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Epigenetics is transforming our understanding of fertility. In this episode, fertility specialist Dr. Oluyemisi (Yemi) Famuyiwa joins us to explore how lifestyle factors like diet, stress, and environmental exposures influence gene expression through mechanisms like DNA methylation and histone modification. Yemi explains the science behind these epigenetic changes, their potential impact on future generations, and actionable ways to optimize fertility through lifestyle choices.

Oluyemisi (Yemi) Famuyiwa is a renowned fertility specialist and founder, Montgomery Fertility Center.

She discusses the KevinMD article, “The role of epigenetics in fertility: Can lifestyle choices affect future generations?”

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Transcript

Kevin Pho: Hi, and welcome to the show. Subscribe at KevinMD.com/podcast. Today, we welcome Yemi Famuyiwa. She is a fertility specialist and founder of the Montgomery Fertility Center. Today’s KevinMD article is titled, “The Role of Epigenetics in Fertility: Can Lifestyle Choices Affect Future Generations?” Yemi, welcome back to the show.

Yemi Famuyiwa: Thank you. Thank you, Kevin. Thank you for having me again.

Kevin Pho: So, let’s’ start again by talking about this latest article for those who didn’t get a chance to read it.

Yemi Famuyiwa: Yes. So, this article is, again, like most of my articles, inspired by questions that patients ask me or things that come up during discussions in the office. It’s something we’ve been delving into—what factors can actually affect your genes? What can influence your eggs or sperm?

And we’ve been exploring not just what impacts your current reproductive cells, but also what gets passed down to future generations. This is where epigenetics comes into play. Epigenetics is all about the factors that influence your genes in a way that can then be passed on to your offspring. So, it’s not just about what you’re doing to your body today; it’s about what it means for the next generation and even the one after that.

Kevin Pho: Go further—tell us more details. What are some examples where genes are affected across generations?

Yemi Famuyiwa: Epigenetics is essentially about how external influences can alter the way your genes behave. It’s important to note that it doesn’t change the structure of your DNA—the sequence of ATGC remains intact—but it changes how the genes are expressed. Environmental cues, lifestyle factors, and even what you eat can influence this.

Here’s an analogy: imagine you have a recipe book, and your DNA is the entire book. Now, epigenetics is like adding sticky notes to certain pages, telling you which recipes to follow and which to skip. You might have all the genetic material there, but the expression of that material is turned on or off based on these external “sticky notes.”

For example, one way to modify gene expression is by adding a methyl group to the DNA, which essentially mutes that part of the gene. Another way involves histones—these are molecules that DNA winds around. If the DNA is tightly wound, it’s harder to read; if it’s loosened, it’s easier to read. These mechanisms help regulate which parts of your DNA are active or silent, and that’s what we mean when we talk about epigenetics.

Kevin Pho: Can you share specific examples of phenotypes being muted or expressed in future generations?

Yemi Famuyiwa: Absolutely. There’s a well-known study from Sweden where researchers looked at individuals whose grandfathers had experienced famine. They found that grandsons of these individuals had a lower risk of cardiac death. Interestingly, when grandmothers experienced famine, their granddaughters had a shorter lifespan. So, we’re talking about effects that span two generations.

Another example is what we call “epigenetic drift,” which is often studied in twins. Imagine one twin growing up in a stressful environment with poor nutrition, while the other twin grows up in a healthier environment with better access to resources. Over time, these twins will start to show differences in development and health outcomes, even though they started with the same genetic material.

Think of it like cooking—if you put one recipe in a poorly equipped kitchen and another in a high-end kitchen with all the right ingredients, you’re going to get very different results. This is what happens with the environmental influences on your DNA.

Kevin Pho: What specific factors can knock at the DNA and cause these changes?

Yemi Famuyiwa: Several factors can influence DNA. Stress is a big one—elevated cortisol levels from chronic stress can have significant impacts. Sleep deprivation, poor nutrition, and exposure to harmful chemicals are also culprits. A bad diet, for example, deprives your body of essential nutrients, which are like the building blocks your DNA needs to function properly. Without them, your genetic material doesn’t perform as well.

Kevin Pho: In terms of diet, what specific components impact fertility epigenetics?

Yemi Famuyiwa: Nutritional deficiencies are a major factor. Diets that lack vegetables, protein, or essential vitamins fail to provide the necessary ingredients for optimal DNA function. Famine is a clear example—nutrient deprivation affects gene expression. Similarly, a poor diet that’s high in processed foods can lead to oxidative stress, which damages DNA.

Think of your body as a kitchen. If the kitchen is poorly maintained or if you’re using low-quality ingredients, you’re not going to produce good results. The healthier your environment and the better your ingredients, the better your DNA will function.

Kevin Pho: I assume smoking also plays a role. What other factors impact epigenetics?

Yemi Famuyiwa: Yes, smoking is another big one. Exposure to harmful chemicals—whether from smoking, pollution, or even certain treatments like chemotherapy—can negatively impact DNA. These chemicals alter how genes are expressed, sometimes with long-lasting effects.

Kevin Pho: As a fertility specialist, do you bring up epigenetics during patient counseling?

Yemi Famuyiwa: Not directly. Most patients aren’t familiar with the concept, so I focus on practical advice. I emphasize healthy eating, avoiding oxidative stress, and maintaining a good environment for their bodies. The goal is to optimize the health of their embryos and, by extension, their future children.

For example, in areas with food deserts, we see poor pregnancy outcomes due to a lack of access to healthy foods. These disparities not only affect the immediate pregnancy but also have potential multigenerational effects. This is something we’re just beginning to study and understand.

Kevin Pho: You wrote that the Mediterranean diet is associated with improved fertility outcomes. Do you recommend it to patients?

Yemi Famuyiwa: Yes, though it doesn’t have to be specifically Mediterranean. Any diet rich in vegetables, fruits, nuts, and healthy fish—like those high in omega-3s—will suffice. In many cultures, people eat fresh, farm-to-table foods that mimic the Mediterranean diet. It’s about the components, not the label.

In contrast, Western diets heavy in processed foods lead to poorer health outcomes, including shorter lifespans and increased rates of diabetes. It’s a global trend—urbanized areas adopting Western diets often see declines in health metrics compared to rural areas with traditional diets.

Kevin Pho: You also wrote that exercise fosters positive epigenetic changes. Can you expand on that?

Yemi Famuyiwa: Exercise helps regulate glucose metabolism and reduces the risk of metabolic syndrome. It doesn’t have to be intense—even a short walk after dinner can make a difference. The key is consistent movement. Some people refer to it as “exercise snacks”—small bursts of activity throughout the day. It’s all about staying active.

Kevin Pho: Can harmful epigenetic changes be reversed?

Yemi Famuyiwa: Yes, many harmful changes are reversible with healthier lifestyle choices. For example, recent research on THC showed it negatively impacts sperm motility and morphology. However, once individuals stopped using THC, their sperm parameters improved over time. This shows that making healthier choices can reverse some damage.

Kevin Pho: We’re talking to Yemi Famuyiwa, a fertility specialist and founder of the Montgomery Fertility Center. Today’s KevinMD article is titled, “The Role of Epigenetics in Fertility: Can Lifestyle Choices Affect Future Generations?” Yemi, as always, we’ll end with some take-home messages for the KevinMD audience.

Yemi Famuyiwa: My take-home message is this: the more you know, the healthier you can be. Knowledge empowers you to make better choices for your fertility and overall health. Start taking care of your body now—don’t wait until your 30s or 40s when egg quality or sperm health may already be compromised. Let’s be proactive about enhancing fertility.

Kevin Pho: Yemi, as always, thank you so much for sharing your perspective and insight. Thanks for coming back on the show.

Yemi Famuyiwa: Thank you very much.