Cover Story
Before couples can undergo nuclear genome transfer in the UK they have to go through a rigorous process including counselling
transfer so far seem to be healthy, though there aren’t
detailed data available about their development. But
experts caution that being born healthy doesn’t mean
MRT is necessarily safe.
“You don’t expect to see problems at birth but later
on when their brains and immune systems develop,”
explained Dr Keefe. As the first MRT baby was born
in 2016, it’ll take many years before we have a clear
picture of how the procedure has affected their
development, if at all.
“Most conditions are rare enough that we’re going
to need thousands of babies born through MRT before
we can determine if the procedure is safe,” he added.
Ethical dilemma and regulatory framework
Beyond its potential health risks, the new fertility
treatment has also raised thorny ethical questions.
Key among them is to what extent should we allow
people to use technology to try to produce offspring
that are as genetically close to them as possible.
One answer to this is found in Mitochondrial
Replacement Techniques: Ethical, Social, and Policy
Considerations, a 2016 report compiled by an expert
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MARCH 2020
committee assembled by the US National Academy of
Medicine.
“Prospective parents seeking to use MRT to satisfy
their desire to have children who are at significantly
reduced risk of manifesting serious mtDNA disease
and with whom they have a genetic connection is
justifiable within the limits of protecting the health and
well-being of the children who would be born as a
result,” said the report.
To that end, the committee recommended MRT
clinical investigations only if safety was established
and risks to the individuals involved were minimised.
According to the report, any clinical attempts also
needed to be limited to “women who otherwise are at
risk of transmitting serious mtDNA disease, where the
mutation’s pathogenicity is undisputed and the clinical
presentation of the disease is predicted to be severe,
as characterised by early mortality or substantial
impairment of basic function.”
Another issue that puts the morality of nuclear
genome transfer into question is that it involves
modifications to the germ line of the newborns,
meaning that the engineered DNA of female
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