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Three parents and a baby?

by Jeffrey P. Kahn, Ph.D., M.P.H.
Director, Center for Bioethics
University of Minnesota

One of the leading reproductive medicine clinics in the United States has announced the success of a technique they developed to help women whose eggs don't seem to fertilize and develop properly. It can involve inserting the genetic material from an infertile woman's egg into the "shell" of a donated egg whose genetic material has been removed -- think of the yolk of one egg being transferred into the shell and white of another egg. Or material may be injected from the inside of a donated egg into the infertile woman's egg, to give it a needed boost for fertilization and development -- think of an injection of egg white. Mixing the "boosted" egg and sperm in a test tube fertilizes it, as with any other in vitro fertilization (IVF).

The clinic, at St. Barnabas Medical Center in New Jersey, reported the first successful births using this method, along with genetic analysis of the babies born as a result. It turns out that the non-genetic material in the donated shell or injected into the egg does in fact contribute some genetic information to the babies, leading some to comment that they have three genetic parents: the two women whose eggs are mixed along with the sperm donor. Is this the beginning of genetically engineered children? Should we be creating babies by such experimental means, and what, if any, regulations ought to be imposed on them?

Genetic engineering or harmless mixing?

Are such children really the genetic products of three different people? The genetic contribution from the donated egg is limited at best, coming only from the DNA in tiny energy-producing organelles called mitochondria. This DNA can be fingerprinted and traced back to the individual from whom it came, so there is some unique genetic contribution. But on the scale of the individual's entire genome, it is a tiny proportion compared to the contribution from the woman whose eggs are boosted and the man whose sperm is used to fertilize it. A more important issue may be genetic disease caused by defects in mitochondrial DNA, even though they are quite rare. Whatever genetic heritage is passed on from the egg donor to the resulting child will also be inherited by successive generations of children. So while the genetic change is neither controlled nor intended, it is permanent. How can we be sure that such heritable changes aren't harmful? We lack sufficient information and experience to be able to answer the question, so why not limit such experimental reproduction until we can?

Limiting regulation by limiting funding

It is very difficult to regulate research in assisted reproduction technologies because it is almost all done in the private sector, and research performed solely in the private sector is beyond the reach of most federal regulation. Dr. Jacques Cohen, a researcher and physician at the clinic, said he did not seek review by the federal oversight panel on DNA-related research such as gene therapy "because they didn't give us federal funds. I would be happy to talk to them if they gave us funds." He's right that they were under no obligation to seek government approval, but that leaves consideration about the impact of the research up to the researchers themselves -- the equivalent of leaving the foxes to guard the henhouse. Most researchers are people of great integrity, but they should not try to serve what may be conflicting interests.

Mixing the contents of two women's eggs is likely to be just the beginning of our efforts to manipulate eggs and sperm to help overcome infertility, to avoid disease and maybe even to enhance the characteristics of our children. These new abilities also bring serious responsibilities, but we lack the policy processes to link the two. It is time to close the loopholes that allow clinics to hide behind a curtain of privacy in research on new reproductive technologies, especially when the success or failure it brings will be passed on to future generations.

Visit the
"Ethics Matters" Archive
where you'll find other columns from Jeffrey Kahn
on a wide range of bioethics topics.

"Ethics Matters" is a biweekly feature from the
Center for Bioethics and CNN Interactive.



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