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But a new procedure intended to give women with mitochondrial disease a better chance of having babies who would not develop this genetic condition has added a new layer to the public debate around in vitro fertilization (IVF).
Writer Kim Tingley dove into the world of mitochondrial DNA for a piece in The New York Times Magazine titled "The Brave New World of Three-Parent IVF," speaking with two women who had cytoplasm from a third person injected into their eggs years ago resulting in healthy babies.
Sharon Saarinen, featured in the Times, was willing to be a guinea pig at age 36. Her doctors' goal was to give fertilization and development a nudge; she was willing to do anything to have a baby.
"It's hard to explain to someone who hasn't been through [infertility] the roller coaster of emotions," Saarinen tells allParenting 14 years after the procedure gave her a healthy baby girl who continues to thrive today. "It's such a strong drive and feeling of desperation to have a child you can't see past anything else."
Saarinen doesn't know if her daughter has DNA from three people; she's never been tested. "From Day 1, I've always felt this was a miracle procedure for me," Saarinen told the Times. "As my daughter grew and she's fine and so intelligent, it just backed my belief that it was the right thing to do."
allParenting asked Saarinen if she would have been as enthusiastic about the procedure if she had a different outcome. "I would have loved my child [even] if it had a disability," she says.
Is this eugenics?
But as it happens with science, one discovery can lead to another and yet another after that. Each discovery raises questions and, sometimes, the issue of ethics.
Today, researchers believe they can prevent diseases caused by mutations in mitochrondrial DNA through what they call mitochondrial-replacement therapy. This procedure goes beyond Saarinen's cytoplasm injection and creates what media — and now scientists — have termed "three-parent embryos."
This means a child born from the procedure would have the genetic material of three parents, a concept whose complexity confuses many. Society has upped this debate's ante by labeling the procedure as a means toward eugenics.
Also central to the debate: Are the benefits of possibly preventing disease worth the risk of unknown complications down the road? Is it OK to dive in without knowing long-term outcomes?
One woman's journey
Jenny Jordan was in middle school when the first test tube baby was born in the U.S. "Why can't people just adopt?" she says she thought at the time. "There are so many children in need of homes. I would never do that!"
"Little did I know 20+ years later I would be seeking this same treatment. Turns out, I don't ovulate well and my husband's guys don't swim."
Jordan underwent IVF to conceive their daughter. As thankful as she is for the scientific progress that gave her a child, when asked about mitochondrial replacement therapy, she says, "What happens in a lab isn't necessarily the best for the world at large. We as a species need time to process the advances of science and technology."
Determined — with boundaries
Lisa Simonsen decided to do IVF "because I was not married and was not dating anyone significant where I would want him to be the father. I chose to use an anonymous sperm donor because I wanted to have full custody of the child and no possibility of future legal issues, which could have happened if I asked a male friend of mine to donate."
Simonsen relates to the overwhelming desire some women may have "to keep trying and have their own biological child. I wanted to see if my son would look like my side of the family, have my interests, mannerisms and personality."
After trying intrauterine insemination (IUI), IVF succeeded when Simonsen was 42. Her son, Carter, was born prematurely and passed away 10 days later. (Read Simonsen's story.)
She began a second round of IVF, but "doctors now agree that my egg quality is poor overall due to my age, 43," she says. "Medications, vitamins and acupuncture can help so I am trying these options currently prior to possible IUI. I'm also researching adoption."
She rules out mitochondrial-replacement therapy. "I consider it an extreme measure," she says. "If I were to include a third party, it would be a donor egg, surrogate or I would adopt.
"I think that using part of another woman's egg/DNA is risky and is unknown scientific territory and long-term effects are unknown. I would not want to risk my child having possible health problems because I had to have a child with my DNA. I feel that that would be selfish of me."
"Older" moms share advice
Jordan doesn't parse words when it comes to giving advice to young women who want to become parents one day: "Freeze your eggs," she says. "Freeze your beautiful, juicy, 20-something eggs. They keep well, and your 40-year-old self can turn back the clock and have young eggs."
Saarinen echoes Jordan's advice to some extent. "Even if women are young they should still try earlier, because you never know what problems you'll run into." Her thoughts on women of "advanced maternal age?" "Older ladies never give up!"
For women willing to try anything for that baby with their own DNA, Simonsen says, "I think they are missing the fact that you can be a parent to a child that does not have your DNA and it could be just as rewarding and loving as if the child was biologically yours."
"Just like other things in life, accept what God wants for you and set limits for your emotional, physical and financial well-being. Sometimes the most amazing things in life are the ones that you don't plan."