How lifestyle choices today could impact your future family’s fertility [PODCAST]

Listen and followApple PodcastsSpotifyYouTubeMore apps · Browse all episodes

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?”

Our presenting sponsor is DAX Copilot by Microsoft.

Do you spend more time on administrative tasks like clinical documentation than you do with patients? You’re not alone. Clinicians report spending up to two hours on administrative tasks for each hour of patient care. Microsoft is committed to helping clinicians restore the balance with DAX Copilot, an AI-powered, voice-enabled solution that automates clinical documentation and workflows.

70 percent of physicians who use DAX Copilot say it improves their work-life balance while reducing feelings of burnout and fatigue. Patients love it too! 93 percent of patients say their physician is more personable and conversational, and 75 percent of physicians say it improves patient experiences.

Help restore your work-life balance with DAX Copilot, your AI assistant for automated clinical documentation and workflows.

VISIT SPONSOR → https://aka.ms/kevinmd

SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast

RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended

GET CME FOR THIS EPISODE → https://www.kevinmd.com/cme

I’m partnering with Learner+ to offer clinicians access to an AI-powered reflective portfolio that rewards CME/CE credits from meaningful reflections. Find out more: https://www.kevinmd.com/learnerplus

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 “The role of epigenetics in fertility: Can lifestyle choices affect future generations?” Yemi, welcome back to the show.

Oluyemisi (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 read it.

Oluyemisi (Yemi) Famuyiwa: Yes. So this article, again, like most of my articles, is inspired by questions that patients ask me, or by talk when we start talking in the office. So we started looking at what are the things that can actually affect your genes, what can affect your eggs or your sperm, and that’s one of the things I’ve been doing. But also, we’re now talking about things that not only affect the egg and the sperm but things that can be translated to your future generations, right? So epigenetics talks about things that can affect your genes that can be passed on to your offspring.

Kevin Pho: Go further. Tell us more detail. So what are some examples where your genes are affected in future generations?

Oluyemisi (Yemi) Famuyiwa: So epigenetics is what can affect the way your genes actually work. Epigenetics means what can affect your genetics, what can affect your genes, and can be transmitted to future generations. So one of the things that I look at is, when you look at epigenetics, epigenetics are things that tell your DNA how to behave, right? So you may have the genetic code; everything is there, nothing’s missing, but environmental cues or even what you eat can affect how the gene is actually expressed. It doesn’t change the DNA. The DNA is still there, A, T, G, C; the combination is still there, but how it behaves can be changed, right? So let me give you an analogy.

Epigenetics is like when you put a sticky pad, right? You take a sticky pad and you stick it on your DNA, and it’s telling you, “Turn your DNA off,” or “Turn your DNA on,” right? Things that can change how the DNA is expressed, that’s the epigenetics, right? So it could be, for instance, if you tag the DNA, we call it putting in a methyl group, right? You put a sticky tag on the DNA. That sticky tag is like when you’re reading a book, let me say a recipe book, right? The DNA is your entire recipe book. You can put a sticky on different pages of your cookbook, and the sticky tells you, “Don’t read this page; read that page.” So you can turn off which genes are read and which genes are muted. That, in essence, is what epigenetics is. You can have the DNA there, but you may not express it, or you may express it differently.

And one of the ways to do that is if you add what is called a methyl group. You tag the DNA with a methyl group, and it mutes the expression of that DNA. You can also change how the DNA is expressed by, you know, the DNA is curled around histone molecules, right? They’re called histones, right? If you have the DNA tightly wound with a histone, then it’s not read well, or you could loosen that winding up, right? Then you can read it better. That’s how these other things, called the epi, above genes, can affect how the DNA is expressed.

Kevin Pho: So tell us examples of, say, phenotypes that are muted or not, that people can see in future generations, whether that DNA is muted or not.

Oluyemisi (Yemi) Famuyiwa: Absolutely. Let me tell you, there was a study that was done in Sweden, for instance, where they found out that grandfathers that experienced the famine, during the famine, their grandsons were born and had a lower risk of cardiac death. The same famine affecting grandmothers, their granddaughters were born and have a lower lifespan. Ain’t that crazy? And this, we’re talking two generations apart, right?

Another example that people may know about is twins, when you have what is called the epigenetic drift. You take one twin and you put them in one environment that has a lot of stress, that has, you know, things that can affect the DNA. You take another twin that is in an environment that’s eating healthy food, vegetables, things that can lower oxidation. Then those twins start to develop differently. It’s called the epigenetic drift, right? So that’s one of the typical examples.

Another analogy is, think about the things that can affect the DNA, right, things that can cause increased oxidative stress. Think of it as when you have a cookbook, and you take one DNA and you put it in a very salty environment, right? That’s not conducive to growth. You put the other one in an environment where it’s got all these nutrients and everything, and it develops differently. So it’s the epigenetics that’s causing that drift, that change that you see.

Kevin Pho: What can cause that change? What can take a, you know, knock at your DNA?

Oluyemisi (Yemi) Famuyiwa: Yeah, well, like we’ve been talking about, the things you expose yourself to, right? Excess cortisol, sleep deprivation that raises your cortisol levels, bad diet, you know, can also affect those.

Kevin Pho: So when you say bad diet, what specific things are we talking about that can specifically affect the epigenetics of fertility?

Oluyemisi (Yemi) Famuyiwa: So one of the common ones for epigenetics, you know, famine, for sure. If you’re in a nutrient deprivation state, that can affect how the DNA is expressed. If you’re eating a diet that’s, you know, a poor diet, for instance, if you don’t have a lot of vegetables, if you don’t have, you know, the right amount of proteins or nutrients, vitamins, in it, then you’re not giving your genetic DNA enough ingredients to flourish, right?

So I guess I keep going back to the reference: Think of your genetic material in the cookbook. The environment is the kitchen: bad kitchen, bad food, right? And then the ingredients you put in, salt, spices, healthy ingredients, are going to make sure that the food coming out is good.

Kevin Pho: So we talked about diet. I’m going to assume smoking also affects that. Tell me the other factors that can really impact the epigenetics.

Oluyemisi (Yemi) Famuyiwa: Smoking. Smoking is not good; well, we all know that. So anything, you know, if you’re exposed to chemicals, for instance, chemicals that could be bad for your health, for instance, a lot of people, or chemotherapy, for instance, those things really do affect your DNA and can cause changes in how the DNA is expressed.

Kevin Pho: So you’re obviously a fertility specialist. So how do you educate patients in the exam room? Do you ever bring up these epigenetic scenarios when you counsel them?

Oluyemisi (Yemi) Famuyiwa: So what I do mostly is not so much counseling on epigenetics, because most people don’t understand what that means. So then I focus on, can we look at what kind of food you are eating, what kind of ingredients you are putting in your body? Because the healthier the food that you put in, the healthier the embryo. And then if you’re eating healthy food, you have a high antioxidant portion to your food, whereas if you’re not very healthy, then you could be susceptible to what is called oxidative stress, for instance, that we know can damage DNA, right, and can also interfere with your HPO axis. So the key focus for the layperson is how healthy can we make our environment and our bodies and the food we put in our bodies.

I mean, we all know, let me give an example, right? When you have, in certain socioeconomic groups, right, where nutrition is poor, the pregnancy outcome is not good, right? And that’s been studied over and over again, especially where you have some food deserts in some places, right? So there have been government outreaches trying to reach those populations to improve the prenatal care. What they also need to be saying is, “Well, we know that it can affect your baby, but did you know that some of these effects can affect your eggs, going to your baby, and maybe your potential grandchildren?” So what you expose your body to, the insults you put your body through, can have genetic consequences that we’re only now starting to see. We’re only now starting to study more. So stay tuned. I think you’re going to hear a lot more about it.

Kevin Pho: So you wrote in your article that the Mediterranean diet has been associated with improved fertility outcome, right? Is that something that you recommend to your patients?

Oluyemisi (Yemi) Famuyiwa: Yeah, I do. I mean, I do. I think, you know, to give it a name, yes, we’ll call it the Mediterranean diet, but in reality, it’s any diet that’s rich in vegetables, it’s any diet that has a lot of nutrients in it, and it’s any diet where you eat fruit and nuts, if you’re not allergic, and you’re eating healthy fish, you know, the omega-3-high fish. Does it have to be Mediterranean? No, it’s any diet that includes all those things. Mediterranean is a name that most people will be, “Ah, yeah, I think I’ve heard of that. I think I know what that is.”

But if you go, for instance, to some African cultures where they eat straight off the farm, they farm the foods, they have fruits, they have fresh ingredients, their diet is almost like that, right? So you go to the village, and the lifespan is very, very high. You go to the city that’s becoming Westernized, and they’re eating all this Western food, pizza and french fries and stuff. Well, guess what? We’re starting to see the same problem: increased diabetes, decreased lifespan, poor pregnancy outcomes. So any diet that incorporates all those things is what’s healthy.

Kevin Pho: And you also wrote: Exercise, beyond physical benefits, also can foster positive epigenetic changes. So talk more about exercise.

Oluyemisi (Yemi) Famuyiwa: So we know that when you exercise, when your muscle contracts, you’re using more glucose. Have you ever heard there are some cultures where you eat dinner, go for a walk? Exercise, contract your muscles. You decrease your incidence of metabolic syndrome. You use your glucose better.

We now know that with metabolic syndrome, yes, there are some environmental factors, but also some genetic factors, right? We don’t know all the reasons why people have PCO and their children have PCO or an increased risk for diabetes or PCO, or PCO patients have a high incidence of diabetes in their families, right? So that’s part of all that syndrome, right?

So exercise does help. And you don’t have to be an Olympic champion. You know, just go for a walk. Go for a 10-, 20-minute walk. I saw this one coach who talked about exercise snacks. I like that a lot, right? If you sit down a lot, get up once in a while and do ten squats, and intersperse it throughout the day. Move around a bit, you know; do some steps and count your steps. You don’t have to sit down to do the whole thing: “Oh, I’m going to be an Olympic champion in one hour.” You can spread it out and do little things. I think the key thing is just move your body.

Kevin Pho: And one concept that I wanted to talk about was epigenetic plasticity. So it could be reversible, whatever harmful effect, right?

Oluyemisi (Yemi) Famuyiwa: Absolutely, it can be reversed if you adopt a health. Let me tell you, you know, I was just at the ASRM conference a couple of weeks ago, and they had this research that was presented, I believe it came from China, where they, well, I’m not sure exactly where it came from, but they looked at the effects of opioids, no, not opioids, cannabinoids, THC, on sperm and found that it decreased testicular volume, affected motility, affected morphology. And after the people who consumed it stopped, the effect did linger for a while. The good news was that it did recover if they stopped, right?

So if you stop exposing your body to what can be influencing it in a negative way, you can hopefully reverse some of the damage, right? It’s not permanent. You just have to start, you know, start now.

Kevin Pho: We’re talking to Yemi Famuyiwa. She’s a fertility specialist and founder of the Montgomery Fertility Center. Today’s KevinMD article is “The role of epigenetics in fertility: Can lifestyle choices affect future generations?” Yemi, as always, we’ll end with some take-home messages to the KevinMD audience.

Oluyemisi (Yemi) Famuyiwa: So I think the take-home message I want my audience to have is: The more you know, the healthier you can be. The more you know, the more empowered you can be. The more you know, you can take care of your genes, so that I stop seeing patients in their mid-forties, late thirties, that have depleted eggs or egg quality that’s so bad, right? So let’s start taking charge of what we can do to enhance our fertility.

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

Oluyemisi (Yemi) Famuyiwa: Thank you very much.

Listen and followApple PodcastsSpotifyYouTubeMore apps · Browse all episodes