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The Issues Facing Three Person Babies

By D. Joy Riley, MD, MA (Ethics) | February 15, 2018

by D. Joy Riley, MD, MA (Ethics)

On February 1, 2018, Ian Sample, the science editor at The Guardian, wrote an article entitled “UK doctors select first women to have ‘three person babies.’” The Human Fertilisation & Embryology Authority (HFEA), Britain’s reproductive technologies regulatory agency, has given the go-ahead for “mitochondrial replacement therapy.” Mitochondrial replacement therapy is a massaged term which is actually nuclear (in this case, pronuclear) transfer. The Guardian helpfully illustrated the process for the reading public in 2013 and again in 2018.

“Mitochondrial replacement therapy” is not the only massaged term employed. How about “fertilized egg?” This is also known as an embryo. In pronuclear transfer, two embryos are created and destroyed in the process of creating a third, genetically manipulated one. The genetic change is not only the nuclear transfer that is accomplished, but also the novel combining of a nucleus that has the DNA of a genetic mother and father and the mitochondrial DNA of the female “donor.” Finally, the term “therapy” is also a massaged term. Therapy usually means treatment for someone living who is actually ill. This “therapy” does not treat any living human being for a disorder. Instead, the procedure destroys one embryo that might have a disorder and another that has no known mitochondrial disorder, in order to formulate an embryo that, hopefully, will not have a mitochondrial problem. Any “therapy” this technological process produces is apparently for the parents and society, as no individual is treated.

Desiring healthy children who will not suffer is a fairly universal hope. How far we can, or should, go as parents and society, however, are very different questions. In the late 1990s, cytoplasmic transfer was tried in the U.S. Several births resulted before the program was shuttered by the U.S. Food and Drug Administration in 2002. The stories of two of the young people born through this procedure are featured in a 2014 New York Times article. One of those featured has been tested and is reported not to have a third person’s DNA, while the other had not been tested at the time the article was published.

A summary of known results of the previous cytoplasmic transfer experience shows the following:

  • 12 pregnancies through cytoplasmic transfer in Cohen’s practice
  • 17 babies born
  • One early miscarriage: missing X chromosome
  • One twin pregnancy in which one baby was normal and the other was missing an X chromosome
  • One child had symptoms of pervasive developmental delay at one year

Mitochondrial replacement is not synonymous with cytoplasmic transfer, and any problem this procedure may introduce is yet to be discerned. Commenting upon the 2016 birth of an “apparently healthy child created in a similar way at a clinic in Mexico,” Sample wrote, “While news of the birth was welcomed by many scientists, some voiced concerns that the child might not have the regular follow-up checks that are needed to ensure it is developing properly.”

The Nuffield Council on Bioethics, an independent advisory body in the UK, has advised thusly:

Regulation: follow-up
Families using such techniques should commit to allowing very long term follow-up of their children and families in order to further knowledge about the outcomes of these techniques. To support this aim we would recommend the creation of a centrally funded register of any such procedures performed in the UK, accessible to researchers over several decades.

Would follow-up include life-long observation and testing for children born through the methodology of three-person embryos? Would young women born by this means be forced to have children only through IVF and some equivalent of pre-implantation genetic diagnosis (PGD)?

Additionally, safety concerns raised by University of Sussex evolutionary biologist Ted Morrow have been dismissed by the HFEA. Morrow describes himself as “not a pro-lifer,” but he is apparently concerned about possible effects of mitochondrial replacement in humans. In a previous era, C. S. Lewis raised a different concern about such technologies in his essay Abolition of Man: “...the power of Man to make himself what he pleases means...the power of some men to make other men what they please.” Surely these are words to ponder.

Related Resources

CMDA Ethics Statement on Three Parent Human Embryos

Techno-Babies: Some Assembly Required? by David Prentice, PhD

Outside the Womb by Scott B. Rae and D. Joy Riley, MD

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