This is something that has been on my mind a fair bit lately. We've taken our son into the pediatric endocrinologist because he's under the first percentile for height. My husband is five feet two inches. I'm five feet three. We're not huge...but I'm really worried that our son will be even smaller. Being a short man (our daughter is also short, but it's not as big a deal for women, I don't think) is not an easy road in our society. My husband had some unhappy times as a kid and as a teenager. He came through it pretty well...but I don't really want my child going through that. The verdict from the endocrinologist was that he is likely to have a growth hormone deficiency, which is good in one sense...that means that there is something to be done that can help him. But then again, it means daily shots for seventeen years. I've actually had several people say to me (jokingly) "Didn't he disclose his genetics before you agreed to marry him?" (He's also ADD, both my kids have gotten webbed toes, weird shark teeth run in the family...there's more,but I'll spare you). Yes, I did think about it. Especially the ADD one. Did I really want to run the risk of passing on some of these things to my kids? Have them be unhappy for some or all of their lives because of some of the effects of the problems? And my answer was yes. My husband and his family are attractive (my kids' big eyes and long eyelashes are all him!), very intelligent, creative, funny, and generally fantastic people. There are too many good things in the genetic mix to say that it isn't worth passing on the few not so great ones. Besides...my family has its own issues. We have a strong history of all sorts of addictions, my mother is bipolar (that's the least of her problems!), we have bad skin as teenagers...I'm sure I could think of a few others if I tried. I don't think anyone is perfect in the genes department. But most of us have good things to pass on as well. So I'd say...weigh it up. Find out if the good things about the parents outweigh the potential bad. And good luck keeping the decision rational. This is a visceral, evolutionary drive. I don't think rational thought will work that well!

I am bipolar, and it ws really a rogh stint from 18 to 20, let me tell you.  Treated, it's not nearly as bad.  However, since I KNOW my kid is at risk for the disorder, I know to keep an eye out for symptoms, and not bash those with mental illnesses (thanks, mom and dad).  I think she should be okay, and that treatment could come her way much earlier than it did for me.

I think if it were Huntingtons or Cystic Fibrosis...or some other crippling or fatal genetic disease, I'd be far more likely to be worried, but since it IS something I've survived, and there's so many treatment options, I (and DH) weren't too worried...at least not enough to forgo having DD and DS-to-be.

I think it's often based on what a person's experience was.  So if your genetic history has caused you or a family member significant trauma, adoption may leap to the foreground on the reproductive choices map.

As an adoptive parent I will say that you don't necessarily know a child's full medical history.  In international adoption I believe it's general rare to know that much information and even in domestic adoption it's not always all known.
Adoption is fantastic, don't get me wrong, but I didn't feel either better or worse about genetic stuff through adoption.

I think it is wise to gather resources prior to having children, in general.  If your children will be at risk for various diseases that's a great spot to focus a bit of energy.

to be an inherited condition.  In fact, honestly, I probably have more than one.  Its true that the one can be extremely debilitating and disabling, but my doctor did tell me that those of us with the worst cases almost never had children who were as effected...he believes that it takes inheriting certain genetic material from both parents to cause more extreme cases in younger people.  That makes sense to me as I have suspicions about both sides of my family.  I do have two kids who have been diagnosed with very mild versions of my condition, and quite frankly, all of them show symptoms.  

This bothered me for awhile, until I started thinking about all the other crappy genes I had inherited and was passing along, too.  People in family develop diabetes, every manner of heart disease, and osteoporosis at alarming rates...and since my husband was adopted, we have no idea what time bombs he could be carrying.

So, I think few of us can afford to worry.  I've come across few who have no reason to believe that they are carrying anything other than perfect genes.  And quite frankly, the only way to be sure of that would be to have whole families who died young due to accidents...and then I'd questioned whether risk taking behavior was a genetic problem...

Now, for diseases that we can test for like cystic fibrosis, I would ofcourse get prenatal testing and go from there...and I would consider myself lucky if I had two or three pregnancies without passing it along.

I don't know, I think you are always taking a chance when you have a child, whether through birth or adoption.  You don't ever really know what the future is going to hold, or what challenges the child could face.  

While there are genetic predispositions, as far as I know, no genes have been identified for most mental illnesses, including bipolar.  I also find it interesting that your sister would take so much comfort in the idea of adoption.  While I know there are ways to get medical histories and all of that, mental illness is quite nebulous, again, you cant' really be 100% sure that there is nothing lurking in a family's history.

My MIL, her father, & uncle all had polycystic kidney disease, which is hereditary.  The father had one of the first kidney transplants, but it didn't take and he died in his 40s.  The uncle was one of the longest living people on dialysis when he died in his 70s.  My MIL had a kidney transplant seven years ago, and has complications, but it saved her life, and money, because she did it before she had to go on dialysis.

DH & his brother show no signs of it, nor do any of their cousins.  We defintiely discussed this when we decided to have a baby.  I think we were more concerned about the fact that we have to keep it quiet, because DH & possibly DS would not be insurable (pre-existing condition, you know).  But as far as the disease, we know it's there, and we hope that in 30 years, which is when many people get symptoms, if DS has it, there will be a cure.  I don't know the percentages on passing it on, but we decided that it's a disease that's manageable, we know it's a possibility so we can watch for it, and we just have to put it in the back of our minds like we do all the other horrible things that could "possibly" happen.  We are having faith that everything will work out, and if it doesn't, we will be able to figure out how to handle it.

That's our motto.  Dh's family has a number of mental health issues, ranging from a brother who has schizophrenia to a sister who's bipolar and a range of anxiety and depression issues. across the board.  We watch our two kids (4 and 6) very carefully for signs of developing issues, we both have therapists, and we know that early intervention (as with any condition) is the key to living with a mental health issue.  If something emerges, we don't have any problem with taking any kid to the appropriate counselor, using meds, whatever- and we're planning to talk with both kids about their mental health histories when it becomes age appopriate- just as we would talk about other significant issues (alcoholism, breast cancer) if they existed in our genetic histories.  Having a baby is always a crapshoot- you never know what you're going to get.  Adoption is the same in many ways, since she won't know the full health history of the baby anyway (or perhaps she will?  I'm not sure about that these days.)  In any case, you never can tell what will emerge- not all mental health issues can be traced back to a genetic predisposition- sometimes things just happen.

First, my disclosures so you all know my biases up front:

• I have a PhD in genetics.
• Both of my children are adopted.
• I have a hereditary condition (not psychiatric).
• My elder son has a hereditary abnormality in one eye; my younger son is tiny, in the bottom 1%.

As a geneticist I tend not to over romanticize genes; they change too much in the mix from generation to generation.  Genes just don't impress me much.  But actual hereditary disorders - whether or not the actual genes have been identified - are another story.  These are worth evaluating; there are some I myself would not risk passing on.  At the same time, adoption isn't a form of quality control.

As Laura pointed out, every child is a crapshoot.  You might pass on your husband's disorder, your own sunny disposition, or great-uncle Ernie's violent temperment that you don't even know about because it's been lurking silently in your genes for generations and the family never talks about Ernie anyway.  Maybe all of the above, and ugly to boot.  You'll love them just as much regardless.

Everyone has traits worth passing on, but your genes are unlikely to be "better" than the genes of the child who needs a family.  And deciding for or against biological children neither validates nor denies the value of your own life.  The decision should simply be on it's own merits.

My children, by the way, are perfect.  Every mother loves the children she has, not the hypothetical substitutes she can imagine.  Like many adoptive parents, I remain thankful for the blessing of infertility that brought me my family.

A few others have already said this in the thread, but I'll add my 2 cents.

My husband is bipolar but it didn't stop us from trying to have biological children of our own.  As it turns out, we haven't been able to conceive so we are pursuing foster care/adoption.  DH has said at times that he worried about passing along his mental illness to our kids and he's just as happy if we never have a biological child.  

But...

The two kids we hope to adopt also have their own set of challenges, including possible mental illness.  So we're dealing with it anyway.  

Having kids is like that box of chocolates that Forrest Gump talked about - you never know what you're gonna get.  

I think what is important is that your sister and her husband are talking about it now - preparation, even the mental kind, can do wonders for your ability to cope in the future.

i think my advice would be not to have children. Really. If it's not bi-polar, it will be something else. A disposition that isn't like yours. Short when you are tall. An inclination to golf when you prefer soccer. Adoption or biological reproduction: like others have said, it's a crap shoot. They need to decide if they want to be in the game and then decide which option is right for them.

We've given birth twice and adopted twice.

My understanding is that we all carry genetics from many hundreds of generations before, and different things present themselves all the time.

I don't feel like I know much more about my bio kids than my adoptive children.  I agree with those who say "it's a crap shoot".  You never know what you're going to get.  I've known people who micro-manage genetics (using selection methods) and those who micro-manage adoption.  You still get great kids;each with his or her own joys and challenges.

On a side note: a bit of a gripe:
One of my children, who came by way of adoption, was recently diagnosed with type 1 diabetes.  She's thin, athletic, and eats organic. I can't tell you how many people have asked me, or said, "well, you probably don't know much about their genetic history!?"  I generally remind them that "I know about as much as I do about my bio kids".
In reality, we only get a good one or two generations of "good" medical info even in bio relationships.

Sheesh.  As time goes by I barely remember which cute baby said which cute thing.  I'd be hard pressed to recall medical issues of the far-flung relatives.