I’ve written in the past about technologies that have been or are being developed that would allow IVF using nuclear DNA from one woman and mitochondrial DNA from another. The idea here would be to avoid certain diseases transmitted via the mitochondrial DNA. A woman whose mitochondrial DNA carried those traits could have the nuclear DNA from her egg transferred to a stripped-out egg provided by a different woman who did not carry those traits. This egg–now composed of DNA from two different women–could then be fertilzed for use in IVF.
There’s been a lot of discussion in the UK of both the safety and the ethics of using mitochondrial DNA replacement. The HFEA (the UK agency that regulates all things ART–which I thought had been defunded but obviously still exists) has been seeking consultation with various communities for some time. And this consultation continues, as this post from Olivia’s View makes clear.
There are several things to think about in connection with this. First, there are the obvious concerns over whether the technique is safe (which it seems to be) and whether it is ethical (I am not troubled by it myself, but I know others will disagree.)
Second, perhaps because I’ve written recently on the expanding egg market made possible by reliable egg-freezing technology, I see now that this might be another (albeit small) outlet for the egg market. After all, in order to do this you need a third-party egg from which you will strip the nucleus. Given that the mitochondrial DNA ultimately contributes only a little bit to the child who may result from that process, many characteristics of the egg-provider won’t matter. But still, you need an egg and eggs have not always been easy to get. The rise of egg banks will change that. (I suspect this is a small outlet for the egg market because this technique may not be widely used. I don’t actually recall how common the occurence of flawed mitochondrial DNA is.)
Finally, I’m struck by the Olivia’s View note that the HFEA is anxious to take into account the view of the DC Network. This leads me to think about whether a child conceived via this new technology would consider herself/himself a donor-conceived child. Of course, the real answer to this is probably something like “some might while some might not” but even with such a wishy-washy answer, thinking about the question is interesting.
I think, for instance, that some–maybe many–people who understand the idea of a genetic connection between gamete provider and child might not know much about mitochondrial DNA. It certainly doesn’t have the same place in the public discussions of DNA testing and “real” parents. If you focus on people who ascribe great importance to genetic linkage, what will they say about the mitochondrial DNA link? Is it equally important or less so?
Of course, if it is important, this could lead you to say that splitting the genetic connection between the two women is immoral and we ought not to use this technology. But I don’t know if that is the only conclusion. Could you instead include that just as it is important for a child to know/have a relationship with a gamete provider, so it is important for a child to know/have a relationship with their mitochondrial DNA provider?
In general, I assume that women who use this technique will be using their own eggs. After all, if you are using eggs from a third party, why would you use eggs with problematic mitochondrial DNA? So the women using this technique will have the more substantial genetic connection–the one determined via nuclear DNA–to the child. What counselling should they receive about telling the child about the mitochondrial DNA?
I’m trying to imagine the parent/child conversation about this. I can see how a conversation about using third-party gametes generally might go but it seems to me that the mitochondrial DNA conversation is a more technically complicated one that might need to wait until a child is older if you’re going to get even general comprehension. But perhaps I’m wrong about this? Maybe there are ways to explain?
All in all I’m just beginning to grapple with the issues that surround the question of how those conceived with this technology might be like/not like donor conceived children. Unsurprisingly, there’s a lot to consider.