have a child, they must either have one unaffected parent who is a carrier of the gene, or they must be a carrier themselves.
In the case of a carrier, the risk of passing on the mutated gene to their child is 50%, and if both parents are carriers, the risk is 25%. In such cases, it is important to undergo genetic counseling to ensure that the couple is aware of the risks associated with having a child, as well as the options available to them if they do decide to have a child.
For couples where one partner is affected by ALD, there are a few options available to them. In some cases, preimplantation genetic diagnosis (PGD) may be used to select unaffected embryos for implantation. This is a procedure that is done in conjunction with in-vitro fertilization (IVF). PGD is used to test embryos for the presence of the mutated gene before they are implanted.
In other cases, couples may opt to use donor eggs or donor sperm in order to avoid the possibility of passing on the mutated gene. This is a personal decision, and one that must be made with much thought and consideration.
Overall, ALD is a complex disorder, but it does not necessarily mean that individuals with this condition cannot have children. With the help of genetic counseling and medical support, many couples affected by ALD have successfully had children.