Britain's House of Lords voted 280 to 48 to permit the use of three-person IVF - mitochondrial donation to prevent incurable mitochondrial diseases, which afflict around 4,000 children per year - on a case-by-case basis. On February 3rd, the UK House of Commons had already approved the exception to existing law.

The technique has generated controversy because women with mitochondrial disease will be able to get a healthy mitochondrial DNA 'transplant' that would allow them to have children without fear of passing the disease along. To critics that is a slippery slope to 'designer babies'. In the United States, President Obama refuses to allow federal funds to be used for Somatic Cell Nuclear Transfer (SCNT) due to much of the same fear about misuse of science.

Credit:Bies, CC BY-NC-SA

Mitochondria are how we produce energy in our cells - in 1948, Albert Claude of the Rockefeller Institute likened them to energy factories for our bodies, a metaphor that remains to this day. Mitochondria oxidize different kinds of food into a common energy currency, called ATP, that is used throughout most of our bodies.

As part of our evolutionary history, mitochondria have given us a second genome, inside the trillions of cells in our bodies, but since it is mothers who pass mitochondria on to children, a mitochondrial disease, often fatal, will be passed along as well. To stop the transmission of mitochondrial diseases, it is now possible to replace a mother's faulty DNA with a healthy version - but that technically means 0.2% of a baby's genetic material, nothing to do with looks or personality or anything about the person, would come from a third party. Estimates are this will help 150 babies per year in England but will be a huge relief for mothers who are concerned about having children - and lead the world in fixing a fixable problem.

Like bone marrow in the 1960s, the original IVF in the 1970s, and hESC in the 1990s, there will be ethical concerns, and those will need to be addressed. And sometimes science will not win, like with the American government refusing to allow SCNT, but for today, science gets a victory - in the home of the people who invented Frankenfood hysteria and the belief that vaccines cause autism, no less. 

Now it is up to science to show this works. Though it looks promising, there are safety and efficacy issues to address, but there is no more work that can be done with animal models, so experimenting on a case-by-case basis is the only way to proceed. At the end of the day, mitochondrial disease is a disease and, like any serious disease, we have an ethical mandate to find ways to prevent it.

On January 27th, an Institute of Medicine committee in the United States began meetings to consider the ethical issues raised related to fixing mitochondrial disease. The meetings will be held until spring of 2016. 

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