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DNA testing forever changed donor conception

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DNA testing (and the family secrets it sometimes reveals) has been in the news a lot this year. As Dani Shapiro’s memoir Inheritance made clear, a simple DNA test can upend an identity and dismantle a family story. Those of us working in the field of reproductive medicine know that Shapiro’s story is far from unique. Increasingly often, young (and not so young) adults learn “by accident” that they were donor-conceived.

Readers may wonder how this happens. How can parents keep a secret so significant from their children? As a therapist whose practice includes many parents who had children through donor conception, I would like to shed some light on this.

(In a future blog, I’ll address the feelings and experiences of their children. Many are bewildered by their parents’ decisions not to tell them. They’re angry about the widespread practice — and seeming acceptance — of anonymous egg and sperm donation. Possibly for them, and for their parents, one step toward healing might be gaining an understanding of the reasons and patterns for this secrecy.)

Two major reasons for secrecy around donor conception

Donor parents have usually experienced infertility. Donor conception is almost never a first choice. Often, men and women who have children through the help of a donor experienced infertility or had an illness that rendered them infertile. Possibly, they have a genetic condition that they want to avoid passing on to a child. Loss brings them to donor conception and remains with them during and after the process. Some feel that everyone “will be better off” if they try to pretend that this is their full genetic child.

Doctors advised secrecy. For many years (and even in some places today), physicians encouraged denial, secrecy, avoidance. As recently as the 1980s and ‘90s, some doctors selected sperm donors for their patients and told them that they had found ideal matches. The plot thickened for many couples when their doctor told them that that he (it was usually a he) would mix the donor sperm with the husband’s sperm. That way, the doctor said, they would never really know.

Three patterns of not telling about donor conception

In recent months, I’ve talked with several parents of young adults who do not know they were donor-conceived. In all instances, the parents contacted me because some member of the family purchased a DNA kit or was talking about doing so. Although their stories differ, all the parents I spoke with were in anguish over their “failure” to tell. Each one of them loves their child or children. Each approached me tormented by what it would mean for their offspring to learn of their donor conception as an adult. In talking with them, I observed three patterns of not telling.

Not telling because it seems best to keep it a secret. Some parents believed it best that the child not know they were donor-conceived — sometimes because their doctor planted that thought. As the burden of secrecy sets in, they may — or may not — have a change of heart along the way. One mother of four adult children, now all in their 30s and married with children, described her family as close and loving, people who genuinely enjoy spending time together. Neither she nor her husband had ever seen any reason to tell. This changed only when her daughter’s mother-in-law gave her a DNA kit as a Christmas present.

Not telling because life got in the way of telling. One dad told me he and his late wife had always planned to tell their two children that he was not their genetic father. Plans changed when his wife died suddenly, leaving him with a 3-year-old and 5-year-old. For years following her death, he was simply in survival mode. He didn’t think about telling his kids until they were teenagers, yet that felt like the wrong time to tell them. Now in their 20s, one of his children was curious about genealogy and had purchased a test.

Not telling because it was a non-issue. Although most people come to donor conception after experiencing infertility and reproductive loss, occasionally I meet people with different reasons. One man had a vasectomy after the birth of his second son because his wife was advised not to become pregnant again. The couple divorced and he went on to remarry. When he and his new wife wanted to have a child together, donor sperm represented an opportunity rather than a loss. This dad said he had always felt closest to his third son, the one conceived with donor sperm. He never considered donor conception an issue. Only when he began reading articles of people accidentally learning that they were donor-conceived did he become alarmed.

A changing landscape

Although the idea that “nobody needs to know” has not entirely vanished from the practice of donor conception, I am happy to be able to end on a positive note. Today, most people who have a child through the help of a donor recognize that their child has a right to know their origin story.

The post DNA testing forever changed donor conception appeared first on Harvard Health Blog.

Dear Mark: Collagen vs Whey Follow-Up

For today’s edition of Dear Mark, I’m answering questions from last week’s Collagen vs Whey post. You guys had a lot of questions, mostly about collagen, and I’m here to answer them. Can collagen help with plantar fasciitis? Should you take collagen and whey together in the same smoothie, or do they cancel each other out? If a person can’t have whey, is there an equivalent protein powder source? Is glycine a good replacement for collagen? What about liquid whey from raw milk—how does it compare to powdered whey? If I wanted to get my glycine from foods, what would I need to eat and how much of it?

Let’s find out:

Is there any evidence that collagen supplements can help with plantar fasciitis? Suffering from this recently and the stretching from MDA has helped but looking to get that last 10% of healing so there is no pain.

Fascia is basically pure collagen. If collagen supplementation has been shown to improve pain in other parts of the body made of collagen, like the knees or tendons, and improve collagen synthesis in collagenous tissues like skin and joints, I see no reason it shouldn’t also improve the fascia. Boosting collagen synthesis is boosting collagen synthesis, and supplemental collagen does it.

A good thing to try is eat 20-30 grams of collagen with 200 mg of vitamin C 30 minutes before a workout that you know targets your plantar fascia.

Hey Mark,

Is there any benefit to having them at the same time? Or do they cancel each other out?
I’m a big fan of stirring collagen into any foods I make that have sauce.
What about a 50/50 smoothie of whey and collagen?
Thanks for any insight!

I’m unaware of any unique benefit.

When you think about how collagen appears in the natural world, it’s usually alongside muscle meat.

Entire culinary traditions revolve around the consumption of collagen and muscle meat together. Think Vietnamese pho (bone broth and meat). Think French (reduced broth-based sauce poured over meat). Think Mexican (bone broth-infused rice served with meat). Hell, go all the way back to the Pleistocene and humans were boiling smashed bone fragments in stomach casings.

No reason to separate them.

It is possible for a person to be allergic to casein and I don’t think it’s possible to have fully casein free whey protein except maybe the isolate. However, if the person is allergic it wouldn’t be safe. What’s the next best complete protein if a person can’t use whey, and wants the convenience of a powder? I’ve seen beef protein before, but have no idea of the quality.

I’d say go for egg white protein. Extremely complete, tasteless, and blends seamlessly into anything.

Is it true that collagen doesn’t work/assimilate without vitamin C? I try to take mine with some cherries or lemons.

It seems to work better. The recent study that found pre-workout collagen improved tendons also included vitamin C.

I sometimes buy raw A2 milk from Jersey cows, and make my own whey. Wondering how that compares to powdered whey?

That’s awesome. The liquid whey will have a broader range of nutrients, but the powdered whey will be more concentrated and far higher in protein. Remember that whey protein is basically dehydrated liquid whey and you’ll get a picture of how much liquid whey goes into whey powder.

My interest in this has led me to start studying biology because I would like to know more about nutrition and digestion. Because the way that my nails changed seems incredible to me and it really makes me wonder what else collagen is doing.

You make a good point. I often use improvements in one area of health as assurance that other areas of health are also improving. I’m sure that’s not always true, but I think that’s a pretty safe assumption most of the time.

My question to you Mark would be to echo the same question others have posed, ie are there any downsides to me taking whey, collagen and glycine simultaneously in my pre-workout shake? Otherwise I have a real dilemma, as it appears that there is very good science to support having both collagen/ glycine as well as rapidly digested essential aminos (from whey) in your system before undertaking a ‘fasted’ workout.. A tough question I know but any insight you have would be much appreciated!

There’s no reason to avoid it. Do it. Should be good for both your connective tissue and your gains.

Would glycine supplements have a similar effect as collagen? Glycine supplementation would be way less expensive than collagen:
• 30 grams of collagen (=~10 grams glycine) from Great Lakes = 5 tablespoons, costs =~$1.13 if you buy the 8 pound bag.
• 10 grams of glycine from Bulk Supplements =~$0.18 if you buy the 5 kilogram bag.

Pure glycine is great for things like balancing your intake of methionine. As I wrote in the original post, muscle meat is high in an amino acid called methionine. Methionine metabolism depletes glycine, so the more meat you eat, the more glycine-rich connective tissue, bone broth, and collagen supplements you should be eating to balance out the amino acids. This is the basic foundation for eating all that collagen I recommend.

But balancing methionine for longevity and health isn’t the only reason we’re eating collagen. Collagen is the most abundant protein in the body, providing tensile strength to our bones, teeth, ligaments, tendons, and cartilage. It’s an important structural component of the skin, lungs, intestines, and heart. And as far as the evidence so far available suggests, eating the amino acids that make up collagen separately doesn’t have the same effect on those collagenous tissues as eating them together in a collagenous matrix.

In one study, rats with osteoporosis ate collagen hydrolysate that scientists had marked with a radioactive signature to allow them to track its course through the body. It survived the digestive tract intact, made it into the blood, and accumulated in the kidneys. By day 14, the rats’ thigh bones had gotten stronger and denser with more organic matter and less water content.

Another study found similar results, this time for cartilage of the knee. Mice who ate radioactive collagen hydrolysate showed increased radioactivity in the knee joint.

When you feed people collagen derived from pork skin, chicken feet, and cartilage, many different collagenous peptides appear in the blood. You don’t get any of those from isolated glycine.

All that said, pure glycine can be a helpful supplement. As mentioned, it’s great for balancing out methionine intake from muscle meat consumption. It’s also been used in several studies to improve multiple markers of sleep quality. And glycine is probably the most important component, if you had to choose just one, of collagen.

Collagen is ideal, but glycine isn’t a bad option. In fact, I’d argue that perhaps collagen plus supplementary glycine could offer the best bang for your buck.

Mark, can you please do a post examining the different amounts of glycine in actual foods, i.e. pork rinds, chicken skin, connective tissue rich cuts of meats, etc? I’d really like to get my collagen and glycine from food sources and know how much of the foods I would have to eat in order to get the 10g you mention.

I’ll do a quick answer.

An ounce of pork rinds gives you 3.38 grams of glycine.

An ounce of roasted chicken skin gives you 1 gram of glycine.

A pork tail of about 4 ounces will give you almost 3 grams of glycine. Oxtail should be about the same.

So getting your glycine from food alone is entirely doable, but you’ll probably have an easier time if you like chicharrones/pork rinds and animal tails. There are some higher quality pork rinds out there these days, like the Epic brand ones.

Hi Mark – thank you for all of your great information!!!
I make homemade Greek yogurt at home – I strain it in a fine mesh strainer and get an incredible about if whey as a result. I generally mix about 1/4 cup back into the yogurt to get the right consistency. I throw the rest out. Is this consumable as whey for the diet?

It is consumable. But keep in mind that liquid whey isn’t as protein-dense as whey powder. It’s still good to eat and a great source of probiotics.

Thanks for your questions, everyone. Take care!