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26 September 2020 

Babies to be created from three people


issue 27 - May June 2015
First IVF and now three parent babies. Humans always find ways to manipulate nature to find solutions to problems. Can genetically engineered babies be one these? Laleh Lohrasbi examine

When in the 1920s the British writer, Evelyn Waugh, famously said: ‘I can never understand how two men can write a book together; to me, that’s like three people getting together to have a baby’, few would have imagined that less than a century later the idea would be close to becoming a reality. However, earlier this year in a historic debate that has stirred much controversy, one third of British MPs (382 to 128) voted to allow the in-vitro creation of babies using the DNA of three people.
Proponents of the procedure say it is supposed to prevent the inheritance of genetic diseases. That is true in part because for the moment the procedure only covers hereditary ‘mitochondrial diseases’. Nevertheless it is considered to be a huge step forward which has caused bitter divisions in the scientific community and raised many ethical concerns. Mitochondrial diseases are caused by genetic faults in the DNA of tiny structures that provide power for the body’s cells. Each cell – as well as a women’s egg – is comprised of several tiny structures such as the nucleus and mitochondria. The nucleus contains the DNA molecules which consist of more than 20,000 genes responsible for a person’s identity such as their looks and personality. Mitochondria are structures in cells which generate energy that allows the human body to function. These particles are also called ‘cell batteries’.
These tiny structures also contain a very small amount of DNA which makes up only 0.054% of an individual’s overall DNA and is completely different from the nuclear DNA that determines personal characteristics and traits, but it is nevertheless powerful enough to cause a deadly disease. A mutation in this DNA can cause the mitochondria to malfun¬tion causing liver failure, muscle wasting, blind¬ness, brain damage and death. The mitochondria are passed down the maternal line, meaning that any mutations are guaranteed to be passed on to the next generation. About 2,500 women in Britain are at risk of bearing children with this devastating condition. Health officials estimate that around 125 babies are born with the mutations in Britain every year. As defective mitochondria are passed only from mother to child so scientists in the UK have pioneered therapies that use functioning mitochondria from a female donor meaning that the final embryo will be formed by mother, father and the donor. Two methods are suggested for this new IVF procedure which health officials are planning to offer from next year: embryo repair and egg repair. In embryo repair, two eggs are fertilised – those of mother and donor. Both the parents’ DNA is then transferred to the donor’s embryo which has had its nucleus already removed. Then the embryo is implanted in the mother’s womb.
In egg repair the mother’s DNA is transferred to the donor’s egg before being fertilised by the father’s sperm. After fertilisation the embryo will be planted in the womb. It is not clear which method is safer or more effective. However, mitochondria have a tiny amount of their own DNA so any resulting child would carry genetic information from three people. The team at Newcastle University who originally developed the method, are at a more advanced stage with the embryo repair method.
Pro and against
The procedure has received many different reactions. Its advocates believe this is very good news for patients with mitochondrial DNA disease. Professor Dame Sally Davies, Chief Medical Officer for England said: ‘The intention in making these regulations is to ensure that mothers who carry faulty mitochondria can have healthy children free from devastating and often deadly conditions caused by serious mitochondrial disease.’ Prof Dagan Wells, Associate Professor at the NIHR Biomedical Research Centre, University of Oxford, believes: ‘Disorders involving defective mitochondria can have cata¬strophic consequences for the affected individuals, sometimes causing death during infancy. For many years it has been possible to diagnose mitochondrial conditions, but what then? There have been few treatment options and no cure. Now, after years of careful research, we are finally at a point where a cure for mitochondrial disorders may be within reach’. While scientists mention that mitochondrial DNA repre¬sents less than 0.054 per cent of the total DNA, and would have negligible effect on individual characteristics, some groups including Human Genetic Alert have opposed the procedure and likened it to genetic modification. They say: ‘crossing this line would lead inevitably to a future of ‘designer babies’ and a new consumer-driven eugenics.’
Jacob Rees Mogg MP believes the difficulty with starting such a procedure is that it would be very hard to see where to stop. He says: ‘Once the germ line is changed at one point you decide that isn’t allowable in other cases. At the moment there is a very clear boundary that babies cannot be genetically altered. And once you have decided that they can, you have done something very profound.’
He adds: ‘It does affect the person in a very fundamental way even if it is very small. That is a permanent change and will be inherited by their descendants. It’s not a cure for disease, it is the creating of a different person.’ While British Prime Minister David Cameron voted in favour of the legislation, saying it was not ‘playing God’ but offering parents the chance to have a healthy baby, the Catholic Church in England and Wales believes there are serious ethical objections to this procedure which involves the destruction of human embryos. The Church argues that there should be more time for consultation and research, while adding that it ‘did not want to prevent people from benefiting from a major advance in genetics and assisted reproduction.’ In the Islamic faith the involvement of three people in a fertility procedure such as where the egg of the mother is replaced with one from a donor is already practised. Some scientists have warned that three-parent babies could be at greater risk of cancer and premature ageing. Dr. Trevor Stammers, Programme Director in Bioethics and Medical Law at St Mary’s University, says: ‘…[babies] will have to be monitored all their lives, and their children will have to be as well.’ He believes that the interaction between mitochondria and nuclear DNA is not fully known yet and changing the mitochondria is a very complex matter that is not like changing the cell’s batteries.
In 2000 scientists in the US adopted a different in-vitro fertilisation technique to conceive a child with DNA from three people. However the procedure was later banned due to safety and ethical concerns. There remains a view that there are numerous serious risks associated with this technology. For example Dr Paul Knoepfler, associate professor at the University of California, believes the most notable risk is the possibility of having mentally disabled babies or even deceased babies. Britain is the first country to allow a move described as ‘bold’ by supporters and ‘potentially reckless’ by detractors. The first baby from three people is planned to be born in 2016.

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