The finding of haematuria in relatives is suggestive. While X-linked inheritance is the most common pattern, genetic testing is revealing that atypical presentations may be more common than currently thought. Genetic testing
Genetic testing plays an increasingly important role in confirming the diagnosis where the clinical features do not amount to proof. Other tests
The use of eye examinations for screening has been proposed. Other tests may include a urine or blood test. Treatment
Kidney disease and renal failure
In addition to measures for chronic kidney disease (CKD) of any cause, there is evidence that ACE inhibitors can slow the deterioration of kidney function in Alport syndrome, delaying the need for dialysis or transplantation. The development of proteinuria has been recommended as an indication for commencing treatment.Once kidney failure has developed, patients usually do well on dialysis or with a kidney transplant. Transplantation can rarely be associated with the formation of antibodies to type IV collagen in the donor kidney resulting in progressive graft failure as a result of Goodpasture syndrome (Alport post-transplant anti-GBM disease).Gene therapy has been frequently discussed, but delivering it to the podocytes in the glomerulus that normally produce the type IV collagen in the glomerular basement membrane is challenging. Hearing loss
It is not known whether ACE inhibitors or other treatments affect hearing loss. For those with classic Alport syndrome, hearing aids are often required in teenage or young adult years.
Surrogate motherhood became possible with advances in reproductive technologies, such as in vitro fertilization. Not all women who become pregnant via in vitro fertilization are surrogate mothers. Surrogacy involves both a genetic mother, who provides the ovum, and a gestational (or surrogate) mother, who carries the child to term. Lesbian and bisexual motherhood
The possibility for lesbian and bisexual women in same-sex relationships to become mothers has increased over the past few decades due to technological developments. Modern lesbian parenting originated with women who were in heterosexual relationships who later identified as lesbian or bisexual, as changing attitudes provided more acceptance for non-heterosexual relationships. Other ways for such women to become mothers is through adopting, foster parenting or in vitro fertilization. Transgender motherhood
Transgender women may have biological children with a partner by utilizing their sperm to fertilize an egg and form an embryo. For transgender women, there is currently no accessible way to carry a child. However, research is being done on uterus transplants, which could potentially allow transgender women to carry and give birth to children through Caesarean section. Other types of motherhood include adoption or foster parenting. However, adoption agencies often refuse to work with transgender parents or are reluctant to do so. Social role
The social roles associated with motherhood are variable across time, culture, and social class.