Three-Parent IVF: What, Why, And Why Not

Few things in life are simple, but until now one fact has consistently held true for every person on the planet — everyone has two biological parents, one male and one female. A revolutionary new IVF technique dubbed “three-parent IVF” could soon change that.

You may have seen mentions of three-parent IVF circulating around the internet. But what exactly does this new IVF technique involve, what are the ethical concerns, and will this technique really usher in a new era in human reproduction?

What Three-Parent IVF Is

Three-parent IVF, also called mitochondrial replacement, has been in the news again because a British regulating body presented its advice to the UK government last month. Before we can discuss what that advice entails, you'll need to know just what this controversial new IVF technique actually is. This is perhaps best accomplished through a glossary of terms that are relevant to the debate, and the technique.

Mitochondria

Mitochondria are tiny organelles that power every cell in the body, with the exception of red blood cells. Mitochondria covert the energy of food in order to power many functions within the cell. Mitochondrial DNA is inherited from mothers only — they are created from the outer shell of an egg cell. The mother's genetic material is contained within the nucleus of the egg cell, which then joins with a sperm cell to complete a new baby's genetic information. Mitochondrial DNA does not affect the appearance or personality of a person, but can hold the key to certain genetic diseases.

Mitochondrial Disease

Mitochondrial diseases are caused by a failure of the mitochondria. Cells receive less energy, and the affected cell can be damaged or die. Different mitochondrial diseases can affect almost all important bodily functions — heart, brain, liver, kidney, skeletal muscles, respiratory system and hormone function.

Mitochondrial diseases can be devastating. Imagine muscle weakness and pain, poor growth, loss of motor control, gastrointestinal problems, swallowing difficulties, seizures, diabetes, liver disease, cardiac disease, and more. In some cases, babies born with mitochondrial disease barely survive birth. Mitochondrial diseases are no joke, and finding a cure could save many families a lot of pain in the future.

Three-Parent IVF

Currently, every single person was created from a sperm cell and an egg cell — so every person has a single biological mother, and a single biological father. Mitochondrial DNA is only inherited from the mother, and that's where three-parent IVF comes in.

This technique would create an embryo from the biological mother and father. The nucleus, containing the parents' genetic material, would then be removed from the original egg and transplanted into an egg from a donor. This donor egg would have its nucleus removed, leaving the membrane, cytoplasm and mitochondria — ready to receive the desired nuclear DNA. The result would be a baby without mitochondrial disease, created from three separate people. In a similar but alternative procedure, discarded IVF embryos from other couples could be used instead of fresh donor eggs to obtain the donor mitochondria. 

The Three-Parent IVF Debate In Great Britain

Three-parent IVF has been in the news again this spring, in the UK and beyond. But the debate started back in March 2011 when the health minister at that time asked the UK's fertility watchdog, the Human Fertilisation and Embryology Authority (HFEA) to take a closer look at three-parent IVF. From the outset, it was clear that the technique would only be performed in cases where a would-be biological mother carries faulty mitochondrial DNA.

The regulating body — which is a quasi-governmental organization — decided to conduct a public debate including consultations with prominent scientists, and to make a recommendation about how to move forward.

The resulting discussion has been country-wide, and also most certainly indirectly involved people from all walks of life across the globe.

The HFEA has now concluded its consultations, and made a report. The regulating body concluded that “the public dialog [...] showed broad support for mitochondria replacement being made available to families at risk of passing on a serious mitochondrial disease.”

It is now up to legislative bodies within the United Kingdom to draft regulations and to continue the discussion. In the meantime, the HFEA makes some key recommendations. Should three-parent IVF become a legal possibility within the UK, the fertility watchdog wants:

• Fertility clinics who want to offer three-parent IVF to be specifically licensed to do so, something that would also fall under the responsibility of the HFEA.
• The right to consider each case of three-parent IVF on a case-to-case basis, with the possibility of more flexible regulations later on.
• To ensure that follow-up studies are conducted to find out how children born as a result of three-parent IVF are developing.
• Mitochondrial donors to be considered as tissue donors (like those who offer organs for donation after death). This means children born as a result of the technique would not have a legal right to know the identity of their mitochondrial donor.
• Continued research into the efficacy and safety of three-parent IVF once the technique is used in practice.

The HFEA's advice hardly represents the end of the debate. The issue would appear before the UK parliament prior to its legalization — and there is no doubt that the practical and ethical implications of mitochondrial replacement will continue there. It is certain that the outcome of the parliamentary debate and vote in the United Kingdom will change the world, however.

Ethical Concerns About Three-Parent IVF

Why new medical technique that shakes the foundations of human creation is controversial, and comes with plenty of ethical concerns. Take your pick:

• Some people say that three-parent IVF, which aims to create healthy babies by definition, is a form of eugenics. Mitochiondrial replacement could truly usher in the age of designer babies and humans playing God.
• The technique used to transplant the intended parents' nuclear DNA into a host egg containing healthy mitochondrial DNA is very similar to the technique used in cloning. Would three-parent IVF open the door to cloning?
• We can't possibly know how children born as a result of this technique will develop. If three-parent IVF goes horribly wrong, that would affect children born as a result of it as well as possibly the whole human race — after those children start procreating.
• If discarded IVF embryos are used, one life is essentially destroyed to make another possible. 
• Children born as the result of this technique would not be guaranteed the right to know the identity of their mitochondrial donor. Is that ethically acceptable?

I just can't forget about a comment I read, that somebody left on a news article about three-parent IVF. The person who left the comment argued that it would be terrible to allow the destruction of the human race (if, presumably, this technique went wrong) because of the desire of a very small percentage of couples affected by faulty mitochondrial DNA to have biological children. Because these people do already, in this day and age, have healthy children either through adoption or by using an egg donor. Should this technique really be approved because someone specifically wants to pass on their own genetic material?

That comment may be harsh, but it sure makes an interesting point. The United Kingdom may be the first country in the world to allow three-parent IVF to be used in practice. While the British Members of Parliament prepare to argue their case in the House of Commons, the wider debate is certain to continue throughout the world.

What is your opinion about mitochondrial replacement and its ethical implications?

An Update on Three-Parent IVF

The first baby to have been conceived with the help of this technique was born in 2016 — that's right, a baby that technically has three biological parents! Since then, more trials have been conducted, and the initial opposition to this technique has waned as its safety is becoming more clear. The technique will continue to be reserved for those parents who live with rare genetic illnesses that could be prevented in their babies with the help of three-parent IVF, in those jurisdictions where it has been approved. There is no risk of GATTACA-like pregnancies becoming routine as of yet, and the focus is entirely on the prevention of suffering.