by Craig Klugman, Ph.D.

If a thruple is a three-person relationship, then would their combined genetic child be a thruby?

A baby boy born in April is believed to be the first child created from the DNA of three parents: mother, father, and egg donor using the spindle nuclear transfer technique. Despite the claims of the media, this is not the first child born with three genetic parents.

Mrs. Y is a carrier of the genetic mutation for Leigh syndrome, is a fatal neurological disease usually diagnosed in a child’s first year. The gene for the disease resides in the 37 genes of the mitochondrial DNA of the cell. The mitochondria live in the cell, but outside of the nucleus that houses most of an organism’s DNA (another 20,000 genes). Mitochondria and their DNA are always inherited from the mother.

After 4 miscarriages and two children dying of Leigh syndrome, Mrs. Y sought the help of John Zhang, and infertility specialist in New York. If the problem was the mitochondrial DNA, the solution would be to use a donor’s egg (for cytoplasm and mitochondria) and exchanging the donor egg’s nucleus for the nucleus from one of Mrs. Y’s oocytes. This is a process called spindle nuclear transfer. Then the father’s sperm is used to fertilize the hybrid egg. This way the child would have both the mother and father’s DNA, but the mitochondrial DNA comes from a third source, the egg donor.

If this sounds familiar, that’s because in February, the United Kingdom announced ethical and legal approval for creating three-person embryos. Also earlier this year, an FDA panel of scientists and bioethicists approved the technique for scientists to proceed with caution. They suggested that the technique only be used on male embryos since any unforeseen problems with the mitochondrial DNA would never be passed on to future generations. They also suggested that are social rules are set up for children born of two parents and thus could lead to questions about identity, kinship and ancestry. Of course, these same concerns were raised in the past over sperm and egg donation, embryo adoption, adoption, and gestational surrogacy.

The Church of England, Catholic Church, and the conservative Center for Genetics and Society have come out against this technique calling it “unsafe, with unknown and unforeseeable health consequences for the child as well as future generations.” Francis Collins, Director of the NIH, believes that altering human germline embryos is “a line that should not be crossed.” Besides the potential future harm argument, these groups have expressed concern that what begins as two potential lives (2 eggs) becomes 1, meaning that one life never gets to exist; that the technique is unconsented experimentation on children; and that such activities violate natural law. Bioethics.net posted a blog by a guest writer on whether this would affect evolution of a species.

The idea of 3 parent embryos is not new. Thirty to fifty children were born with three-parents using a different technique called cytoplasmic transfer where the cytoplasm (and mitochondria) of a donor egg replaces the material inside the mother’s egg. [For full disclosure my mother worked with the clinical embryologist that created this technique during the period it was developed in the 1990s.] The team stopped its work over concerns of miscarriages and children chromosomal abnormalities. Even the ethics conversation is not new, going back to Ramsey’s The Fabricated Man and a large volume of literature that was written after Dolly was born. Back in 2014, many of us made the rounds of media interviews on this topic.

Dr. Zhang states that the actual the procedure was done in Mexico to avert US laws prohibiting the technique. Where Zhang’s team would have encountered problems was in funding and approval. The Dickey-Wicker amendment prohibits using federal funds to create embryos for research purposes. And the 2016 omnibus spending bill passed by Congress prevents funds from being used to even handle an application for manipulating an embryo’s genes. The technique is not illegal in the US, but the FDA is not permitted to handle the paperwork to review or approve an application.

Ironically, bioethics will be criticized no matter position or analysis anyone does. If one comes out in favor of proceeding with use of the technique then there will be strong accusations that bioethics does nothing more than rubber stamp what scientists want to do and is not interested in the sanctity of life. And if one comes out against such techniques then critics such as Harold Pinker will say that bioethics seems to exist simply to put the brakes on science that could save lives. The reality is that no matter what US bioethicists or legislators say, one can always go elsewhere to do controversial work.

Little has been made of the social justice aspects of these techniques. Producing a child through these processes are not cheap and as they are experimental, they are not covered by insurance. Thus, the opportunity to have a genetic child without the risk of mitochondrial disease for some is dependent on their ability to pay. Rather than argue about whether this is “God’s will” or whether the sanctity of an embryo is violated, we should be asking whether as a society, this is where our resources should be spent and if they are, how do we make them available to all.