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    Reproductive technologies and the new math: When it takes three parents to make an embryo


    Like ART, MST and PNT are controversial because in addition to potentially placing us on the proverbial ethical slippery slope to creating genetically modified children, these new technologies definitely add to the ever-enlarging number of parents a single child may have, including the genetic father who contributes half the nuclear DNA; the birth father who raises and claims the child as his own; the genetic nuclear DNA mother who contributes half the nuclear DNA; the genetic mtDNA mother who contributes all the mtDNA, the gestational carrier or birth mother who carries the pregnancy, allows it to come to term, and delivers the baby; and the mother who raises and claims the child as her own.

    Regulation of ART in the United States differs significantly from that in the United Kingdom. Federal ART regulation in the United States is limited to the 1992 Fertility Clinic Success Rate and Certification Act8 that requires ART clinics to report their results to a central registry. And various disparate state regulations either ban human cloning for reproductive or research purposes, require insurance coverage of ART, or regulate or prohibit surrogacy agreements.8

    More: Are uterine transplants the answer for absolute uterine-factor infertility?

    In contrast, in addition to prohibiting cloning, the United Kingdom regulates ART to a much greater extent than in the United States through the 1990 Human Embryology and Fertilization Act and the 1985 Surrogacy Arrangement Act.8 And it is important to note that neither MST nor PNT involve human cloning, because the nuclear DNA comes from gametes and not mature somatic cells. However, because our understanding of pathology related to mtDNA disorders continues to evolve, the true utility and role for MST and PNT in ART remain to be determined. Finally, although Parliament approved the use of MST and PNT, further approval by the House of Lords is required before the United Kingdom’s reproductive regulatory agency will consider permitting human trials of MST and/or PNT.


    1.    British Broadcasting Company. On this Day 25 July 1978: First ‘test tube baby’ born. Available at: http://news.bbc.co.uk/onthisday/hi/dates/stories/july/25/newsid_2499000/2499411.stm. Accessed February 26, 2015.

    2.    British Broadcasting Company. MPs say yes to three person babies. Available at http://www.bbc.com/news/health-31069173. Accessed February 26, 2015.

    3.    Taylor RW, Turnbull DM. Mitochondrial DNA mutations in human disease. Nat Rev Genet. 2005;6(5):389-402.

    4.    Schapira AH. Mitochondrial disease. Lancet. 2006;368(9529):70-82.

    5.    Schaefer AM, Taylor RW, Turnbull DM, Chinnery PF. The epidemiology of mitochondrial disorders--past, present and future. Biochim Biophys Acta. 2004;1659(2-3):115-20.

    6.    Human Genome Project Information Archive. The science behind the Human Genome Project, understanding the basics. Available at: http://web.ornl.gov/sci/techresources/Human_Genome/project/info.shtml. Accessed February 26, 2015.

    7.    Anderson S, Bankier AT, Barrell BG, et al. Sequence and organization of the human mitochondrial genome. Nature. 1981;290: 457-465.

    8.    The Center for Bioethics and Human Dignity. G12 country regulations of assisted reproductive technologies. Available at https://cbhd.org/content/g12-country-regulations-assisted-reproductive-technologies. Accessed February 26, 2015.

    Adam S Levine, MD, JD
    Dr Levine is Adjunct Professor of Law, Stetson University College of Law, Gulfport, Florida, and Adjunct Professor of Law, Western ...


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