Your Family Health History

“It Runs in the Family”

You’ve heard the saying. What does this really mean? Biologically-related family members share genes in common, and we can see evidence of this in the physical resemblances among many family members.

Families often also share much more than genetics. Family members share their environment, dietary and exercise habits, lifestyle behaviors, and cultural practices. Most common health problems are a result of our genes interacting with the environment to cause disease. Chronic health conditions like heart disease, diabetes, mental illness and certain cancers often have a familial component. In families where multiple closely-related biological family members have the same condition, there may be an increased risk for others to develop the same disease.

Recipients (the women who may choose you as their sperm donor to achieve a pregnancy) do not have the opportunity to meet you and ask about your overall health and the health of your extended biological family members. Our extensive inquiry into your family health history helps us to provide a well-rounded portrait of each donor’s family medical background. Knowing this information in advance is extremely helpful to the recipients and to donor-conceived individuals at all stages of their life.

Ethnicity Matters

Compared with common health conditions that have complex causes, some genetic disorders occur with increased frequency in specific ethnic groups and are due to single-gene defects. You are more likely to be a carrier for cystic fibrosis, sickle cell disease, or Tay-Sachs disease if you are a member of certain ethnic groups. Carrier testing is available for many of these conditions, and can help identify pregnancies at-risk for these diseases. You will be screened for some of the genetic disorders that are more common in your ethnic group.

Families are Unique

Nearly every family has health conditions that affect its members with increased or decreased frequency. For example, a person in one family may be at greater than population risk for coronary artery disease, while being at lower than population risk for colon cancer. These risks are marginally increased or decreased from the background risk for all families, and all families have some risk.

Gathering the Information

Family medical history is reliable only when the information supplied is accurate and up-to-date. Optimally, the information gathered should include the name of the disease or condition, the family member who is affected, the age at diagnosis, how the condition was treated, and the outcome (disease resolved, is ongoing, resulted in death, etc).

For those family members who are no longer alive, how old were they when they died and what was the cause of death? Old age and natural causes are not sufficient, acceptable explanations for a death.

In some families, complete health histories are hard to obtain because of privacy concerns, family members not being in contact, and/or certain cultural biases against sharing such information. Confidentiality should always be respected when gathering personal medical information.

We recommend that if you are not aware of this kind of family health history information, you may want to identify someone in your family who can help you with this. Often there is one individual in the family who takes great interest in these matters.

Red Flags

Family medical history can help identify patterns in families that may be red flags. For example, examination of the family medical tree can reveal clues that increase the likelihood that a health condition is hereditary. These include:

  • Multiple family members with the same or related disorders
  • Earlier age of onset than typical
  • Conditions associated with intellectual impairment or developmental delay
  • Diagnosis in the less-commonly-affected sex
  • Bilateral disease (e.g., breast cancer in both breasts)
  • Conditions associated with one or more major birth defect
  • Disease in the absence of risk factors or after preventive measures
  • Growth abnormalities (asymmetry, under- or overgrowth)
  • Consanguinity (parents related by blood)

Conversely, health conditions are unlikely to be strongly genetic if they affect people in very old age, or if they are related to exposures such as heavy smoking or exposure to infectious agents or trauma.

Risk Assessment

A board-certified genetic counselor reviews all donor health histories and reviews them with the Medical Director and the Executive Director. Donor family health histories are evaluated for risk for disease transmission that exceeds the general population risk. Those individuals with such histories are ineligible to be sperm donors.

After the family history has been gathered and interpreted by a professional such as a genetic counselor, health recommendations can often be made. For common health problems, those who are identified as being at average or general population risk, standard public health recommendations apply: Maintain a healthy weight, don’t smoke, and get plenty of exercise. If a history suggests that an individual is at above average or high risk for a disease or health problem, personal prevention measures and surveillance options can be employed after discussion with a physician. In high-risk families, some individuals will benefit from genetic testing.

Resources

To learn more about genetic health and about collecting your own family medical history information, visit the website of National Society of Genetic Counselors (NSGC): http://nsgc.org/p/cm/ld/fid=51