From IVF run by AI to 3-parent babies, the sci-fi future of fertility treatment
DOCTORS’ confirmation last week that at least one British baby has been born from a high-tech IVF method called mitochondrial donation was hailed as “a fantastic breakthrough” by campaigners.
Between one and four pregnancies have so far led to live births after the procedure, which is used to prevent crippling diseases.
It works by mixing DNA from a female donor’s egg with the mother’s to stop faulty genes being passed on.
Mitochondrial diseases, known as “mito”, affect around one in 4,000 babies.
The Lily Foundation, which supports families with mito, says a “substantial number” do not make it to adulthood.
With no symptoms, mums can carry faulty DNA in their mitochondria, tiny parts of cells that produce our body’s energy, and usually find out only after having their first child.
The diseases can cause seizures, fatigue, blindness, deafness, learning disabilities and poor growth.
Children can be born with severe or mild symptoms that get worse over time, but mitochondrial donation aims to avoid this.
It combines healthy mitochondria from a donor egg with DNA from an egg fertilised by the mum and dad, with the resulting embryo carried through pregnancy normally.
Almost all our DNA is in a part of the cell called the nucleus, not the mitochondria.
So even though the baby has DNA from three people, 99.9 per cent comes from the mum and dad.
With just 0.1 per cent from the donor, the baby won’t inherit traits from them.
It is a complex process and not guaranteed to work but can be the only way affected women can have their own healthy children.
The Human Fertilisation and Embryology Authority confirmed to The Guardian that at least one, but fewer than five babies in the UK have been born this way, but it is unknown whether they survived disease-free.
Liz Curtis, chief of The Lily Foundation, said: “This is a fantastic scientific breakthrough. We’re delighted that there is now hope for some mito families.”
‘IVF doesn’t work for everyone’
After progress was made with the technique, a change in the law was required in 2015 to permit the procedure.
Two years later, the Newcastle Fertility Centre became the only national centre licensed to perform it, with the first cases approved in 2018.
The HFEA says 32 patients have been granted approval for the process but the low number of births means most cases have either not gone ahead yet or have failed.
Sarah Norcross, director of the Progress Educational Trust, which advocates for people with fertility issues, said it was “not a surprise” it hasn’t been done more times.
She told Sun Health: “These things take forever because of bureaucracy.
“You have to select the right patients and egg donors and it’s a sophisticated IVF technique; IVF doesn’t work for everyone.”
Professor Darren Griffin, a genetics expert at the University of Kent, said it is “inevitable” that demand will rise as screening for mums improves.
He said: “I think, on balance, the benefits far outweigh the risks.
“People will naturally be sceptical about anything that involves genetics but, given we have the technical know how, would it be ethical not to use it?”
IVF has been used millions of times in the UK since the first “test tube baby”, Louise Brown, was born in Oldham in 1978.
The lab procedure involves injecting sperm into an egg to fertilise it, then implanting the fertilised egg into the mum.
But fertility advances that fiddle with DNA or screen for disease face opposition and accusations of scientists “playing God”.
Campaign group Christian Action Research and Education said last week that the use of mitochondrial donation “crossed an ethical line”.
These issues will continue to be hotly debated as science advances.
Genetic diseases are largely untreatable because they are so deeply rooted in DNA.
But in the UK it is illegal to carry out genome editing on embryos that lead to a pregnancy, meaning scientists cannot prevent genetic disease by editing DNA in the womb.
It is an ethical minefield as embryos would be destroyed for research.
Experts say that, without a law change for gene editing research, the key to improving IVF is boosting success rates and making it cheaper.
Despite around one in seven couples in the UK suffering fertility issues, a cycle can cost up to £5,000 and often multiple cycles are needed.
Prof Griffin said training machines to run the process would boost capacity, making treatment cheaper.
Science could one day grow new eggs from stem cells
He said: “If embryologists were supervising an automated process rather than physically having to do every single one, they could do five times as many.”
Researchers are trying to use artificial intelligence to select the healthiest eggs and sperm most likely to succeed.
Robots could also be used to store, label and manage samples, saving lab time.
Dr Evelyn Telfer, a reproductive biologist at Edinburgh University, is working on reducing the toll on patients.
Mums-to-be currently undergo hormone injections and egg removal for every IVF cycle.
Dr Telfer believes a small piece of an ovary could be removed from the body, allowing eggs to be stored in the lab and matured with hormones when required.
Dr Telfer also said science could one day grow entirely new eggs from stem cells, which can be taken from the skin or even sperm, in a huge advance for same-sex couples.
Although a long way off, one study this year revealed the first baby mouse had been born from two male parents using stem cells.
Research is also under way to develop drugs that stimulate the ovaries and womb lining to improve pregnancy chances.
IVF often fails because the woman’s eggs or ovaries are too old, or because the embryo fails to implant in the uterus.
Sarah Norcross added: “These breakthroughs don’t come from nowhere and there is a real need for more embryo research in the UK.”