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Of course, family history is an incredible gift for a future child's permanent health history, and reviewing a donor family tree with a genetic counselor can help shape the family history and genetic test results into a useful tool for a child conceived in a donor cycle. But we also know that this appointment may seem intimidating to egg donor candidates and we spend a lot of time thinking about how to best help integrate this important session so that it is informative, thoughtful, empathic, and straightforward for egg donor candidates.
We've been asking the egg donors who come to Advocate Genetics for their genetic screening appointment, and here is what they say:
How easy was it to schedule an appointment with us? Average score of 5/5! Meaning. . . Easy. ⭐
How would you rate the ease of communication with our team in preparation for your appointment? Average score of 5/5! Meaning. . . Easy. ⭐
How comfortable were you in sharing your personal medical history and your family history during the counseling session? Average score of 4.93/5! Meaning. . . Very Comfortable. ⭐
How would you rate your genetic counselor's understanding of your questions or the decisions you were facing? Average score of 5/5! Meaning. . . Best Understanding. ⭐
How burdensome was it to gather and share your family history in this session? Average score of 4.47/5! Meaning. . . Most donors found it not at all burdensome. ⭐ . . . But a few donors had to work a little harder to gather information, and we are so grateful to them for taking this responsibility seriously!
We also take this information seriously, and we are honored to be part of such an important experience for intended parents and donors alike.
If you have a question about genetics and how it pertains to a pregnancy when you're working with an egg, sperm, or embryo donor, a genetic counselor can highlight the important issues and help you narrow down what is most important to you. Our match consultations are tailored for this very important discussion.
Sometimes people assume that if they have a non-genetic child that their child won’t be like them.
And I think that’s a really big misconception about the way genetics works. Of course, there are things that are hardcoded in the DNA. Think about it like a computer. We all use this technology and we might even buy the same model. There are some things that are simply hard-coded in there. But we all use our computers very differently. It really depends on what software you add and how you use the thing.
The important thing is that our environment influences how our DNA is read and that changes who we will be.
More specifically, you might have heard a lot about epigenetics and the maternal environment. So if you carry your baby who comes from a donor egg or donor sperm or donor embryo, will you influence the way the genes are expressed? Absolutely, you will! And will it amount to much? Will your child’s hair be a slightly different color than it might have been or will your baby love strawberries because you love them and ate them nonstop during pregnancy? Unfortunately, there are no scientific studies that can really answer these questions. The science has focused on much smaller endpoints, things like whether there are methylation differences (one of the mechanisms that control which genes are "read" in each of the cells) according to different maternal environments (these are mainly things like medical history, condition status, or nutrition status of the carrying mother or gestational carrier). So even though the medical community can point to a generalized "epigenetic" effect that will come from carrying a pregnancy, it's still a bit of a mystery how the maternal environment in pregnancy will shape a child's life in a very specific way.
We know that good prenatal care and nutrition are important, of course, but does the carrying mother or gestational carrier affect the epigenome in other distinct and individual ways? Probably. That question will likely keep scientists busy for a few years trying to get at exactly how. But also, here’s the important thing. . . epigenetics never ends! It has to do with how the genes are expressed (or chosen to be read) by the environment. And your child's cells will express their genes for their entire life. So the things you expose your child to, the household you raise your child in, what your child enjoys doing, all of it will affect the way the genes are expressed. And you’ll have a different kid in front of you than that kid would have been if they had been raised in a different home. It’s mind boggling how amazing the genome is, built as it is to respond to the environment we find ourselves in, and selectively use the hard-code in a way that will help our bodies to thrive. I mean, it's kind of brilliant, isn't it? But then again, how could it be any other way? That's why we're here today.
If you have a question about genetics and how it pertains to a pregnancy when you're working with an egg, sperm, or embryo donor, a genetic counselor can highlight the important issues and help you narrow down what is most important to you. Our match consultations are tailored for this very important discussion. And check out the webinar series at EM•POWER if you are exploring the meaning of various choices for egg, sperm, or embryo donation. Our focus in that organization starts with embryo donation, but there is a lot there that might be of interest to fertility patients at all points in their journey.
Disclaimer: Please keep in mind that the information provided here is not meant to be a medical opinion about your specific case. The problems of every patient are unique and should be addressed by their physician or other health-care professionals in an individual conversation. You are welcome to bring up questions inspired by this blog post with your medical team. However, no one should use this blog as a source of medical care.
Gina Davis, MS, CGC