Author’s opinion: The use of these techniques is currently medically and ethically unjustifiable.
The United Kingdom has recently approved mitochondrial transfer (3 parents children) to prevent the development of mitochondrial diseases in the children of mothers affected by these types of conditions. This has opened an ethical debate on the use of such techniques, especially if they can modify the germline.
Now, a recent article has addressed their use in the field of reproductive medicine and discussed their use in infertility treatment and disease prevention (see HERE).
It is well known that the efficacy of assisted reproduction techniques is limited, with pregnancy rates when in vitro fertilisation is used of 29.1% per aspiration cycle and 33.2% per embryo transferred; when intracytoplasmic sperm injection is used, these rates are 27.9% and 31.8%, respectively.
It is therefore thought that identifying possible genetic abnormalities and then applying personalised medicine could improve these figures. It is also believed that they could help to resolve human infertility, since half of the cases are thought to be due to a genetic cause, and could be remedied by correcting the corresponding mutation responsible for infertility using genome editing. This has already been applied in different cases of genetic mutations in sperm in the case of azoospermia.
Gene editing in reproductive medicine
However, in the author’s opinion, the use of these techniques is currently medically and ethically unjustifiable for three reasons. First of all, there is still very little experience in genetic modification in humans, as fewer than ten products have been approved for use in these diseases. Secondly, there are very few cases of the clinical use of techniques that modify the germline; and thirdly, they can cause genetic abnormalities in the children created. He, therefore, concludes that, for now, these techniques should still not be used from the point of view of the good of the children born.
On the ethical assessment of the prevention of mitochondrial disease transmission, this has been amply addressed in previous reports (See HERE).
In short, the author concludes that the application of genome editing techniques in the reproductive area should not advance towards clinical application.