I think most couples who are deep in the world of fertility have given a thought to donor eggs.
For lesbian couples, using their partner’s eggs for the other to carry, otherwise known as reciprocal IVF, is commonplace and can be a wonderful way for the couple to feel connected through the pregnancy.
But for those heterosexual couples, using donor eggs was never the ideal and for most there is an inherent grieving period. In part, they’re often grieving the loss of their child not sharing their own genetic makeup. I say ‘they’ because the male also grieves. He also had a dream that his genes would mix and merge with his loved one to create a whole new person.
But here’s what I came to tell you…
Even though the genetic material of your child, the DNA, will come from the donor and the sperm, the gene expression will be determined by the gestational mother.
In other words, your (donor egg) baby comes preprogrammed with it’s own genetic makeup that is not your own, but YOUR uterine environment has the power to turn those genes “on and off”. It’s called epigenetic modulation and it’s really rather beautiful!
The same gene expression modulation happens in every pregnancy, be that of donor eggs or not, so it’s important we all have a handle on what our bodies are capable of… read on!
Pioneering work by Prof. Carlos Simón (Interdisciplinary Group for Reproductive Health, IVI Foundation, and Stanford collaboration) has demonstrated that the interaction between the embryo and the endometrial lining at the point of implantation initiates a molecular “dialogue”. This cross-talk involves complex biochemical signalling that can influence which genes in the embryo are activated or silenced. (Simón et al, 2017)
So, hypothetically speaking, you could implant five identical donor eggs into five different women and each child would develop differently depending on:
- Maternal diet and metabolic health
- Uterine receptivity and microbiome
- Stress levels and cortisol Inflammatory markers
- Even the mother’s exposure to acupuncture, hypnotherapy or other mind/body therapies would make a difference.
The key to understanding how this is possible lies in first understanding methylation.
DNA methylation is an epigenetic mechanism where small chemical groups called methyl groups (–CH₃) are added to specific areas of DNA. It doesn’t change the DNA sequence itself but instead, alters how accessible or active certain genes are, influencing whether they’re turned on or off.
During pregnancy, the maternal environment (nutrition, hormones, inflammation, stress, medications, toxins, uterine blood flow) influences how the foetal epigenome is constructed. This includes the placement and removal of methylation markers.
Metabolic Syndrome & Diabetes
Nutrition plays a huge role in methylation. In fact, a major piece of research highlighting just this came after studying children who were born to mothers exposed to famine in the Netherlands in the final weeks of World War II, known as The Dutch Hunger Winter of 1944-45. It showed that these children were at a higher risk of having obesity, glucose intolerance/diabetes and cardiovascular disease in adulthood due to altered DNA methylation of the IGF2 gene in offspring whose mothers were exposed to famine very early in gestation. (Heijmans et al, 2008)
The key nutrients are those known as methyl donors. These are essential for DNA methylation.
- Folate (B9)
- B12
- Choline
- Betaine
- Methionine
- SAMe
A 2019 study showed that mothers who had adequate amounts of these nutrients in early stages of gestation could prevent their children from obesity, diabetes and cardiovascular risk. (Haig, 2019)
Environmental Pollutants & EDCs
But what was more astonishing was that these same nutrients could protect against environmental pollutants and EDCs (endocrine disrupting chemicals). “BPA-induced DNA hypomethylation in the offspring was negated after female mice were supplemented with methyl donors in their diet.” (Li et al, 2019)
If you’re a fan of my blogs you will know that these same environmental pollutants and EDCs radically and negatively affect offspring reproductive capability if the mother is exposed during the reproductive programming window. To read more on this head over to https://truthfertility.com/blog/can-you-predict-your-fertility)
Microbiome & Immune Response
You will also know that I talk a lot about the importance of a healthy vaginal microbiome. (See https://truthfertility.com/blog/the-importance-of-a-healthy-vaginal-microbiome) This isn’t just to improve implantation rate, reduce miscarriage risk, and improve semen quality - though it does all of those things too! It’s also important in determining your child’s immune health. Your microbiome works to suppress or activate genes, determining things like inflammatory response, allergy risk and autoimmune tendencies for your child.
Stress & Inflammation
Rather unfortunately, stress plays a significant role in all things fertility, not just now but for your children too.
“Fetal exposure to superabundant glucocorticoids [high cortisol] can result in lifelong effects on neuroendocrine function” (Downs, 2023), impacting their nervous system and HPA axis/hormone control centre. (Whirledge & Cidlowski 2010)
Therefore, if the gestational mother has cortisol dysregulation so too will your child, regardless of their genetic blueprint. (Duthie & Reynolds, 2013)
But here’s the good news.. high cortisol can be mitigated by ensuring adequate levels of those all important nutrients we spoke of above. Methyl donors help buffer stress-induced methylation errors - stabilising gene expression.
And this is the one us acupuncturists can really take credit for. It’s well documented that acupuncture has significant anti-inflammatory effects and also works to lower cortisol. (Li et al, 2021) So by having regular acupuncture treatment throughout pregnancy you are actively engaging in improving your child’s mental and hormonal health, now and for the rest of their lives!
The conversation between you and your baby
At implantation, the embryo releases signals (such as microRNAs and cytokines) that instruct the endometrium to become more tolerant and supportive. In response, the endometrium produces molecules that regulate gene expression within the embryo and placenta. This process influences which genes are “switched on”, affecting implantation depth, placentation, growth trajectories and immune development. (Simón et al, 2015)
It is during this peri-implantation window (approx days 6–14 post-transfer) that interventions like acupuncture, nutritional priming and stress modulation may have profound effect.
Blood Flow
So, I don’t think you need any further “selling”. Methyl donor nutrients are super important. But perhaps what’s more important is blood flow. There’s little use in having adequate supplies if blood flow is impaired and they’re not getting to the tissues. Stagnant or inadequate blood flow increases local oxidative stress leading to epigenetic activation of inflammatory genes (e.g. TNF-α).
Forgive me for doing one last plug for acupuncture but this one is crying out for it! Several good quality studies show acupuncture to be effective in increasing vascularisation indexes (blood flow). These studies have been carried out using women undergoing IVF, demonstrating that “acupuncture might be beneficial in women undergoing IVF-ET by increasing endometrial blood flow and endometrial receptivity.” (Dong et al, 2024)
It does this by working to reduce oxidative stress, thereby increasing blood flow, and ultimately epigenetically silencing inflammatory pathways which acts to stabilise implantation.
The Take Home
I’ve got to be honest… It’s my view that donor eggs are presented as an option far too early in many cases I’ve come across. These couples, in my view, have usually had inadequate diagnostics to really understand whether their problems are entirely down to egg quality.
When your consultant says “it’s probably due to egg quality” then I think the emphasis is on ‘probably’ and should warrant further investigation. There’s no single test that can tell you whether your eggs are viable but if all other blood tests, scans and semen analyses return normal then you can start to be more certain that egg quality may be the culprit. But when I say ‘all other tests’ I don’t mean the ones that the fertility clinics run. These are basic and actually tell you very little.
My advice to you is, If you’re unsure about whether to take the leap to donor eggs, run a full gambit of diagnostics first before you decide. We’re talking double and single stranded sperm DNA fragmentation tests, microbiome tests, full hormone profiling, adrenal stress profiling, blood clotting profile, immunology testing, etc. These are tests that aren’t often available in a lot of UK IVF clinics but are usually run as standard in most fertility clinics abroad. We happen to run them too since they’re super important!
In our clinics I’ve actually only seen a small handful of couples who ‘needed’ donor eggs - we can usually step in to do what’s necessary so the couple conceive using their own egg and sperm.
But for some, the thought of running test after test is overwhelming and there is no escaping the fact that donor eggs have a good success rate. So if donor eggs is the next step for you, or even if it’s not! Take solace in the fact that every gestational mother the world over will be nurturing and shaping their child’s whole health - from their immune systems to their BMI to their emotional wellbeing. What you do now affects them forever, and will continue to affect generations after them.
I find that thought as terrifying as I do heart warming!
References:
Díaz-Gimeno P, Simón C, et al. (2017) “Window of implantation transcriptomic stratification reveals different endometrial sub-types.” Human Reproduction (2017) https://www.sciencedirect.com/science/article/pii/S0015028217305022?
Heijmans et al. (2008), “Persistent epigenetic differences associated with prenatal exposure to famine in humans.” Proceedings of the National Academy of Sciences (PNAS), 105(44), 17046–17049. DOI: 10.1073/pnas.0806560105
Haig, D. (2015). “Maternal–fetal conflict, genomic imprinting and mammalian vulnerabilities to cancer.” Philosophical Transactions of the Royal Society B: Biological Sciences, 370(1673), 20140178. DOI: 10.1098/rstb.2014.0178. https://pubmed.ncbi.nlm.nih.gov/26056362/
Li et al (2019) "Prenatal epigenetics diets play protective roles against environmental pollution.” Clinical Epigenetics Journal, https://clinicalepigeneticsjournal.biomedcentral.com/articles/10.1186/s13148-019-0659-4?
Li et al (2021) “The Anti-Inflammatory Actions and Mechanisms of Acupuncture from Acupoint to Target Organs via Neuro-Immune Regulation.” DOI: 10.2147/JIR.S341581 https://pmc.ncbi.nlm.nih.gov/articles/PMC8710088/
Downs, Jaclyn. 2023. Enhancing Fertility Through Functional Medicine: Using Nutrigenomics to Solve ‘Unexplained Infertility’. CRC Press
Whirledge & Cidlowski, (2010) “Glucocorticoids, stress and fertility.” Minerva endocrinological 35, no. 2, 109.
Duthie & Reynolds (2013), “Changes in the maternal hypothalamic-pituitary-adrenal axis in pregnancy and postpartum: influences on maternal and feral outcomes.” Neuroendocrinology 98, no. 2, 106-115.
Simón et al (2015), “Hsa-miR-30d, secreted by the human endometrium, is taken up by the pre-implantation embryo and might modify its transcriptome.” Development, 142(18), 3210–3220.
DOI: 10.1242/dev.124289
Dong et al (2015), “Effect of Acupuncture on Endometrial Blood Flow in Women Undergoing in vitro Fertilization Embryo Transfer: A Single Blind, Randomized Controlled Trial” https://pubmed.ncbi.nlm.nih.gov/36790554/