Genetic testing on egg donors is nothing new at Fairfax EggBank. Historically, we’ve used these results to determine whether the donor is appropriate for our donor egg program. But we’ve made a recent commitment to deepen the level of genetic information a recipient can obtain on a donor. Effective September 2018, we launched the GenPanel + program – a select group of donors who completed an expanded genetic testing panel.
Our eventual goal will be to have all new donors complete expanded panel testing. Here are the top five reasons why we think this GenPanel+ program is so important.
As you search for an egg donor, you are likely to seek someone who resembles you. You also want to have a thorough understanding of her medical history. After all, you are pouring your heart and soul into conceiving a baby. Knowing that you will love this future child with every fiber of your being, you want to protect her (or him) even before she is born.
Genetic testing may give you some control and predictability over the health of your donor-conceived child. The more information you have, the better equipped you are to understand the reproductive risks for your family. By comparing the donor’s genetic testing results with those of your spouse, partner or donor providing the sperm, and in consultation with your healthcare provider, and careful decision making, you can significantly reduce the chances of having a child affected by a genetic condition.
You may realize your favorite donor is a GenPanel+ donor who is a carrier for a genetic condition. Before you dismiss her, consider the following.
Virtually every human being is a carrier, whether we know it or not. Harvey Stern, M.D., Ph.D., Fairfax EggBank’s Director of Reproductive Genetics, clarifies: “In fact, we’re all carriers for several genetic conditions, only some of which today’s technology can detect. It’s important to note that being a carrier is not the same as actually having the genetic condition in question; in fact, carriers don’t show signs of the condition and are expected to remain healthy. The chance of a child inheriting a genetic condition requires that both reproductive partners are carriers for the same genetic condition(s). Being a carrier is part of being human – it’s normal.”
There is no national standard for genetic carrier testing. While all egg and sperm banks do some level of genetic screening of their donors, the extent of DNA-based carrier testing has varied widely among gamete banks. Until fairly recently, genetic carrier testing was limited, or prohibitively expensive. A program simply eliminated an individual found to be a carrier for one or more of a relatively small list of conditions. When you can only see a very small fraction of a donor’s genetic makeup, a positive carrier status may look like a red flag, or indicate that a donor is not “perfect.” This view was never a particularly rational position since we are all carriers of recessive conditions. However, it reflected the reality that extensive carrier testing was not routinely recommended, available or affordable.
What matters is the carrier status of the man providing the sperm for your donor egg cycle. If he does not have an unwanted mutation in the same gene as the egg donor, then you will significantly reduce the risk of having an affected child.
In the past, we eliminated over 30% of donors from the donor egg program since they were a carrier of a rare genetic condition. As a consequence, even though they had highly desirable traits and would be the ideal donor for many recipients, we did not introduce them into the program.
This exclusion criterion becomes unsustainable as genetic testing becomes increasingly robust. What will happen as genetic screening tests for more conditions? We’d have to eliminate all carriers. Eventually, we wouldn’t allow any donor to enter into our program.
The truth is, genetic compatibility is going to be different for each set of intended parents, and a donor who is not a good match for one family may be just right for another. By including GenPanel+ expanded genetic testing donors, including known carriers, in our donor program, we can offer you more donors who meet Fairfax EggBank’s high standards for quality and safety, and give you additional information to help reduce the risk that your donor-conceived child will inherit an unwanted genetic condition.
Many male partners undergo genetic testing as part of the workup before donor egg IVF. Upwards of 70% will find they are a carrier for one or more genetic conditions. Do you know if your male partner or sperm donor is a carrier? Then you can review any GenPanel+ donor’s test results immediately online. You won’t need to waste several weeks having the egg donor undergo additional testing for that condition, and face the risk of having to find another donor if the first one tests positive for the condition.
It’s nothing new that expanded genetic testing is becoming more routine in the fertility world. In fact, in March 2017, American College of Obstetricians and Gynecologists (ACOG) published two Committee Opinions, advocating for health practitioners to recommend expanded genetic testing. ACOG posited “ultimately, the goal of genetic screening is to provide individuals with meaningful information that they can use to guide pregnancy planning based on their personal values.”
You’re taking a big leap of faith by trusting a compassionate stranger’s donation to conceive your child. You’re also counting on Fairfax EggBank to meet or exceed the regulatory requirements and professional standards for donor egg banking. As donor testing continues to advance, and authorities like ACOG, ACMG, and ASRM continue to update their recommendations, we will continue to evolve. Fairfax EggBank is, and will continue to be, the trusted source for donor eggs.