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Old-fashioned baby-making is definitely more fun. But for many couples struggling with infertility, high-tech treatments are the only way to get sperm and egg together.

Couples now have surrogacy, in vitro fertilization (IVF), and perhaps soon, three-parent IVF, as viable baby-making strategies. The British Parliament recently approved the use of three-parent technology. Granted, three-parent IVF has to pass some red tape before it becomes available in the U.S., but experts believe that it may soon be an option for couples stateside.

Three-parent baby-making, also called mitochondrial manipulation (a way more accurate term), is a procedure in which unhealthy mitochondrial DNA—which are linked with conditions including brain damage, cystic fibrosis, heart failure, muscular dystrophy, and blindness—from mom’s egg or embryo is swapped with healthy DNA from a female donor.

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Not everyone is thrilled with the possibility.

“Many critics of these procedures are concerned that this is the beginning of a ‘slippery slope’ where embryos will be genetically modified in order to produce ‘designer’ babies,” says Thomas A. Molinaro, M.D., a reproductive endocrinologist with the Reproductive Medicine Associates of New Jersey in Eatontown. “In reality, this is very far from the case. Three-parent technology has nothing to do with designer babies.”

That’s because, in three-parent IVF, doctors do not modify the nuclear genes that determine our physical traits. Mitochondria are like batteries, producing the energy our bodies need to properly develop, so swapping unhealthy mitochondria for healthy ones in no way “designs” a baby, he says. It simply gives the embryo the energy it needs to develop. What’s more, mitochondrial transfer doesn’t even touch the DNA that determines personality and appearance.
 

It’s important to remember that, while people are raising ethical questions about these three-parent babies, IVF once stirred similar controversy.

Baby-Making in the Past
“Initially, the concept of IVF was greeted with skepticism and was viewed by many as ‘unnatural,’” says Molinaro. In 1969, when the first (unsuccessful) IVF attempts were underway, a Harris poll found that a majority of Americans believed techniques like IVF were “against God’s will.” And when the first IVF cycle stuck in 1977—and, get this, in England—people felt that it flew in the face of religion and reduced humans to a commodity, says board-certified reproductive endocrinologist David Adamson, M.D., past president of the American Society for Reproductive Medicine and chairman and CEO of Advanced Reproductive Care.

Nine months later, when the first IVF baby (then called a test-tube baby), Louise Brown, was born, the public’s perspective on IVF slowly changed. “Once it was clear that a healthy baby like Brown could be produced by this technology, it gradually gained acceptance.”
 

In fact, when a 1978 Gallop poll asked Americans if they had “heard or read about the baby born in England from an egg fertilized outside her mother’s body,” 93 percent had (which goes to show you what a media frenzy it was). Sixty percent of Americans said they thought IVF was okay, and 28 percent said they opposed it because it was “not natural.” The rest weren’t quite sure what to think of the new technology.

Then, in 1979, after 11 public meetings, the Ethics Advisory Board approved federal funding of IVF research. The next year, the U.S.’s first IVF clinic opened its doors.

Just like with IVF, much of the current controversy surrounding three-parent IVF isn’t about the exact technology when you really get down to it; it’s about not having babies the old-fashioned way. “From an evolutionary perspective, nothing is more important than reproduction,” says Adamson. “Without it, our species dies out. Therefore, the emotional and psychological components of reproduction are strongly wired into our being. Every person has thoughts and emotions about reproduction. They probably are right for them as individuals, but may not be right for others. Because it is so personal, people feel threatened when others have different perspectives about something so personal and feel they have to be defensive about it.”

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Baby-Making in the Future
However, as was the case with IVF, research is what’s going to make or break the future of three-parent technologies. “As of now, it is largely conceptual and the true risks and benefits of the technology have not been demonstrated in larger-scale studies,” says Molinaro. “If the treatment proves to be beneficial and safe, as IVF was proven to be, then I think widespread acceptance will follow.”

And in time, just like IVF helped lead to the development of three-parent IVF, mitochondrial transfer could give way to more technologies that can help couples struggling with infertility issues.
 

“Three-parent IVF has dramatically increased our understanding of reproductive biology,” says Adamson. So much so that experts believe mitochondrial transfer may, in the future, be a tool for women suffering from genetic disorders or just lackluster eggs to have children that are genetically related. For instance, three-parent technologies could allow couples to use a donor egg when necessary. But instead of the egg passing on the genetics of the donor, it could still pass on the mother’s genetic material, says IVF pioneer and specialist John Zhang, M.D., Ph.D., founder of the New Hope Fertility Center.

What’s more, it may help prevent women from having to use donor eggs at all. If endocrinologists can replace eggs’ faulty mitochondria with healthier versions, the viability of that egg may improve, says Molinaro. That’s huge for women who want to have children into their 30s and 40s but are worried their eggs may not be in tip-top shape when the time comes that they are ready to have children.

To find out even more about the future of fertility science and “designer babies,” pick up a copy of the March issue of Women’s Health, on newsstands February 10. 

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