Are genetics important when choosing an egg donor?
This month, we’re highlighting the work of fertility’s “unsung heroes” – the professionals that deal with the nitty gritty of fertility. Genetic testing is an essential part of the egg donation process. And genetic counselors are the specialists who interpret the results of those tests.
When two people meet and decide to have children together, no one asks, “Have you had your genetic testing done?” But that’s changing.
When you’re introducing 2-3 different sets of genes into the mix (say two dads and an egg donor), genetic screening becomes a crucial step in ensuring that the result is a healthy baby. And that’s when some intended parents start to feel confused, concerned, or out of control. Everyone is a carrier for something, so genetic counselors parse through all the possible combinations to minimize any potential issues.
Our case managers frequently field genetics questions from intended parents, so we connected with Amy Vance of Bay Area Genetic Counseling to answer some common questions we're asked about genetic testing
What genetic health issues should I avoid when choosing a donor?
Genetic counselors evaluate potential egg donors and their families based on ASRM guidelines. According to Amy Vance, Genetic Counselor and founder of Bay Area Genetic Counseling, potential donors are ruled out if they or first-degree family members have: “major malformation with multifactorial or polygenic inheritance, known chromosome abnormalities, and mental retardation of unknown etiology.”
Amy adds, “If such a condition were identified, the recipient would be informed of the risks so that they can make an informed decision regarding use of that donor, or the applicant may be excluded from participating in the donor program if the donor clearly doesn't meet the guidelines.” So, any extreme genetic issues could prohibit a woman from donating her eggs, while others would be discussed with intended parents before they move forward.
However, there are other conditions that have a genetic component that don’t raise the same immediate red flags. Amy says, “There are many conditions which don't clearly fit into the guidelines, such as mental health issues, ADHD, autoimmune disease, etc. These common diseases have a genetic component and there would be an increased risk to offspring, but whether they are considered ‘significant’ is subjective and is up to the intended parents to decide.” Intended parents need to decide what issues they would be willing to accept in an egg donor, and which would warrant searching for a different donor.
How do I decide whether a health issue is a significant risk for my family?
Every family is different, as are the potential health issues that each family is prepared to handle. It is normal for anyone to have health issues in their family history, but frightening for parents to think about when choosing an egg donor.
“Some people are very concerned about allergies or asthma because they value pets, while others are not concerned about ADHD or mental health issues because they have experience with those in their own family and feel comfortable handling those issues should they arise. Other people want to avoid any cases of cancer in a donor’s family because they have had negative experiences with cancer in their family however most cases of cancer aren’t related to single genes.”
Amy has worked with hundreds of hopeful parents and helped them weigh up the implications of genetic carrier status in a donor and themselves.
Parents’ individual histories and perspectives shape what they will ultimately be able to accept in an egg donor, and that’s okay. Common conditions like asthma, allergies, ADHD, or various mental health issues are up to each parent’s discretion. For more serious illnesses and cancer, talking with a genetic counselor and your fertility doctor can help to assess your level of comfort.
Most people starting a family don’t stop and weigh the unique genetic predispositions that they could pass on to their children. But those looking for an egg donor are forced to confront both their egg donor’s own genes and their own. Every child is a completely unique person, regardless of their genetic makeup, and who they will be is never entirely within a parent’s control. But seriously weighing your family’s priorities – and leaning on your genetic counselor’s experience – will help you gain peace of mind as you choose your perfect egg donor.