3 June 2014
A scientific panel reviewing the use of three-person IVF or mitochondrial transfer has said that UK researchers will be ready to create babies with genetic material from three adults in about two years, subject to the expected legal amendments to make it legal, according to the BBC.
HFEA review of mitochondrial transfer
The Human Fertilisation and Embryology Authority (HFEA), the independent UK regulator for the use of human eggs, sperm and embryos in fertility treatment and research, commissioned an expert panel to review the science behind two related techniques to prevent the birth of children with mitochondrial disease to women who carry mitochondrial mutations.
These both involved the use of donor egg cells with healthy mitochondria, but involve cloning techniques applied at different stages; in embryo repair or pronuclear transfer the parental genetic material in a fertilised embryo is removed and inserted into a healthy donor embryo, from which the genetic material has previously been removed, to create a new embryo. In egg repair or maternal spindle transfer, the maternal genetic material is transferred from the egg cell to the healthy donor egg cell, which is then fertilised by the father’s sperm to create an embryo. Both approaches result in an embryo in which the vast majority of the genetic material comes from the father and mother, but the mitochondria (and small amounts of mitochondrial DNA) come from the female donor.
The panel’s report said that there was no evidence that either technique was unsafe, nor that one was superior to the other, but called for some further safety checks before the technique should be used. Panel member Prof Robin Lovell-Badge reportedly said: "The direction of travel still suggests that it is all safe, but we don't know what's round the corner so we're being a little cautious". This is what has prompted the estimate of another two years until implementation.
The motivations for UK regulatory change
A Department of Health spokesperson said that the report would be considered along with responses to their consultation on the subject held earlier this year, and that mitochondrial donation “will give women who carry severe mitochondrial disease the opportunity to have children without passing on devastating genetic disorders”, as well as maintaining UK scientific pre-eminence in the field.
The latter must be considered a significant motivation given that affected women could also have a healthy child via conventional IVF simply from the direct use of healthy donor eggs in place of their own. Either the right to biological parenthood or pioneering science – or indeed both – must therefore be the driving force behind the UK’s race to be the first to use mitochondrial transfer.
Parliament is to have a free vote on whether or not to amend the law to allow the technique later this year; it is expected to be approved, but politicians and others have voiced various ethical concerns about the procedure.
The view from across the pond
The equivalent US regulator (the FDA) has also recently reviewed the scientific status of the technique along with potential measures to minimise risks in human trials; these included the possibility of restricting it to the creation of male offspring only, as they would not be able to pass on any ill-effects to subsequent generations, and careful criteria for the selection of prospective mothers and egg donors for inclusion in clinical trials.
Whilst the advance of science with potential to improve or transform health is an undeniably positive goal, balancing the possible gains against ethical and societal concerns and health risks can be difficult. The HFEA scientific panel were clearly enthusiastic about the technique, but embraced a degree of caution in calling for additional tests. It will be interesting to see how the UK Department of Health deci de to respond.