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Birth expected in mitochondrial donation for infertility trial

28 January 2019
Appeared in BioNews 984

Greek and Spanish researchers have announced that a clinical trial using mitochondrial donation to treat infertility has resulted in a pregnancy.

Once born, the baby will be the first confirmed birth following maternal spindle transfer (MST) where this technique was not used to prevent transmission of mitochondrial disease. The researchers hope that it can offer an alternative to egg donation.

'For some patients, it's very hard to accept that they cannot get pregnant with their own [eggs],' said Dr Nuno Costa-Borges, scientific director of Spanish centre Embryotools. 'Spindle transfer may represent a new era in the IVF field, as it could give these patients chances of having a child genetically related to them.'

MST is not permitted in Spain, so Embryotools partnered with the Institute of Life in Athens, Greece, to carry out the clinical trial with approval from the Greek National Authority of Assisted Reproduction.

The pregnant woman is 32, Greek, and has previously had four failed IVF cycles and two surgeries for endometriosis. She is one of 25 women taking part in the study, but the researchers are waiting to see the outcome of the first pregnancy before doing more embryo transfers.

Mitochondrial donation was developed to prevent passing on potentially deadly mitochondrial diseases. Mitochondria are tiny organelles inside cells which have a small amount of their own DNA. Normally inherited only from the mother, if a woman's eggs contain mitochondria with a deleterious mutation, she could not previously have healthy, genetically related children. 

Mitochondrial donation allows the mother's nuclear DNA to be transferred into a healthy donor cell (whose nucleus is removed), so the resulting child had nuclear DNA from the parents and mitochondrial DNA from the donor. 

The first child resulting from MST was born in 2017 to an Israeli couple who had lost previous children to Leigh Syndrome. The treatment was extremely controversial, not least because the embryo transfer took place in Mexico, in a perceived attempt to sidestep regulations.

A clinic in Ukraine previously claimed to have established pregnancies using the related technique, pronuclear transfer (PNT) (see BioNews 885). The difference is that MST takes place before the egg is fertilised, and PNT just after.

MST and PNT are legal in the UK following a decision by parliament in 2015, but only when used to prevent passing on serious mitochondrial diseases. The first patients were approved for the treatment in February 2018 (see BioNews 936).

SOURCES & REFERENCES
A third MRT-baby is on its way
Practical Ethics | University of Oxford |  22 January 2019
Embryotools achieves the world’s first pregnancy with a new nuclear transfer technique for treating infertility
University of Barcelona |  17 January 2019
Investigadores españoles logran un embarazo con una técnica pionera contra la infertilidad
Las Provincias |  18 January 2019
Pregnancy reported in the first known trial of ‘three-person IVF’ for infertility
STAT |  24 January 2019
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HAVE YOUR SAY
Comment (User:116639 - 01/02/2019)
In the context of the research protocol titled "Maternal spindle transfer for the 
treatment of mitochondrial diseases or infertility problems related to cytoplasmic
defects in the oocyte" licensed by the Greek National Authority of Assisted Repro
duction the ioLIFE(Greece) and Embryotools(Spain) research team announced the
achievement of an advanced pregnancy. It is worth noting that in addition to the
repeated failed ivf attempts and the history of endometriosis, the patient was a
poor responder. There were only two available oocytes for MST, two blastocysts
were created, one was euploid and embryotransferred.The prenatal tests are 
normal. The course of the case reinforces the decisive role of mitochondria and
cytoplasm in fetal development as well as the efficacy and safety of MST.

Konstantinos E. Kostaras
Ob-Gyn MD,PhD
IVF unit ioLIFE

info@kostaras.gr
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