“This is impossible, but it happened,” doctors at Kyiv’s reproductive medicine clinic Nadiya say about the birth on January 5, 2017, of the world’s first child whose genes have information about three people – parents and a donor.
The newborn girl’s mother is a 34-year-old woman who had suffered from infertility for 15 years. Ukrainian and Israeli clinics applied various methods without apparent success. The trouble was that the fertilized ovum (egg cell) ceased to develop on a third-fifth day. Science still does not know why this occurs. All they are saying is that the ovum is short of energy for development.
Past year Kyiv doctors decided to take risk: this woman’s and her husband’s nuclei were transplanted to the donor’s egg cell which had its nucleus removed (in other words, the cytoplasm was taken from the donor’s cell). As a result of this technique, doctors received the so-called reconstructed egg cell. It had the genetic set of a nuclear DNA from mother and father (about 25,000 genes) and a cytoplasmic DNA from the donor (37 genes), i.e., “three parents.” According to doctors, laboratories in Ukraine and Germany confirmed the presence of DNA from three persons, when they examined the woman during her pregnancy.
“The girl, who was born in early January, is absolutely healthy. Our case is unique in that this baby is the world’s first to be born after a pronuclear transfer [transfer of the own fertilized ova. – Author]. Before this, patients could only be helped in such cases with donors’ egg cells. The indication for our transfer was blockage of the embryo’s development,” said Valerii ZUKIN, director of the Nadiya clinic of reproductive medicine.
WHAT BRITAIN AND MEXICO FAILED TO DO
At first glance, the technique looks “simple”: the nucleus with information about the bearer is excised from the donor’s egg cell (a small part, cytoplasm, remains behind in the cell wall) and two parental nuclei are inserted there. This creates a zygote – the future embryo. But only the most up-to-date diagnostics and technologies can help do this in practice.
“We do everything by indications. In this case, embryos developed badly, and we presumed that, in all probability, it was caused by the low quality of mitochondria in the egg cells’ cytoplasm. They do not provide enough energy to let the embryo develop. This worked. If bad development is caused by chromosomal irregularities in the nucleus itself, the same method will not rectify the situation. In this case embryos will be bad and have chromosomal faults associated with the transfer of the genetics of the nucleus’s chromosomal material,” Iryna SUDOMA, Doctor of Medical Science, scientific director of the clinic, explains. “The main information is in the nucleus, while the mitochondrion comprises a very small quantity of DNA. We simultaneously fertilized two egg cells – the mother’s and of the donor’s. Fertilization creates two nuclei in the egg cell. At the moment when the nuclei of the egg cell and the spermatozoid were ready to merge, we removed them from the two egg cells and transplanted the parental material – the nuclei that comprise the entire set of genes – into the donor’s egg cell. The donor’s cytoplasm and mitochondria began actively to form an embryo, and we transferred the soon-received embryo to the mother.
Geneticists and embryologists call this method experimental and say it is an extraordinary event. They claim that the secret is in the following: firstly, it was to take some time; secondly, the new equipment helped; and, thirdly, the techniques that allow the embryo to be examined better. In some countries, particularly in the UK and Mexico, attempts were also made to do the same, but the received embryos had chromosomal faults. So this method is banned in the US because of an unpredictable result. As for the Ukrainian patient, the embryo was without any faults and the child is quite healthy.
“Undoubtedly, it is a qualitative breakthrough in reproductive technology, for we could not improve the embryo’s quality up to now. Our main goal was to avoid deterioration: here we have a fertilized egg cell and wait to see the way the embryo is developing. And what if it has stopped? We could do nothing. And now, applying this method, we can improve the embryo’s quality – the energy component, the so-called viability, and the cytoplasm. We have thus overcome the barrier at which the embryo’s development used to stop. We must not stop, having a mechanism like this. I think it is only the beginning of the road,” Doctor of Medical Sciences Viktor VESELOVSKYI says.
THE GOAL IS TO IMPROVE THE DEVELOPMENT OF EMBRYOS IN WOMEN AGED OVER 40
According to geneticists, indications for nuclear transfer are some rare genetic diseases of man or woman, the blockage of embryos’ development (one instance for 150-200 women), and the development of “normal” embryos in the women aged over 42.
“Women aged over 40-42 very often do not have normal embryos. We came to know this not so long ago – when we began to genetically examine embryos: for example, only 20 percent of 43-year-old women have them,” Zukin explains. “We can claim unambiguously that it is a new development because, earlier, we could only examine the embryo and say whether or not it is normal. Now we can improve it.”
Incidentally, doctors emphasize that they are not making “super-humans.” They only give patients an opportunity to make proper use of their genetic material.
“As for indications, we offer patients a choice: we first suggest refusing the childbirth if they cannot give a birth on their own, then we suggest adoption – not at all the worst option – and only then we suggest using a donor’s egg cell,” Pavlo MAZUR, an embryologist at the Nadiya clinic.
The specialists say they are busy now actively creating the technologies of improving the development of embryos in over-42 women. As for recognizing the Ukrainian technique and the unique birth of a “three-parent child” in Ukraine, Zukin says they are now working on a publication in a specialized journal, for the method will only be officially recognized after this. As for the legal side of the matter, in Ukraine everything that is not banned is allowed now. There is no law that regulates the application of these and other similar techniques.