By Bettina M. Lengsfeld
This year a baby boy was born resulting from a procedure that utilized DNA from three parents. A Jordanian couple, who had experienced miscarriages and two childrens’ deaths due to Leigh’s disease, underwent mitochondrial spindle transfer (MST) to replace a small portion of the mother’s DNA with donor DNA. The baby is now five months old and healthy.
Mitochondria produce energy for the cell and contain thirty-seven genes, separate from the 23 chromosomes of DNA, which make up the majority of a person’s characteristics. During fertilization, one-half of the chromosomal DNA comes from the father and one half from the mother. All of the mitochondrial DNA is inherited from the mother. A range of diseases, such as, Leigh’s disease, Barton syndrome, or progressive infantile poliodystrophy, affect children born with defective mitochondrial DNA. In the United States, it is estimated that 1,000-4,000 children are born each year with mitochondrial diseases.
In the MST procedure, the chromosomal DNA is removed from the mother’s egg and inserted into the donor egg, where the chromosomal DNA has been removed. The resulting egg includes the healthy mitochondria from the donor and the mother’s chromosomal DNA. This new reconstructed egg can then be fertilized and implanted in the mother. Only 0.2% of the total genetic information in the baby is from the donor egg.
In 2015, the United Kingdom approved the new technique while the Food and Drug Administration (FDA) in the United States has yet to approve MST. Procedures using a slightly different method of mitochondria replacement were partially successful in the early 2000s in the United States. The FDA barred the procedure after several unsuccessful attempts, stating that more oversight and data was required before the procedure would be approved.
The medical benefits are substantial for couples that face the tough decision of whether or not to have children if the mother is a carrier of defective mitochondrial DNA. However, the social, ethical, and legal implications still need to be examined.
The U.S. has long resisted allowing methods of genetically altering embryos for reasons other than disease prevention and creating designer babies. Effectively, MST alters the genetic information of the embryo to prevent disease. It is unlikely that this method can truly create designer babies, because the mitochondria only holds thirty-seven genes and most likely only affect the function of the mitochondria. The FDA is likely to approve the technique once the efficacy and safety of the procedure is satisfactory.
Once MST is approved in the U.S., questions would remain as to the children’s right to know the identity or medical history of the donor. Presently, with traditional in vitro fertilization (IVF), sperm and egg donors’ identities are protected in several states. Although, Utah Code Ann. § 78B-15-708 allows children conceived through artificial insemination to have access to the sperm donor’s medical records. This policy must balance the donor’s privacy and the child’s need to know their medical history in case of disease. MST may result in the same need. Future medical effects of having a donor’s mitochondrial DNA are unknown at this point, and therefore children of these procedures may need medical and genetic information of the donor to treat future disease.
In conclusion, mitochondrial replacement procedures are the newest artificial fertility technology, but have yet to be approved in the United States. Legal questions surrounding the donor’s and resulting children’s rights will have to be addressed. The privacy of the mitochondria DNA donor must be balanced with the need of the 3-parent children to know their medical and genetic history for maintenance of their own health.
Student Bio: Bettina is a Staff Member on the Journal of High Technology Law. She is currently a 2L at Suffolk University Law School and President of the Intellectual Property Law Student Association. Bettina received her doctorate in Microbiology from the University of Texas at Austin, and her Bachelor of Science in Molecular Biology from the University of California, San Diego.
Disclaimer: The views expressed in this blog are the views of the author alone and do not represent the views of JHTL or Suffolk University Law School.
