Several months back, we reported in our blog that the authorities that regulate IVF and other fertility procedures in the UK were considering allowing IVF with mitochondrial transfer to move forward. Mitochondrial transfer is more popularly known as “three parent IVF,” because it involves three genetic parents: the woman who provides her chromosomes, the husband who provides his chromosomes and the donor who provides the mitochondria which contain their own DNA. The HFEA in the UK has now given the green light for tightly regulated research to proceed on mitochondrial transfer. So, now it is likely that fertility researchers in Britain will move forward and learn whether this technique can help couples with mitochondrial diseases.
It has been known for some time that couples suffering from infertility, including those who get pregnant using assisted reproductive techniques such as IVF, are more likely to have complicated pregnancies.: more high blood pressure, diabetes, miscarriages, preterm births and likely birth defects as well. This is true even with singleton pregnancies. What is not so clear is why this is so. Is it the patient population? Women who have infertility tend to be older and have more medical and metabolic problems. Is it the fertility medications such as clomid and injectables? Is it something in the process of IVF or IUI that causes problems? Researchers at Cedars Sinai Hospital in Los Angeles have received a large grant from the National Institute of Child Health and Development to help study the molecular events the underlie an early pregnancy after IVF. They will be looking at both genetics (the DNA in the chromosomes) and epigenetics (changes in gene expression that occur outside the chromosomes) to try to discover an explanation for these problems
In Reproductive Medicine we are comfortable in offering our IVF patients Preimplantatation Genetic Testing (PGD) and Screening (PGS) to prevent the transmission of genetic diseases and reduce miscarriages. Many of us in the field are concerned that there is also a slippery slope, and that advances in genomics may make it too easy to cross that line. Researchers in China are now trying to use these new tools to help couples select smarter babies. To many of us in the west this sounds like Brave New World, the novel by Aldous Huxley, but in China this idea is not so controversial. If their project is ultimately successful, it should raise enormous ethical concerns for all of us, and more importantly is the potential that our patients will insist on access to this technology regardless our ethical concerns.