United Kingdom-based researchers have achieved a remarkable reproductive medicine milestone. They’ve introduced eight babies into the world with mitochondrial donation. This innovative technique, which replaces disease-causing mitochondria from a mother’s egg with healthy mitochondria from another woman’s egg, enables families at risk of passing severe mitochondrial diseases to have healthy children. Mitochondrial donation, or mitochondrial replacement therapy, is better known as “three-person IVF.” The creative and complex animatronic TRII relies on genetic material from two women and one man.
With Australia looking to be the first to trial similar technology, the success of this clinical trial has garnered international interest. This pilot project stems from the mitoHOPE Program. It has announced plans to run a clinical trial beginning in the latter half of next year. Professor John Carroll, director of Monash’s Biomedicine Discovery Institute and head of mitoHOPE, is overseeing the effort. For 2023, the program has been funded with $15 million by the Australian federal government.
Understanding Mitochondrial Donation
Mitochondrial donation is a revolutionary technique to prevent transmission of often-disabling, sometimes-fatal mitochondrial diseases. In Australia, an estimated 60 babies are born with these fatal diseases annually. These diseases lead to significant health consequences and even mortality. Thus, this technology is particularly critical for families with a known history of such conditions. Only mothers are able to transmit mitochondrial diseases onto their offspring. That is why this approach holds so much promise for families impacted by these debilitating conditions.
The technique requires two eggs, one from the mother and one from a donor. The healthy mitochondria from the donor’s egg are inserted into the mother’s egg before it is fertilized with sperm. This technique guarantees that the resulting child will inherit mitochondrial DNA only from the donor, and none from the mother.
“For families that would have very likely had children with high levels of mitochondrial genetic disease, they’ve been able to prevent that,” – Professor John Carroll
To further guarantee safety and ethical compliance, the mitochondrial donation technique has been placed under stringent regulatory oversight. In March 2022, the Australian federal government took a historic step by passing legislation known as Maeve’s Law. This law allows mitochondrial donation to be used, but only in tightly controlled conditions.
The Role of mitoHOPE
The mitoHOPE Program is a collaboration between leading institutions such as Monash IVF, Monash University and Murdoch Children’s Research Institute. This new partnership aims to build on the clinical evidence that will be gathered from the UK trial. It will then refine and apply those findings in an Australian context.
Professor Mary Herbert, one of the principal investigators from the successful UK study, has moved to Monash University. She hopes to continue pushing this precedent-setting work. The next clinical trial will be done in strict accordance with Australian law and the necessary licensing framework.
“[It] is being conducted in full compliance with Australian legislation and the required licensing framework,” – Monash IVF spokesperson
It’s a program that is extremely short-term outcome driven. It places a newly robust focus on long-term follow-up of children conceived with such a technique.
“We really have to monitor those babies and children as they grow up and make sure that none of the disease-causing mitochondria come back,” – Professor John Carroll
The Future of Mitochondrial Donation
In developing this groundbreaking technology, researchers have a deep understanding of the need to move forward with caution. In her remarks, Professor Carroll stressed that the evidence so far indicates this alternative method is both safe and efficacious. Yet he cautioned that continued monitoring and ethical reflection will remain key.
“We have to proceed with care, with caution, step by step to make sure it’s as safe as it possibly can be,” – Professor John Carroll
Recent breakthroughs have filled the world’s scientists with hope. They hope these breakthroughs will work miracles for families struggling with mitochondrial diseases.
“For the first time, we have now an evidence base and experience of mitochondrial donation in a clinical setting,” – Professor John Carroll
Australia, too, is gearing up for its first clinical trials, and anticipation is high. Everyone is hopeful that these innovations will change the reproductive landscape for so many families across this country.
