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UK to allow babies from three people (bbc.com)
172 points by jcrei on Feb 3, 2015 | hide | past | favorite | 159 comments



To those wondering, this does not involve gene splicing or anything like that.

Instead, defective mitochondria are being replaced with mitochondria from a healthy donor. This technique is only valid for diseases involving defective mitochondria.

The mitochondrial DNA is responsible for very very little of the genetic material that defines who a person is, essentially limited to how effective the mitochondria are at their job. This is around 0.1% of the total genetic code.

Mitochondria are organelles in our cells that break down molecules to provide energy for the cell, in the form of ATP. They have their own genetic code completely distinct from the host cell's DNA.

The mitochondria are replaced in either the egg OR in the embryo. In both cases this is done by removing the nucleus (containing the cell's genetic material) from the cell that has defective mitochondria and transferring it to a donor cell with healthy mitochondria. The donor cell's nucleus is completely removed.

The mitochondrial DNA is passed down from the mother alone, whilst the DNA in the embryo is formed from both the mother and father. For this reason mitochondrial DNA has much less genetic diversity. Mitochondria 'reproduce' by binary fission which is similar to bacterial cell division and produces little variation in its genetic code, whilst egg and sperm go through meiosis allowing the genetic code to be mixed.

Opposition seems to be coming from two camps.

- Those who don't like the destruction of the donor embryo (when that method is used),

- Those who think this is the start of ever more invasive genetic modification of humans, or so called "designer babies"


>Those who think this is the start of ever more invasive genetic modification of humans, or so called "designer babies"

Well...this is the start of ever more invasive genetic modification of humans.


I guess it is! That said, I don't think the 'slippery slope' arguments made in parliament are valid, precisely because this is a very specific kind of genetic modification:

> "But one thing is for sure, once this alteration has taken place, as someone has said, once the gene is out of the bottle, once these procedures that we're asked to authorise today go ahead, there will be no going back for society."

Replacing mitochondria is very different to designing genetic traits, either through careful selection of eggs and embryos, or splicing, and I think that conflating the two is silly.

If laws were introduced that would allow modification of the primary genetic material that debate would be had then. This law will not shoo-in laws that provide for that kind of genetic modification.


You could equally apply the slippery slope argument to regular medicine.

> If the NHS starts giving out vaccines today they'll be giving out botox in a few years time, right!?

People can already (though perhaps to a lesser extent) have designer bodies, if they can afford it, thanks to modern medicine. Genetic medicine doesn't seem to introduce a fundamentally new problem.


The 'slippery slope' argument also seems easy to fix in this case.

Can't we just extend whatever laws with the addition of this specific treatment? Anything else has to be looked at on a case by case basis.


> Can't we just extend whatever laws with the addition of this specific treatment? Anything else has to be looked at on a case by case basis.

Cue people shouting about how politics are slow and killing people while also forcing politicians into making medical judgements that they may not be qualified for, further increasing the chance that they become the playthings of lobbyists who "do their homework for them".

I'm utterly divided on this issue by the way, just noting the inevitable discussion that follows your logic.


My concern about this isn't the specific procedure, it is the moving of the line of what is allowed. What will happen next? I am sure there will be an illness where just a tiny bit of gene splicing could improve the lives of x amount of babies.

You look the blocking of websites.. It started with child porn which everyone thought was acceptable but then the same legislation was used against piracy websites. Now Britain has an internet filter...

Before there was a red line in genetics. Allowing this procedure really blurs that line and I worry this is just the start of a slippery slope..

As for how much it helps parents. It doesn't help many with their first child as the parents are often not aware they are carriers of conditions. For subsequent children adoption was always available.


How is different than giving antibiotics to somebody ill? You are preventing the natural outcome, with something artificially created. I think many people when the topic is "DNA" simply over-react.


The argument is that changes to genetics bridge generations. If you kill someone with medicine they die. If you give someone a faulty gene, it could affect exponential number of people with each generation.

Unless it affects reproduction ;)


It is the same with antibiotics, people that naturally would not be able to reproduce, will, so the global genetic outcome will change, and possibly something making a given person susceptible to a given infection will be passed to the next generation. But nobody, fortunately, pretends that it is a bad idea to give antibiotics to patients.


What's wrong with "designer babies".

I think it would be cool if you could clean up your DNA removing all the nasty genetic diseases you could pass on to your children.

I wouldn't really change the appearance of my child though.

Plus I would keep most of the original genetic material just fix the bits that are detrimental to a long and healthy life.


You end up with an aristocracy that can afford to have better superhuman children meanwhile the plebs can't afford it. And it would perpetuate itself. Bye tabula rasa in birth and death.


We already have an aristocracy that can afford better schools, better neighborhoods, and the like. If designer babies one day leads to no more birth defects or unwanted children it is not a future to be feared.

there will always be people who have an advantage over others, the majority simply comes from where you were born followed to whom to you were born too.

The real fear is likely that some will make choices that are not politically correct, it is certain this would happen in non Western countries.


We computer professionals think we'll be or are part of that aristocracy, so it's okay.


We will probably become collared pets once "gene hacking" becomes a thing. The real aristocracy will use the law to make unauthorized genetic modifications a crime punished more harshly than unauthorized computer access, which is already sometimes punished more harshly than crimes like armed robbery.

Consider the ethical implications of the job they pay you to do. Always. Who will be benefiting from my work? Who might be harmed by it? Can I trust my employer to protect--or even just accurately represent--my own interests?

Do not take jobs that grant more power to the powerful at the expense of the weak.

My litmus test for human gene-mod technology will be whether I will ever be able to repair my phi-GULO pseudogene, to restore the mammalian ability to synthesize ascorbates (vitamin C) in the liver, without needing to get permission from anyone to do it, and without paying more than a year's salary or using more than one garage of space on the equipment. If I can do that, this particular genie cannot be re-bottled.

And you can bet I'd be selling CKGGRAKDC-GG-D(KLAKLAK)2 under the table, too.


Taking the most obvious example from India: You end up with lots of boys. They'd just be legally designed instead of backstreet-aborted girls. That kind of gender imbalance and bogus value on the favoured gender makes for trouble down the line: demographic lulz and a miserable time for second-class undesigned/undesired citizens.


Wouldn't this quickly flip the desire to want boys?

If a girl has 1000s of male suitors perhaps they would need to start paying a dowry...

Not that I agree with choosing the sex of your child for non medical reasons.


> What's wrong with "designer babies".

It destroys our existing concept of the human experience. Is it silly to want to live among "natural" children? Then explain me why it's not silly to want to continue the species at all?


I can just imagine our distant descendants reading through this thread, thinking how horrible we are for condemning our children to genetic diseases and inequality.

Just like we look down at the people who fought against the smallpox vaccine because it was unnatural.


> our children

What does this phrase mean?


Children? As in the next generation, descendants, kids, etc? What do you think it means?


Well, I'm trying to highlight the "our" part. Does it matter to you how much the kids have to do with "us"? If so, why?

As I was trying to express above, it seems strange to me to imply somebody is irrational for wanting "natural" kids, but not likewise call someone out for caring about creating "their" progeny at all.


I'm confused about your confusion. All I meant was that future generations will probably think it's weird and immoral that we allow children to have genetic diseases, when we have the technology to stop it.


I'm trying to ask a deeper question in response. Asking what "our children" means was an attempt to get there with a somewhat Socratic method.

What I'm trying to do is get you to consider the full implications of not caring about whether things are "natural". What if we not only swapped around genes, but edited genes directly to cure things? What if we added enhancements? What if we completely genetically engineered babies from scratch and called them "our children", would that be okay with you? What if we made AI enabled robots and called them "our children"? Why not... just not have children at all anyway? At what point do you draw the line, and by what principle? To say that "natural" humans doesn't matter raises the question of why "humans" matter at all in the first place.

I raise the issue of the "human experience" because that's the paradigm I live in, and I wonder what I'm going to do without it. I suspect that anybody who cares about "the next generation" but doesn't care if babies are "natural" also thinks they're living within the "human experience" but they haven't thought it through. I think that if you don't care about "natural" babies, you might as well go all the way and be an anti-natalist. I'm actually quite open to that as well, at least it's consistent.

BTW one way of avoiding genetic diseases without genetic engineering would be genetic screening. Such things exist as I understand, I met a guy who said he worked for a company that did this sort of thing. Certain couples just avoid having children. Maybe they can adopt. Is that unfair to them that they don't get to have "their" children? Again, why does that even matter if you don't care about things being "natural"?

Thank you for continuing this conversation so late after the article was posted, btw. Now that I've laid it all out I wonder what ideas you have in response.


> What if we not only swapped around genes, but edited genes directly to cure things? What if we added enhancements? What if we completely genetically engineered babies from scratch and called them "our children", would that be okay with you? What if we made AI enabled robots and called them "our children"?

All of these things will happen in the (potentially near) future. The world will be much weirder, but also better.

I mean you can argue that people shouldn't reproduce at all, but good luck convincing everyone of that any time soon. A significant percentage of people believe even having such a view is horribly immoral (it's associated with eugenics and other bad things) and that reproduction is a basic human right.

So if we are going to be reproducing, there is nothing wrong with removing genetic diseases.


> good luck convincing everyone of that any time soon

I wonder why people's willingness to accept is your standard for what is acceptable. I would think convincing people of having designer babies, while less extreme, has the same hurdle.

> we are going to be reproducing

And again, "we ... reproducing" seems a little strange here if you're willing to accept a future with robotic "offspring" as an extension of your view. It's more like "we are creating new life and bestowing our culture onto it". Is that what people really want? Is there any point to it?


Congratulations, you were born with Monsanto mDNA Correction! Due to intellectual property restrictions, you must attain a license to activate your reproductive system and pass on our genetic code.


I wish people wouldn't conflate those promoting GMOs with copyright/patent maximialists - the two issues are orthogonal.

Monsanto are an awful company, and a very large part of that is down to their maximalism, rather than the GMO part.

Continuing to conflate the two issues just does one's own argument a disservice (it's a strawman) while also reinforcing the maximalists' position that GMOs have to be patentable.


> invasive genetic modification of humans

Besides safety, are there any issues with that?


There is the GATTACA argument that unequal access to genetic modification will foster even greater socioeconomic inequality than we already face today. The film imagined a future in which genetic superiority could be measured by percentile and that job eligibility was based almost exclusively on your genetic score.

The implication is that the widespread but costly availability of genetic modification in tandem with free market capitalism would necessarily form such an enormous social wedge.

I haven't thought about the issue enough to agree or disagree with the theory, but I am stating it here as a potential answer to your question.


I think that we shouldn't generally take Hollywood movies too seriously when thinking about public policy. It's heartwarming to think that the will can triumph over heart disease but in things don't usually work that way in real life.

The current lottery in genetic endowment that nature provides us is horrendously unfair. I expect that fixing problems is going to be a lot easier than creating super-human abilities so I expect that genetic modification will tend to make life much fairer for the foreseeable future.


GATTACA was a film about a society that only thought they were measuring genetic superiority.

Which is still a great warning to heed, but the hero of the film is the hero because he proves that the genetic screening was wrong about him.


> There is the GATTACA argument that unequal access to genetic modification will foster even greater socioeconomic inequality than we already face today.

Absolutely nothing we can do artificially will have as great of an impact than genetically gifted individuals having children together ... which is already happening and has been happening for eons ... I mean, that's what evolution is. The smart get smarter, the fast get faster, the strong get stronger, and the inferior disappear from the gene pool.

If anything, genetic modification will allow the less gifted to pool funds and improve their own gene pool in a way that was simply not possible before.

Now, I think all of this is futile, for reasons touched in GATTACA. It is my absolute most favorite movie. Watch it again =)


"I mean, that's what evolution is. The smart get smarter, the fast get faster, the strong get stronger, and the inferior disappear from the gene pool."

That's not "what evolution is". See [1] for why this is a fundamentally wrong way to think about it.

[1] http://evolution.berkeley.edu/evolibrary/misconceptions_faq....


Thanks for mis-quoting me.

This is the actual quote:

> genetically gifted individuals having children together ... which is already happening and has been happening for eons ... I mean, that's what evolution is.

That is exactly what evolution is. The fit only mate with other fit individuals, accelerating the spread of traits which make them fit.

With regard to my other statement:

> The smart get smarter, the fast get faster, the strong get stronger, and the inferior disappear from the gene pool.

The burden is on you to prove that intelligence, speed, and strength aren't being heavily selected upon in the human population. I made it as an off-hand comment, but I think it's pretty spot on regardless.


I didn't mis-quote you. I quoted verbatim two linked and adjacent sentences from your comment. What you claim to be the "actual quote" was the second sentence (which I quoted) and the one that followed it (which I didn't). I didn't misrepresent what you wrote.

I'll say it again: "...genetically gifted individuals having children together" and "The fit only mate with other fit individuals" is not what evolution is. Forms of life (including humans) have sometimes evolved strategies that try to allow them to select mates based on fitness, but the emergence of these strategies also allows those that use bluff and deception to gain an advantage by deceiving fitter mates into mating with them. "Fitness" here isn't some linear value, its multi-dimensional.

Also, the very idea of individuals being "genetically gifted" is fairly meaningless. In a sense, every living human is genetically gifted because we possess genes that allowed every one of our ancestors over the last 2.4 million years to survive long enough to successfully reproduce. Most of the ones that tried didn't manage that.

Survival of genes (not individuals) is what counts. Evolution doesn't have a purpose and it doesn't result in progress ("accelerating the spread of traits which make them fit", as you put it). I just tried to point that out.


> The smart get smarter, the fast get faster, the strong get stronger, and the inferior disappear from the gene pool.

That stopped some time ago for humans, at least in industralized countries. Modern medicine, long periods of peace and (eventually) welfare provisions have taken care of that. This is a further step in that direction.

Evolution works over huge numbers, both in life and death; by effectively reducing the death-count around the globe, we're progressively abolishing it for humans.

> If anything, genetic modification will allow the less gifted to pool funds and improve their own gene pool in a way that was simply not possible before.

I fear that "pooling funds" could signal a mischaracterization of poor people as "less gifted", which is absolutely not the case. "The poor" are the ones who have historically improved our genepool, by constantly churning huge numbers of children who would then proceed to fight to death (often literally) for survival and success. "The rich" have always opted for in-breeding, low numbers and social welfare among their peers, resulting in weak genes and lots of hereditary diseases surviving the centuries. In this sense, "the poor" have absolutely nothing to gain from genetic manipulation: children are their only resource and they will continue to produce as many as they can, resulting in a stronger and more variegated gene pool without having to add anything to the process.

The GATTACA scenario is real in the sense that a certain mindset is common around modern elites, a view that the rich must be somehow superior to the poor (smarter, healthier, harder-working, etc) otherwise they wouldn't be where they are. Policies like Tony Blair's suggestion that "fat people should pay more for healthcare" are appallingly neo-darwinistic, but they've also been mostly rejected out of a sense of human decency. I expect this will continue to be the case; as a lot of modern history reminds us, it takes very little to send entire populations back to the Middle Ages, and genetic discrimination would light a very powerful fuse.


That stopped some time ago for humans, at least in industralized countries. Modern medicine, long periods of peace and (eventually) welfare provisions have taken care of that. This is a further step in that direction.

Evolution works over huge numbers, both in life and death; by effectively reducing the death-count around the globe, we're progressively abolishing it for humans.

That's a common argument, but isn't it putting too much emphasis on death as a driver of natural selection? I mean, a person who lives 80 years without ever having children is as much an evolutionary dead end as a bird who dies before he gets to reproduce.

As long as there are genetic factors that lead to some people have more or less children, evolution is still at work, even if they both live to be the same age.


This treatment doesn't do anything to reward the mutated mitochondrial genes (your 'step in a direction'), it eliminates them from the population.

If you were saying that the mutated mitochondrial genes were a sign of otherwise inferior genetics, gross.


    > Absolutely nothing we can do artificially
    > will have as great of an impact than
    > genetically gifted individuals having
    > children together.
When those two individuals have children their genes are fused together by random chance. Do you really think gene technology won't get better than random chance?

We already have technology that's good enough to improve on that, e.g. splicing out a gene known to cause a disease from one of those parents.


> When those two individuals have children their genes are fused together by random chance. Do you really think gene technology won't get better than random chance?

Yes. Because what really matters is the restriction of the pool from which those random genes are chosen through mate choice. The overwhelming majority of the time you're randomly choosing between identical genes.

When you start playing with genetic engineering, the whole world is your oyster and your choices are liable to be far worse than random chance among a carefully curated pool. I think genetic engineering will be fantastic for curing specific ailments, but will be a total flop when it comes to creating super humans. Natural selection will always do it better.


But no DNA is being modified.


Technically you are correct, no DNA is being modified. However, the mix of genetic material is being altered.


The mix of genetic material gets altered every time an egg is fertilised. In humans, across the planet, this happens several hundred thousand times each day. It's not something that we should be afraid of.


Not really. Nobody calls it genetic modification when you change your gut flora.

No genome has changed at all.


It is for saving lives, not making people prettier.


One day, in a decade, a century, a millennium, it will be used to make kids prettier.

I don't think it will make them happier though.


There's a genetic modification for that.


"This is around 0.1% of the total genetic code."

More like 13% ... check my math ...

Most chromosomes have 2 copies per cell.

However ... there are many copies of the mitochondria : http://en.wikipedia.org/wiki/Human_mitochondrial_genetics#Qu... <i> Each human cell contains approximately 100 mitochondria, giving a total number of mtDNA molecules per human cell of approximately 500.</i>

Mitochondira make about 15% of then genetic material in a human cell.

total chr1-22+X/Y ~= 6,200,000,000 (6.2 billion, sizeof genome = 3.1B times 2) sizeof one mitochondira : 16569

so ((100)(50016569))/6200000000 = .13362096774193548387


This calculation is looking at the amount of genetic material in a cell by (essentially) weight. Let's take that as the right way to compare these for a moment.

----

Nuclear genome (no sex chromosones): 2,881,033,286 base pairs

Sex chromosones (avg): 262,592,623 base pairs (310,541,120 women, 214,644,126 men)

Nuclear genome (avg): 3,143,625,909 base pairs

Mitochondrion genome: 16,569 base pairs

mtDNA in a cell: 500

----

The proportion of genetic material in a cell that comes from mtDNA is thus:

(total mtDNA) / ((nDNA no sex) * 2 + (nDNA sex) + (total mtDNA))

(16,569 * 500) / (2,881,033,286 * 2 + 262,592,623 + 16,569 * 500)

which is 0.00137, or 0.137%

If we look at just the amount of information encoded, we get:

(mtDNA) / (nDNA + mtDNA)

(16,569) / (3,143,625,909 + 16,569)

which is 5.2710^-6 or 0.000527%


How do mitochondria replicate their own DNA? Do they somehow have the rest of the cell do it, or do they contain/produce and use all of the necessary enzymes/proteins/base-pairs/etc to do it by themselves?

The relationship between them and their host cell almost seems similar to ant-fungus mutualism.


All of the DNA replication machinery that operates in mitochondria is encoded in the nucleus, translated in the cytoplasm, and then transported into the mitochondrion:

"The remaining ~1500 mitochondrial proteins are encoded in the nucleus, including all proteins needed for replication and expression of the small mtDNA genome (Falkenberg et al., 2007)"

from http://ac.els-cdn.com/S0092867409012458/1-s2.0-S009286740901...


This is actually a now-standard theory of the origin of mitochondria (that they were originally separate organisms):

https://en.wikipedia.org/wiki/Symbiogenesis


Opposition is also from those who don't think that human reproduction is a moral imperative to be guaranteed by the state - under the fallacy that it somehow increases our collective quality of life.

Like me.


That's an interesting point, and perhaps a good argument for not diverting public health resources towards this kind of procedure (I'm sure there are good arguments for the opposite, too).

But there's a big difference between not actively endorsing a procedure like this and making it illegal.


Not really. This procedure is likely to be inaccessible to the general public without subsidy via insurance (public or private).

My argument is that one's ability to reproduce should not be guaranteed by the state, and therefore the state should not create laws that overtly or inadvertently sanction the genetic engineering of eggs or embryos to that end.

This law does precisely that.


> one's ability to reproduce should not be guaranteed by the state, and therefore the state should not create laws that overtly or inadvertently sanction ...

Ok, but even taking the first part of that as given I don't understand why the second part follows.

I don't think one's ability to go on holiday should be guaranteed by the state, either, but that doesn't mean plane travel should be illegal.


From the article:

"The method, which was developed in Newcastle, should help women like Sharon Bernardi, from Sunderland, who lost all seven of her children to mitochondrial disease."

Reasoning:

Sharon Bernardi hasn't been able to reproduce naturally without this "method".

But the UK is going to make this method legal - and because its healthcare system is publicly funded the UK government (and thus the public) will also pay for the implementation of the method.

This represents an example where the state is making a guarantee - a formal promise or assurance - that it will pay for citizens that normally couldn't have children to be able to have them.

From the article:

Prime Minister David Cameron said: "We're not playing god here, we're just making sure that two parents who want a healthy baby can have one."

What's not logical about that?


Ok, I think the issue must be a misunderstanding of how the UK health system works, then. The NHS definitely won't fund all medical procedures just because they're legal, and whether or not it is publicly funded / guaranteed is still moot at this stage – that decision will happen entirely separately.

What you're saying is equivalent to "botox shouldn't be publicly funded, therefore it shouldn't be made legal". Botox is legal in the UK, of course, but you definitely won't be able to get it on the NHS, so your "therefore" doesn't follow.


This is the UK, once legal it will become available if the appropriate committees think the funding is well spent.


Namely the Human Fertilisation and Embryology Authority (HFEA) and the National Institute for Clinical Excellence (NICE).


So condemning some children to horrible genetic diseases somehow makes the world more fair?


That's both flimsy and a perversion of my logic, which is a direct rebuttal of the logic of the article itself.

The article gives an example of a woman who tried 7 times to have children and failed because she is genetically defective in terms of her ability to have children.

The government, however, has made special allowances to a 1990 law prohibiting egg and embryonic re-engineering so that this woman can.

The Prime Minister's stated rationale: "We're not playing god here, we're just making sure that two parents who want a healthy baby can have one."

So clearly - the state is paying for people who can't have children to be able to have them - under the pretense that doing so is beneficial to society.

To be able to select this procedure, the prospective mother must already know about her condition. If she knows about her condition, she should be educated to abstain from having children instead of receiving public funds to have her defective DNA altered to facilitate the process of reproduction.


But the alternative isn't necessarily no children, but unhealthy children who also carry the genetic condition.

In any case reproduction being covered by the government is a separate issue, but I don't see why it shouldn't be.


We (my beautiful wife and I) are currently going through the baby-making limbo, and it looks as though IVF will be the necessary next step. When you start actively trying to have children, there's loads of literature preparing you for the pregnancy swelling and the sleepless life of parenthood etc - less so preparing you for the anxiety, uncertainty, and just general feeling of not being in control of your life which comes from things not working for you.

I couldn't imagine the additional emotional turmoil that would come from repeated miscarriages, terminations etc. I'm really holding myself back from thinking about the ecstasy that a confirmed pregnancy will provide after our time and struggles - to have complications and loss after that would be devastating.

So bravo to the scientists working on this, to the parliament for 'permitting' it, and of course to those struggling wannabe parents having to fight for their family dream.


We did IVF and got pregnant on our first try. We now have a beautiful 2 year old boy :)

Good luck.


We did it four times, and now have four beautiful sons aged 4 - 15 (some requiring a couple of attempts). Not saying IVF will be easy for you, but that it's perfectly fine and - for some people - more efficient way of making babies. We never did find out why making babies the old-fashioned way doesn't work for us.

Very good luck!


Just adding to the data, we did it once and got twin girls on the first go. Instant family. We then got a "surprise" (my wife says I'm not allowed to use the word "accident") three years later with a naturally conceived girl.

Chaps - when the docs tell you you're infertile and need IVF, don't assume you'll be infertile forever. Have a vasectomy and "make it so".

Good luck with your IVF, if it works, it'll totally be worth it. Probably.


I have some friends who struggled with infertility, went through the whole IVF thing (big medical bills, without success) but ultimately had repeat success with the help of modern NFP methods such as NaPro and Billings:

http://www.thebillingsovulationmethod.org/

http://www.naprotechnology.com/


IVF involves all the same hormonal and ovulation monitoring that NFP would, so I'm a bit baffled by the apparent belief that this anecdote is anything other than raw probability in action.


I simply offered the anecdote for consideration.

I had three couples in mind. One went through IVF three times, the others two times each. In none of the cases were there successful results, though in all three cases there were significant financial costs. All three couples had a child (two of them more than one, so far) after they began using a modern NFP method to track the female partner's fertility; and the financial costs involved were a tiny fraction of the costs of IVF.

The anecdote certainly does not prove IVF does not work, nor was that my intention in relating it.

So what is the point? Well, many couples are oblivious to the existence of modern NFP and its effectiveness at helping couples both avoid and achieve pregnancy, without recourse to surgery and/or pharmaceuticals. I simply want/ed to help raise awareness of these methods.


...many couples are oblivious to the existence of modern NFP...

Gosh, why wouldn't their fertility doctors have told them about it? b^)


Because they can't charge as much.


That's the same argument made by conspiracy theorists claiming pharmaceutical companies suppress cancer cures, and it's just as bullshit.

My infertility treatment involved a cheapest-first approach, and that's entirely standard. We were told about charting cycles for best chances, analyses were done, some drugs were tried, and we were able to get pregnant via IUI for about $300 total. IVF is pretty much the final option, tried after everything else fails.


Just because idiots use an argument doesn't mean the argument is stupid.

30 seconds of Googling brings up this article [1] (a secondary source, primary sources are Bloomberg and Washington Post), discussing the impression that doctors are performing/suggesting unnecessary, yet expensive surgeries/treatments. Even if it turns out not to be true (after proper research), it's an argument worth considering in any situation that involves financial incentives not aligned with the desired outcome.

[1]: http://globaleconomicanalysis.blogspot.co.uk/2013/10/unneces...


Uh oh - stealth religious content on HN! Downvote! Downvote! Downvote! Even if it's backed up by legitimate science... The Catholic Church is behind it! Abort! Abort!


I can just hear the guy who wrote the software for creating UK birth certificates: "I know for sure that I need to display two parents max on these."

And I feel for the poor programmer whose job it is to deal with the brand-new edge case of putting three parents' names on one.


IVF can currently involve 5 people as it is. Sperm donor, egg donor, surrogate, couple whose child this will be.

This method ups it to 6.


It takes a village...


The kid could also have an organ transplant.


Make the parents field a list without fixed length, ordered by fraction of donor genes. Include exceptions for specific gene identifiers from a different mix of donors.

The default case would therefore be [[0.5 Mom, 0.5 Dad], [mDNA:1.0 Mom]] for girls, and [[0.5 Mom, 0.5 Dad], [mDNA:1.0 Mom], [23X: 1.0 Mom], [23Y: 1.0 Dad]] for boys.

For clones, it would be [[1.0 Nuclear Donor],[mDNA:1.0 Egg Donor]].

For parthenogenesis, it would be [[1.0 Mom]].

For the new UK case, it would be [[0.5 Mom, 0.5 Dad],[mDNA:1.0 Egg Donor],...].

If, for some reason, a cloned baby had the Bt pesticide genes inserted, it would be [[1.0 Nuclear Donor],[mDNA:1.0 Egg Donor],[[Cry1A.105, CryIAb, CryIF, Cry2Ab, Cry3Bb1, Cry34Ab1, Cry35Ab1, mCry3A, VIP]:1.0 Bacillus thuringiensis],...].

The real problem is finding the person to rewrite the Crystal Reports to accommodate the new data structure. Feel sorry for that person.


For most purposes I think two parents would be enough, even if the child was born using more than two parents. Generally the decision to have a child, and the decision to be a family is complicated enough with two people.

A third person to have "rights" over the child can only mess up stuff.


In Australia children are assigned independent legal representation in the Family Law Courts. Australia has taken steps to shift away from parents having rights over children and moving toward children having rights (to be safe, cared for, to see their parents, etc).

I would hazard a guess there is a possibility, down the track, that a court will have to determine whether a child has a right to know from whom her DNA comes.

It will be interesting to see, from the comfort of my arm chair, how this all unfolds over time.


> For most purposes

If only we as software developers could create software for most purposes :(


I really hate this sensational "from three people" thing.

It's a mitochondria transplant.

We don't start calling people "frankenstein's monsters" because they've had a lung transplant, even though that technically makes them a "person from FOUR people!" Shock!


Its not sensational because of the clickbait title.

It is sensational because it is an example of the state sanctioning the customization of human eggs and embryos - which is a pivot of public policy that creates vast consequences.


Mitochondrial diseases can be shitty, shitty things - I have multiple siblings with untreatable and debilitating effects from it.

I didn't know they could even do this (technically), so this news gave me tears of joy.

I am lucky on two counts, to be male (can't pass it on) and also not (yet) had any symptoms myself. It must be horrible for any female who has to decide whether having kids is worth passing those risks on to their offspring.


BBC Radio 4 had an interview with the mother of a kid suffering from these kinds of problems yesterday and, as a parent, it nearly had me in tears.

They had some daft Conservative MP on as well trying a "slippery slope" argument but he completely missed the point about it being mitochondrial DNA so sounded, at least to me, rather silly.


Out of curiosity, presumably your mother knew she had defective mitochondria so why did she elect to have children?


Nope. The ability to diagnose it is pretty new; it went undiagnosed in my oldest sibling until age 12 or so. Not for lack of trying; they just couldn't figure out what it was until then. The effects vary wildly based on where the "bad" mitochondria are distributed throughout your organs, so there's no one thing to look for. Even though she carries it, my mother didn't develop any symptoms herself until well after her children did.

She once told me she wouldn't have had children if she'd known she carried it. I'd make the same choice if I were female.


An Englishman, an Irishman and a Scotsman walked into a pub and bought himself a pint...


It seems to me that the 'three people' metaphor is a bit misguided. I'd look at it as an organ donor-ship to an embryo - just a special organ that gets copied into every cell.


I think "three people" is okay as it correctly gets across how many contributors there are of genetic and other biological material.

Some other sources have been referring to "three-parent babies" though, which doesn't seem right, as the mitochondrial donor has no maternal role or rights to the baby.


It's not, really, it's the other way around. The "mother's" nucleus is transplanted into the donor's nucleus-less egg (which has all the mitochondria). The appropriate analogy would be transplanting one person's brain into another person's body.


It isn't just copied into every cell, it's also heritable—just a very insignificant inheritance.


> Other groups, including Human Genetics Alert, say the move would open the door to further genetic modification of children in the future - so-called designer babies, genetically modified for beauty, intelligence or to be free of disease.

There are people who don't think this is a good thing?! If we could eliminate congenital disease, and make everyone smarter, it would be like fast-forwarding human evolution.


And the kids whose parents couldn't afford to have them genetically improved? They just exist as some sort of permanent underclass?

If you think the inequality and the way poor people get treated is a problem now, wait until rich people are actually genetically superior to the poor.


This is zero-sum thinking. The un-genetically modified kids are no worse off than they would have otherwise been.

Second we could easily solve it by making it available to everyone.

Third, the world is hardly genetically fair as it is. People are born with all sorts of horrible genetic conditions every day. If anything this will make the world more fair.


Just because you perceive something makes the world "more fair" doesn't mean it should EVER be implemented exclusively on that basis.


And it's not. There are massive benefits to genetic engineering. That it makes the world more fair is just a counter argument. The parent comment argued that it makes the world more unfair.


But I am sure that it would eventually trickle down anyway. It's not like middle ages where the rich can't marry the poor, it's not like rich people don't lose their fortunes and become poor. It's not like the moment you stop earning money you have to give back the modifications gained.


If genetic engineering really became this important to human "performance" or health, I would think that most countries who can afford it, will actually have a way for society to pay for such services. It's the right thing to do, and the most profitable for the society as a whole. Just as in health care the smart policy is to spread the cost and risks around and keep the providers in check so that they can't hold individual's health as a hostage.

Exception being the U.S., of course ...


Then it would increase the difference between rich and poor countries. I'm not sure that that would be any better.


How would it be any different to the world today? The chasm between rich and poor nations is huge. The argument against this is similar in many ways to arguing against, say, smartphones because only the rich can afford them. And yet 'poor' people, even in our own countries, and in 'poor' countries have smartphones, or soon will have access to them.

As soon as a nation of people get organised enough to plan ahead well enough to copy existing technology, or trade it, then technology can be had by all.

I don't believe it makes a whole lot of sense for 'rich' people to preserve a specific set of technologies for themselves when they can get richer if more people are able to pay for it. And where that doesn't happen we see other countries copying the technology.


Superior genetics still die in a revolution. Ask Marie Antoinette.


'could not afford'^


i'm completely agree with you about it being in general a great progressive thing, a dream come true.

The devil is always in implementation details. I can't avoid amazement about extrapolating Monsanto DNA-modified seeds tight licensing control unto human "designer" genes.


I'm rarely proud of our government. But this was really forward thinking and really set a good example.


Does anybody know why the "embryo repair" method would be used if the "egg repair" method was also an option? Is the embryo-repair method meant to weed out donor eggs that were not viable (by first ensuring that they can at least be fertilized, by fertilizing them)?


This paper from 2011 has a nice comparison of the two methods, there's pros and cons for both: [1]

According to the HFEA [2], the research group in Newcastle (who wrote the above paper) has been testing the two methods against each other - no decision yet as to the best for treatment, though.

[1] http://hmg.oxfordjournals.org/content/20/R2/R168.full#sec-5

[2] Section 3.4.4 of http://www.hfea.gov.uk/docs/Third_Mitochondrial_replacement_...


The reason why some people believe this to be an ethical problem, and others don't, is that the questions "What constitutes a human being?" and "When does a part of another Human body become a human being?" are hotly disputed.

It's hard to say for certain what aspects of "humanity" is carried by mitochondria. So some will say that there are two mothers, others will say there is only one.

Some will say this is unnatural or violates religious beliefs. In my opinion it's a wide leap to say some reproductive technique is evil just because the people writing holy texts didn't conceive of it a few centuries ago.


What are the legal rights of the parent who contributed only her mitochondrial DNA?


It would be absolutely stunning if the law gives them any rights at all.


One can hope that the updated legislation somehow addresses this. That said, it would be absolutely stunning if the previously existing law didn't simply go 'boink!' in the face of a heretofore novel circumstance. At very least, I could see the need for the courts to set a precedent if/when the first case came along.


I guess it isn't that novel anymore for a woman to donate eggs and not expect to have any rights to any resulting children.

Swapping out the nuclear DNA doesn't really complicate that.


I believe the proposals state that the mitochondrial donor has no legal rights in regards to the child.


See my comment elsewhere with regard to the question of what the child's rights might be.


As I understand it they have the same rights as an organ or blood donor - none.


The article feels pretty one-sided. Ethical dilemmas are more mentioned than actually explained to the reader, while there was space for two interviews with women in favor of the technique (giving that side of the story a personal tone; no sceptic is interviewed, they're just "some people"), plus these emotionally loaded, cheesy subtitles ("life-saving", "proud")...


My take on this is that either make it free for everyone or don't do it at all. If you only allow the rich to have this treatment ( is there a better word for it) then you are artificially inviting a whole new brand of racism and social inequality into the system.

Also everyone should watch Gattaca, it is one of best movies that shows how social inequality can arise in situations like these.


On your first point, most new things are subsidised by the rich at the start, and end up mass produced so the middle-class can have them, often times becoming commoditised to being in the reach of almost everyone. Computers are a good example. The world hasn't divided because of this. The divisions usually come in the form of "zero-sum" status goods such as high-end brands or jewelery that has little instrumental value.

On the second point, Gattaca is a fictional tale, and as such should not be used as evidence to "show" anything. It is, at best, a hypothesis, and one not optimised for accuracy, or subjected to any scrutiny at that. http://lesswrong.com/lw/k9/the_logical_fallacy_of_generaliza...


Although it is probably too early to say (I imagine efficacy vs cost will need to be evaluated by NICE), this is likely to be available on the NHS.


I wonder how people will feel about two men being genetic parents to one baby (with the help of a surrogate mother) once it becomes technologically possible. In that case, no disease is being avoided, but I don't think it falls under the realm of a "designer" baby either. My guess is that many of us will live to see it happen.


[deleted]


That's not the problem - if such a technique worked (it's been attempted in mice [1,2]), two males could produce XX or XY offspring, as you get X sperms and Y sperms. The restriction would be on two females, they could only combine to make XX.

[1] http://www.ncbi.nlm.nih.gov/pubmed/6722870

[2] http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4123998/


Men would get on average 1/3 daughters (XX) and 2/3 sons (XY and YX). The YY offspring would not be viable. Women would only get daughters.


We don't know what happens with YY, but yeah, at least a terrible syndrome.


The X chromosome codes quite a few crucial proteins [0], such as certain clotting factors (that's why women rarely get haemophilia), or retinal proteins (that's why women see more colors, and rarely get daltonism). It is pretty impossible for a fetus to develop with a YY genotype.

[0] http://ghr.nlm.nih.gov/chromosome/X/show/Genes


Re-arranging the deck chairs on the Titanic doesn't seem like quite the right metaphor but at a time when the world's population is exploding this doesn't seem like our most pressing problem.


World population is not exploding, and overpopulation is not and will not be a major world problem.


Based on what? Your opinion?

The U.N. projects world population to increase to 10.8 billion by 2100 from 6.9 billion in 2010.

http://www.un.org/en/development/desa/population/publication...

The academic laziness of you and those who agree with you is disgusting.


10.8 is not enough to be a major problem, and the UN projects total population to start decreasing soon after that.


Surely the large amount of greenhouse gasses festering in the upper atmosphere would seem to contradict that assertion. Or the fish populations mysteriously disappearing from the seas. Or the former rainforests suddenly becoming farmland and chopsticks. Or the many many species going extinct.

Yes I'm sure the Earth can support more humans but it is at the expense all other life.

Humans are so destructive they named an epoch after us. https://en.wikipedia.org/wiki/Anthropocene


Are you suggesting there are no limits to growth? No limits to available fresh water supplies? No limits to energy production?

Once you run you of fresh water and have to rely on nuclear power to run the desalination plants to keep people watered, you have three major problems.


> Are you suggesting there are no limits to growth?

There are limits to growth. We are just not anywhere near them, and don't seem to be approaching them. World birth rates are coming down fast enough that world population will probably never again double.

> No limits to available fresh water supplies?

Fresh water is a local problem. The world fresh water supply is renewable and renews at a rate several orders of magnitude greater than human consumption. Fresh water is a problem because transportation of it is expensive, and people prefer to live in places that have supply problems above places that don't.

Still, I expect that fresh water supply problems will mostly be solved by desalinization rather than migration.

> No limits to energy production?

Nuclear is limited really only by capital expenditure. Solar's limits are also vastly greater than any feasible demand, and it's getting cheaper.

> Once you run you of fresh water and have to rely on nuclear power to run the desalination plants to keep people watered, you have three major problems.

And what would those be? In any case, it makes little sense to desalinize using nuclear. Desalinization is a problem that's a perfect fit for solar power, as the capital cost of equipment is low enough in comparison to the energy costs that you can effortlessly vary production with the load, and the end product can be stored well.


I thoroughly agree with everything this person just said, with only one exception.

I would contend nuclear is limited only by politics. Removing the political impediments to new nuclear would help a lot. The capital risks are a political problem, not an economical.


Honestly, a cheap and infinite source of energy is all we need. Nuclear and Solar engergy is sooner or later going to be both cheap and near infinite. That is likely to solve most problems for humanity.


I also believe that nuclear/solar will provide us with our holy grial energy source; but we've been expecting this for the last 50 years so I don't hold my hopes too high.


http://upload.wikimedia.org/wikipedia/commons/7/72/US_Solar_... (From http://en.wikipedia.org/wiki/Solar_power_in_the_United_State... )

There are issues with transmission and storage, but I'm seeing a pretty comforting trend on the solar side of things.


>The world fresh water supply is renewable and renews at a rate several orders of magnitude greater than human consumption.

I'm gonna need source on that one, please.


The problem with freshwater is not that the global supply is limited, rather that supplies in some high-population areas are.

The Amazon river sends 209,000 cubic meters into the Atlantic every second[1]. That's 18,100,000,000 per day. A single human drinks about two liters (0.02 cubic meters) every day. There are 7 billion humans, so the global requirement is 140,000,000 cubic meters of water. The Amazon alone contains 130 times more than the global requirement for drinking water.

This is domestic consumption, which comprises 10% of water usage[2]. That means that 13 times more water flows through the Amazon than all of humanity uses. That's just one river.

[1]: https://en.wikipedia.org/wiki/Amazon_River [2]: http://www.lenntech.com/water-food-agriculture.htm


First, 1 L = 0.001 m^3. A liter is one cubic decimeter. 0.1 x 0.1 x 0.1 == 0.001 .

Humans use more fresh water than just the quantity that they actually drink. You also have to include the quantity used for sanitation, personal hygiene, and recreation. Even discounting non-household use, a single person can easily clear 100 L (0.1 m^3) per day through their water meter, without even trying.

Go read your water bill some time. Divide your metered usage by 30.5 and restart your calculation on a new bar napkin or envelope. That gives you a multiple of about 26, if the whole planet consumes water like American households, and agricultural and recreational uses are completely ignored. Use that same 10% figure, and the whole Amazon could be completely consumed by only 18.2 billion people.

That's just one river, but it is the one with the most water in it.


Also take into account the much bigger amount that is needed to grow crops and feed livestock; you may be able to use graywater for that, but definitely not saltwater.

Also, water needed by industries and water spoiled by pollution.


Of course there is a limit. But population is soon going to start falling.

Look at https://en.wikipedia.org/wiki/Total_fertility_rate the chart on the right. We're currently at 2.36 fertility rate and falling rapidly. 2.33 is what is necessary for replacement. The US is at 1.9 and Europe is 1.59.



Great source.

The growth rate is slowing as the population is increasing.

Stop a moment to consider how that observation is irrelevant.


I would argue that having offspring with the best chance of surviving and prospering is the most pressing problem and always has been.


So was this banned before?


Yes (at least, in the UK). The brief here:

http://www.parliament.uk/business/publications/research/brie...

Mentions the "The Human Fertilisation and Embryology Act 2008" which banned implantation of a genetically modified embryo. There is a provision in that act for Parliament to approve regulations that provides exceptions for the treatment of mitochondrial diseases.

More: Here's the section of the act:

http://www.legislation.gov.uk/ukpga/2008/22/section/26


Yes, it was explicitly banned in 1990, with the Human Fertilisation and Embryology Act. In 2008 the government modified the act to allow mitochondrial transfer under future regulations, which enabled such research to take place on human tissue [1].

[1] Section 4 of http://www.legislation.gov.uk/ukdsi/2015/9780111125816/pdfs/...


(I wasn't) correct in saying that the implantation of modified embryos was banned in 2008:

http://www.legislation.gov.uk/ukpga/2008/22/section/3

Here's the relevant original text:

http://www.legislation.gov.uk/ukpga/1990/37/section/3/enacte...

edited for error.


Perhaps I'm reading this incorrectly, but as far I can see it was implicitly banned in the 1990 Act by section 3(3d). And then section 3ZA(5) as introduced in 2008 enabled the development of oocyte or embryo-modifying technologies to prevent mitochondrial disease.


I think you're right, sorry for the noise.


No I think we're both correct - sorry, I didn't explain myself properly! I agree with you that it was definitely still banned for implantation.

But by having that clause about mitochondrial disease in, it enabled researchers to investigate (and the the HFE Authority to permit research on) human mitochondrial transfer techniques in vitro by explicitly pointing out the possibility of a future redefinition.

EDIT: this explains it much better than I'm trying to - http://www.hfea.gov.uk/mitochondrial-disease-new-research.ht...


Just to add for (evolution): GATTACA Argument Darwinism

We have to keep in mind that, e.g. in Japan the fertility rate is 1.4/woman.

The rich people make less children than poor.

Beside, in rich countries fertility rate is dropping, especially in big cities.

Therefore, one way of seen this could be just as palliative.


>But Frank Dobson, a former former health secretary,

So, a health secretary?


One could have a Mom, Dad, and ???


Another mother. The nucleus from the "true" mother is transplanted into a healthy donor egg (or embryo) that has had its nucleus removed but still has its healthy mitochondria.


One has to really admire the "free world" where everything is made illegal until our benevolent rulers so graciously let us do otherwise.


excellent remark.




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