Genetic Crossroads

The intersection of biotechnology, reproduction and society

Selling the Next False Hope?

How experimental IVF techniques could be legalized despite evidence of harm

More and more women are speaking out about being sold false hope by the fertility industry. They tell of being encouraged to pay tens of thousands of dollars to put body and psyche through hell, and of never being informed just how low their chance was of ending up with a child, or what the long-term impact of off-label drugs can actually be.

However, the industry’s narratives of choice, empowerment, and healthy babies are well-rehearsed and powerful. And they can already be seen in the promotion of a still-illegal technique known as "three-person IVF," which would combine genetic material from two women and one man in an attempt to create a child without the intended mother’s mitochondrial disease. UK researchers, and their funders, have been lobbying the UK government for years to change the law against human inheritable genetic modification in order to allow this into fertility clinics as soon as possible.

There has been little commentary to date about the economics of "3-person IVF." However, a recent report from the UK Department of Health notes that one of the hopes of legalization is that it would “encourage inflows of foreign direct investment into the industry in the UK.”

According to the report, a woman considering this procedure should expect to undergo at least four cycles of egg extractions, at an estimated total cost to her of 80,000 pounds (about US$136,000.) Although very few women would be candidates for the techniques, the revenue stream to private companies would be on the order of 533,000 pounds (about US$905,000) even if only ten women a year decide to go ahead.

The women who will be encouraged to spend such sums on these experimental and invasive techniques deserve the full story. Although the official line from those promoting the techniques has long been that there is no evidence that they are unsafe, there is in fact a lot of reason to doubt their safety.

First of all, the women who could benefit from these techniques could also be harmed by them. Pregnancy poses risks to women with mitochondrial disorders, and egg extraction (which would be required multiple times from two women in this situation) carries both known and unknown, immediate and long-term health risks.

The risks to any resulting children include all of the following – notably, the first is new evidence just published this month:

  • According to Jörg Burgstaller and Joanna Poulton, mitochondrial genetics scientists at the Vetmeduni Vienna and the John Radcliffe Hospital in Oxford, even a tiny amount of carryover mutated mitochondria can lead to disease in a resulting child if they are preferentially replicated (a phenomenon that the authors show is more widespread and dangerous than previously believed.) Burgstaller states,

So far it was believed that this minimal ‘contamination’ is of no consequence for the baby. However, our data show that the effect may have dramatic consequences on the health of the offspring.

  • Klaus Reinhardt, Damian K. Dowling, and Edward H. Morrow, three evolutionary biologists working in the UK and Australia, note that there are continuous complex interactions that take place between the nucleus and mitochondria, which could be disrupted by this procedure and lead to adverse outcomes, including potential infertility in males. They have concluded,

There are reasons to believe that it is premature to move this technology into the clinic at this stage.

This person would develop from a fertilized egg in which all but a few genes (those of the mitochondria), not just those of the male parent, come from a source other than the egg itself. This clearly makes any such person a product of wholesale genetic engineering. We do not know nearly enough about the process of embryonic development for the FDA to even contemplate approving this procedure.

Enucleation of eggs is traumatic, and has been compared to major transplant surgery; damage to the developmental potential of eggs from these procedures was observed in both recent papers on MST. There is no body of data that would validate use of these techniques in a clinical setting.

  • Paul Knoepfler, Associate Professor in the Department of Cell Biology and Human Anatomy at UC Davis School of Medicine, states

Moving one oocyte nucleus into the enucleated oocyte of another person could trigger all kinds of devastating problems (most likely through epigenetic changes) that might not manifest until you try to make a human being out of it. Then it’s too late.

  • Even Shoukhrat Mitalipov and other researchers at Oregon Health and Science University working to develop these techniques acknowledge that the majority of human zygotes they have produced showed abnormal fertilization, something that was not seen in their animal models and which they cannot explain.

Both the women who may be offered "3-person IVF" as a viable way to have a healthy child, and the women who would provide their eggs and serve as “mitochondrial donors,” have a right to know that no one can actually say whether these crude manipulations will work. And even if the daunting risks are fully disclosed, it would be wise for anyone considering "3-person IVF" to keep in mind how the fertility industry markets standard IVF: by selling exaggerated hope to desperate patients.

Jessica Cussins is a researcher at the Center for Genetics and Society.

more...

Subscribe to Genetic Crossroads

Current Issue

Just Say It

When and how should we open up to loved ones?