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Mitochondrial donation

Mitochondrial donation (~~sometimes called mitochondrial manipulation technology or MMT)~~ is a special form of in vitro fertilization in which the future baby's mitochondrial DNA comes from a third party.

[4]

The two most common techniques in mitochondrial donation are pronuclear transfer and maternal spindle transfer. What this implies is that a baby is being produced with the DNA of both parents, as well as some DNA from a healthy donor of mitochondrial contents. Due to the unchartered nature of producing a child with 3 sources of DNA, this subject is currently quite contentious in the field of bioethics, as is the case with many other gene therapies. Currently, mitochondrial donation techniques are legal in the United Kingdom.

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Background of mitochondrial disease

Genetic faults in the mitochondria cause Mitochondrial disease and affect parts of children's bodies that use a lot of energy causing problems such as loss of muscle coordination, heart disease, liver disease, neurological problems,

[8]

History of mitochondral donation** SP?

In the United States in 1996

[10]

).

In 1997 the first successful baby was born using this procedure (Emma Ott). in In 2001 Cohen and others reported that 10 single babies, twins, and a quadruplet at his New Jersey clinic and a further six children in Israel had been born using his technique. Using modifications of his procedure, a baby had been born at

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In 2002, the US

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In the United Kingdom, following animal experiments and the recommendations of a government commissioned expert committee,

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Case of Emma Ott

~~Maureen Ott, a mechanical engineer living in Pittsburgh, Pennsylvania was the first mother to become pregnant using the~~

~~[18]~~

Case of Alana Saarinen

~~Alana Saarinen (born 2000) is a girl from West Bloomfield, Michigan, US conceived through~~

~~[8]~~

Before Saarinen's birth, her parents had gone through four attempts to have a baby through numerous IVF procedures without success. The fifth attempt using cytoplasmic transfer succeeded when her mother was 36. The treatment involved the transfer of a third donor's cytoplasm, containing healthy mitochondria, to Sharon Saarinen's egg with unhealthy mitochondria. The egg was then fertilized with Paul Saarinen's sperm. During the process of transferring DNA, some DNA from the donor was in the embryo. Ninety-nine percent of Saarinen's genetic material is from her parents, and one percent is from the third donor.

~~[19]~~

~~According to her mother, Saarinen is healthy and has a normal life as a teenager such as playing golf and the piano, listening to music and hanging out with friends.~~

~~[20]~~

Availability

The process is currently not approved as safe and effective in the

[24][25][26][27]

--> Expand on availability:

http://www-ncbi-nlm-nih-gov.ezp.welch.jhmi.edu/pubmed/26915934

http://www-ncbi-nlm-nih-gov.ezp.welch.jhmi.edu/pubmed/26683843

http://www-ncbi-nlm-nih-gov.ezp.welch.jhmi.edu/pubmed/26939505

Technique

In 2016 there were several processes that could be used for mitochondrial transfer.

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A second method, called pronuclear transfer, started with the mother's egg which was fertilized with the father's sperm. The nucleus from a female donor's egg was fertilized, extracted and discarded. The fertilized nucleus from the mother was extracted from her egg and the rest of the mother's egg with the unhealthy mtDNA discarded. The fertilised nucleus was transferred to the donor egg with the healthy mtDNA and the egg placed in the mother's womb.

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Nuclear genome transfer was similar to maternal spindle transfer but the eggs were not initially fertilized and were then activated using

[30]

Polar body genome transfer involved the transfer of polar body genomes from the nucleus and was at a very early stage of development.

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Cytoplasmic transfer used by Cohen and others in 1996-2001 was not regarded as mitochondrial transfer in 2015.

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Although the donor egg is said to contribute only 1% to the genetic make up of the child, when examining the genetic material of these children there are still three identifiable genetic parents.

inherited

the disease as well.

Ethics

Despite the promising outcomes of the two techniques, pronuclear transfer and spindle transfer, mitochondrial gene replacement raises ethical and social concerns.

Mitochondrial donation involves modification of the

[35]

Implications for identity is another ethical concern that has psychological and emotional impacts on a child's life regarding of a person's sense of identity. It debates whether the genetic make-up of children born as a result of mitochondrial replacement affect their emotional well-being when they are aware that they are different from other healthy children conceived from two parents.

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Opponents argue that scientists are "

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On the other hand,

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On February 3, 2016, a report was issued by the

[7]

They recommended that initially it should only be used for male embryos giving rise to newspaper headlines like "no girls allowed."