ADHD: Is It An Issue for an Egg Donor?

Egg donor profiles usually contain a full health history for the egg donor and her immediate family. ADHD, whether medicated or not, is something we may see on a donor profile and this may raise questions for families concerned.

That’s something we talk about with our intended parents before we start a search,” says Senior Case Manager Krystal Lemcke. “Some people don’t mind, but others are rightly nervous and want to know more about the condition. We might ask the agency about it, whether the donor has had a formal diagnosis or takes medication. Some people see it as an asset in that people with ADHD may be hyper-focused and ambitious.

We decided to ask some of our Donor Concierge genetic experts to find out.

Is ADHD a genetic condition that can be inherited?
Emily Mounts and Gena Shepherd, of ORM Fertility:
ADHD (attention-deficit/hyperactivity disorder) is characterized by impulsivity, inattention, and hyperactivity. Individuals with ADHD may have difficulty following instructions and focusing on a task. Other symptoms include impatience, and talking excessively.(1) ADHD can cause behavioral difficulties that can affect relationships, and harm performance at school and later, work. ADHD often occurs with other conditions, such as anxiety, depression, substance abuse, learning disorders, and oppositional defiant disorder.(2) Some children grow out of ADHD symptoms; however, in over 30% of cases, symptoms persist into adulthood.(3)

ADHD is typically treated with a combination of behavior therapy and medication. With treatment, many people with ADHD can be successful in school and lead productive lives. There are many successful individuals with ADHD, and some people report that their ADHD helped them in certain ways, such as by increasing creativity and multitasking.(4)

Genetic testing cannot accurately predict whether someone will develop ADHD, as there is no one “ADHD gene”. ADHD is a multifactorial condition, which means that it is caused by a combination of multiple genetic and environmental risk factors. Studies have shown that relatives of someone with ADHD have an increased risk to have ADHD.1, (5) The severity of ADHD symptoms can vary significantly, even between members of the same family. The risk for relatives of someone with ADHD is likely increased regardless of the severity of symptoms for the affected individual.

Studies have found that the chance that a first-degree relative (child, sibling) of someone with ADHD will have this condition is 15-60%.(5) Relatives also have an increased chance to develop genetically related conditions such as personality disorders, substance abuse, depression, anxiety, and learning disabilities.(1)

It is estimated that 2-10% of the general population has ADHD.5 Even if there is no family history of ADHD, a child may still be diagnosed with this condition.

Amy Vance, of Bay Area Genetic Counseling:
ADHD/ADD is a relatively common condition in children (5-10%) and adults (3-5%).

ADHD is a complex trait from a genetic perspective. Most researchers have suggested that ADHD is polygenic meaning it is caused by a large number of genes, each of relatively small effect, rather than a single gene. There may be environmental influences which interact with these genes, such as prenatal exposure to alcohol, as well as gene-environment interaction leading to ADHD.

Twin studies provide evidence of heritability. The concordance (heritability) in identical twins is reported as 82% compared with 38% in fraternal twins. The higher number of identical twins affected indicates the genetic component. The fact that identical twins were not 100% concordant signifies that the condition is not purely genetic.

For polygenic conditions, the risk to close relatives is often increased above the population risk, but the risk to more distant relatives is not.

The recurrence risk for first-degree relatives of affected individuals is 20-65%. Males have a higher risk. Continuation of illness into adulthood has been found to be associated with increased risks to relatives.

Our goal at Donor Concierge, is to help you make the right decision for your family. Sometimes these are tough calls that’s why our searches include connecting you with the fertility experts who can help.

If you’d like to know more about finding an egg donor, contact us today.

References:
Faraone, S.V., Larsson, H. Genetics of attention deficit hyperactivity disorder. Mol Psychiatry 24, 562–575, 2019; DOI:https://doi.org/10.1038/s41380-018-0070-0
Mayo Clinic. Created June 2019. Accessed June 2020. https://www.mayoclinic.org/diseases-conditions/adhd/symptoms-causes/syc-20350889
Margaret H. Sibley, James M. Swanson, L. Eugene Arnold, Lily T. Hechtman, Elizabeth B. Owens, Annamarie Stehli, Howard Abikoff, Stephen P. Hinshaw, Brooke S. G. Molina, John T. Mitchell, Peter S. Jensen, Andrea L. Howard, Kimberley D. Lakes, William E. Pelham. Defining ADHD symptom persistence in adulthood: optimizing sensitivity and specificity. Journal of Child Psychology and Psychiatry, 2016; DOI: 10.1111/jcpp.12620
Jennifer Lea Reynolds. 2017. ‘Good Habits of Successful People With ADHD’. US News. Accessed June 2020. https://health.usnews.com/health-care/patient-advice/articles/2017-06-23/good-habits-of-successful-people-with-adhd.
Schachar, R. Genetics of Attention Deficit Hyperactivity Disorder (ADHD): Recent Updates and Future Prospects. Curr Dev Disord Rep 1, 41–49, 2014; DOI: https://doi.org/10.1007/s40474-013-0004-0