Global Health Asia-Pacific March 2020 | Page 52

Cover Story Three-person IVF: groundbreaking fertility treatment or dicey gamble? Though the young technique has already led to the birth of a few babies, its efficacy, safety, and morality remain uncertain A The aim of the procedure, dubbed nuclear genome transfer, is to minimise the chances of transmitting mitochondrial disease, a collection of genetic disorders passed on from parents to children that affect the mitochondria 50 MARCH 2020 novel cutting-edge fertility procedure that mixes the DNA of three different people has shown promising results in helping women conceive without passing down debilitating or fatal genetic conditions. Its future is uncertain, however, as the potentially serious health risks and the inevitable modifications to the human genome entailed in the process have also created a storm of controversy. The aim of the procedure, dubbed nuclear genome transfer, is to minimise the chances of transmitting mitochondrial disease, a collection of genetic disorders passed on from parents to children that affect the mitochondria, the so-called energy factories in the cells. These disorders can lead to a wide range of problems, including fatigue, weakness, seizures, vision loss, and heart problems, as well as mental delay and disability in children. In some instances, mitochondrial disease can be fatal and there’s no definitive cure for it. Although disease-causing defects are often passed through the DNA in the cells’ nucleus, where about 99.9 percent of human genome is stored in the form of chromosomes, a minor subset of mitochondrial diseases are caused by mutations in the mitochondrial DNA (mtDNA) itself, a cluster of 37 genes found outside the cellular nucleus that babies inherit only from their mothers. This is where nuclear genome transfer comes in. The technique is a form of assisted reproductive technology involving the use of donated healthy mitochondria to replace the mother’s faulty ones and can be performed in two ways. In spindle transfer, the mother’s nuclear DNA, also known as spindle, is inserted into a donor’s egg whose GlobalHealthAndTravel.com