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Last Updated: Oct 23, 2019
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Three Person IVF - Certain Questions That Need Answers!

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Neha Lad0MBBS Bachelor of Medicine and Bachelor of Surgery, MD - Obstetrtics & GynaecologyIVF Specialist
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Diseases which are caused by some sort of genetic mutations in the mitochondria, can be quite deadly. This is the reason why Mitochondrial Replacement Therapy, also known as Three-Person IVF is being seen as a much more desired option for those women, who carry mitochondrial mutations.

Almost all the genes in a cell remain trapped in the nucleus but a small fraction of them remain present in the mitochondria as well. During the fertilisation of eggs, the genes in the egg’s nucleus get combined with the genes in the nucleus of the sperm, which in turn creates a new cell. On the other hand, mitochondrial genes are involved in this mixing. Rather they are passed on from mother to child.

The main reason behind three-person IVF is to help find a way, so that the mitochondrial genes can be replaced in an affected cell of the egg prior to the time they get passed on to the child. This is carried out when the egg cell of the donor gets acquired and the nucleus is removed from the cell, hence leaving the cell with healthy mitochondria. After that, the mother’s nucleus, which stays unaffected, is removed and gets placed in the donor’s egg cell, thereby creating an egg cell which must contain healthy genes not only in the nucleus but also in the mitochondria.

Genes Are Complex in Nature

  • Genes communicate with one another. Cells get engaged in a variety of complex processes like division of cells or respiration, which are highly unlikely to be performed only by single genes acting in an isolated manner. So a network of genes works together, with each one making a contribution of certain particular components.
  • Genes tend to be variable in nature, which basically means that no two genomes are similar. Due to this reason, the result of a typical pair of genes interacting with one another will at times be different for different individuals. This is the dark side of genetics, which has not been studied in a comprehensive manner and experts are not aware of exactly how widespread this might be.
  • Experts call this type of effect as Epistasis, which can occur between individual genes, between two or more sets of genes or even between whole genomes. The one occurring between whole genomes, has relevance to discuss about the safety and ethics of MRT. The reason is that, when a mitochondrial genome from a donor replaces the affected mitochondria, the parents’ nuclear DNA must communicate with a completely new genomic partner. The ethical implications related to the epistasis getting changed between nuclear DNA and mitochondrial have thus far been completely ignored.

Ethics Comes First
The review of the ethics related to MRT or Three-Person IVF came up with the conclusion that if the procedure was safe, then it could be considered as ethical. In other words, they concluded that if the trials carried out on humans showed that the treatment undertaken was safe, then it could also be considered as ethical as well.

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