D. Joy Riley, M.D., M.A.
Readers are always welcome to send in questions regarding bioethics issues. This past month, a wide range of thoughtful questions and comments have arrived in our inbox. A few representative ones have been chosen for this newsletter (with no identifiers included, of course).
Read on . . . and remember that you can always contact us here.
1) What exactly are three-parent embryos?
Mitochondria are the power packs in our human cells, and reside in the cytoplasm — not in the nucleus. Mitochondrial disease varies widely in its expression, and has a prevalence rate of about 1 in 10,000 (Ricki Lewis, “FDA Considers Mitochondrial DNA Replacement,” Medscape Medical News, 26 Feb 2014). Mitochondria are inherited from females only.
The current proposals of three-parent embryos* include three people thusly:
- the nucleus of an egg from a woman with mitochondrial disease
- the cytoplasm of an egg from a woman with no mitochondrial disease
- sperm from one man
There are at least two ways of putting these together, and each method results in zygotes/embryos, the tiniest of humans, with DNA from three individuals. While some call this “oocyte (egg) modification,” and others, “mitochondrial transfer,” Stuart Newman of New York Medical College calls it the “creation of genetically modified children.”
*It should be noted that the proposal before the FDA also includes three-parent embryos as a possible treatment for infertility, although that application is not widely discussed.
2) Has it been done before?
In 2001, the FDA halted the program of a clinic in New Jersey which involved injections of egg cytoplasm from fertile women into the eggs of infertile women, termed “ooplasm transfers.” It would be erroneous to assume that the New Jersey clinic was the only enterprise engaging in such a practice, however. A picture of one family, who had undergone the treatment in Michigan, was published in the June 27, 2014, edition of The New York Times Magazine (scroll down the document to see it): it is a picture of a wife and husband standing at opposite ends of a small delicate sofa, on which a young girl is perched. The girl is identified as one whose conception resulted from an ooplasm transfer.
3) What were the effects of that research?
The effects are not yet known. The lovely girl in the NYT Magazine photograph described above has had her photograph published once again — this time in The Independent, a UK newspaper. According to the article accompanying the photograph, the Saint Barnabas Medical Centre in New Jersey is investigating the 17 young persons born through cytoplasmic transfer in their particular institution. There has been no long-term follow-up to date, but now a study is underway:
Jacques Cohen, the scientist who carried out the cytoplasmic transfer on the 17 IVF babies when he was employed by the IRMS, said the follow-up began earlier this year and that it is being led by Dr Serena Chen, a fertility specialist at the IRMS. “Because the research team members accepted different positions elsewhere, no follow-up was conducted until this year. The current follow-up study is ongoing and results will be made available in a medical journal,” Dr Cohen said in an email.
These two pictures tell a story all by themselves. Conception by three adult parents is an experiment; the results, however, are borne by the children. It is not the adults who will now be subjected to the investigative techniques of the researchers. How can we as a society pretend that a son or daughter so born through genetic modification can truly give informed consent?