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Archive for the ‘IVF’ Category

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In our long stride toward the inevitable designer babies, the first manipulation has been the noble goal of creating babies free of the mitochondrial diseases carried by their mothers. This series will examine the issue rather thoroughly in four basic segments:

1. The basic cell biology involved.
2. The problem of defective mitochondria.
3. The technique involving three-parent embryo creation.
4. The current state of the ethics debate among governmental bodies here and in the United Kingdom.

Cell Biology

In order to understand the fullness of the debate, we need to understand some very basic facts about cells. Every human cell contains specialized compartments called Organelles (meaning, Little Organs). Just as the human body has organs for specialized function (heart, lungs, stomach, intestines, brain, liver, kidneys, etc.) so too every cell has little organs for specialized function:

Ribosomes make protein.
Nucleus houses the Chromosomal DNA.
Lysosomes do recycling of worn out parts.
Golgi Bodies modify and ship proteins to appropriate destinations
Endoplasmic Reticula make lipids and are sites of protein synthesis.

and then come the Mitochondria.

The mitochondria are frequently referred to as the powerhouse of the cell, because they take in by-products of glucose and extract large amounts of energy for use by the cell. It takes a great deal of energy for cells to function properly, and the mitochondrion is the place where that happens. That having been said, it is one of the gross oversimplifications in biological education to leave it at energy production and move on where the mitochondrion is concerned. In fact, there are two scientific journals devoted entirely to mitochondrial research that immediately come to mind: Mitochondrion, and Mitochondrial Research. Suffice it to say that the scope of the mitochondrion and its effects on human physiology are broad and complicated.

For purposes of understanding three-parent embryo creation it helps to know the following. It is thought in evolutionary biology that at one time the mitochondrion was a free-standing, free-living cell that became incorporated into larger cells, with the result being a marriage that worked for both. It’s called the Endosymbiont Theory. Mitochondria replicate themselves within cells, so when cells divide, each new cell gets an appropriate number of mitochondria. In this way, the mitochondria act somewhat as independent organisms would. Along the way, most of the mitochondrion’s 3,000 genes ended up being transferred to the cell nucleus. The following description comes from the United Mitochondrial Disease Foundation website. I have found them to be an excellent clearinghouse of information with writing that is very easy for the scientific layperson to follow:

The conventional teaching in biology and medicine is that mitochondria function only as “energy factories” for the cell. This over-simplification is a mistake which has slowed our progress toward understanding the biology underlying mitochondrial disease. It takes about 3000 genes to make a mitochondrion. Mitochondrial DNA encodes just 37 of these genes; the remaining genes are encoded in the cell nucleus and the resultant proteins are transported to the mitochondria. Only about 3% of the genes necessary to make a mitochondrion (100 of the 3000) are allocated for making ATP. More than 95% (2900 of 3000) are involved with other functions tied to the specialized duties of the differentiated cell in which it resides. These duties change as we develop from embryo to adult, and our tissues grow, mature, and adapt to the postnatal environment. These other, non-ATP-related functions are intimately involved with most of the major metabolic pathways used by a cell to build, break down, and recycle its molecular building blocks. Cells cannot even make the RNA and DNA they need to grow and function without mitochondria. The building blocks of RNA and DNA are purines and pyrimidines. Mitochondria contain the rate-limiting enzymes for pyrimidine biosynthesis (dihydroorotate dehydrogenase) and heme synthesis (d-amino levulinic acid synthetase) required to make hemoglobin [Note by G.N.: This is the molecule that binds oxygen in every red blood cell]. In the liver, mitochondria are specialized to detoxify ammonia in the urea cycle. Mitochondria are also required for cholesterol metabolism, for estrogen and testosterone synthesis, for neurotransmitter metabolism, and for free radical production and detoxification. They do all this in addition to breaking down (oxidizing) the fat, protein, and carbohydrates we eat and drink.

Do visit their website for specific information on the range of mitochondrial diseases.

Now, without frightening off the non-scientist or non-medical person, the above quote cracks the door ajar ever so slightly to allow a glimpse of the complexities involved at the biological level. Adding further, there needs to be coordination between the genes encoded on mitochondrial DNA (mtDNA) and the mitochondrial genes encoded on the DNA in the nucleus of the cell (nDNA). To date, there are still too many unknowns in the cell biology and the pathophysiology at the cellular level (That’s why the journals devoted to mitochondrial research are going strong, and will be for years to come.). We don’t know all of the coordinated function between mtDNA and nDNA within a given individual, and what other factors there may be (as yet unknown) that govern such function. In other words, are all mitochondrial defects solely attributable to mitochondrial genes (mt DNA and nDNA), or are there other genetic/biochemical defects in the individual at play here? It matters when someone wishes to take the mitochondria from an egg cell, leaving the nDNA intact, and introducing mitochondria from another individual. It matters because the issues are not always so simple as mutations in genes.

Indeed there are other factors around the major genetic factors, and these are known as epigenetic factors. Epigenetics looks at factors involved in the regulation of genes, and when they get turned on and off. Adding still further to the complexity, there may be epigenetic factors in the nDNA that are unknown and alter the epigenetics of the mtDNA., and all of these factors in one kind of cell may well influence mitochondrial function in distant types of cells within the body.

Confused and bewildered yet?

That’s the point. We don’t know what we don’t know, and in mitochondrial disease there is quite a bit that we don’t know. It will be fertile ground for research for decades to come, and that points toward the abomination of three-parent embryo creation in human beings as a vast and unregulated medical experiment. In the next post (Nov. 20, 2014), we’ll look at several mitochondrial diseases and consider what we do know of their etiology, and what we suspect we don’t yet know. Then in the third post we’ll consider the technique involving three-parent embryo creation and consider the ethical dimensions involved.
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Photo Credit: Photo Via http://www.dailymail.co.uk/sciencetech/article-2838705/Three-parent-babies-unsafe-warns-scientist-Adviser-issue-says-unresolved-safety-concerns-years-testing-required.html

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Note: There seems to be two different protocols that have been reported on this, as Melissa points out in the combox below. I’ll track down the correct one and adjust accordingly.

News today from AP that a research team at Oregon Health and Sciences University has replicated work done a few years ago in Britain, constructing a human embryo by using the eggs of two mothers and a father’s sperm.

Read it at FoxNews

The goal here is to prevent diseases that arise from genetic defects within the energy-producing organelle of the cell known as the mitochondrion. These so-called mitochondrial diseases are very real and quite varied. As the article states:

About 1 in every 5,000 children inherits a disease caused by defective mitochondrial genes. The defects can cause many rare diseases with a host of symptoms, including strokes, epilepsy, dementia, blindness, deafness, kidney failure and heart disease.

So the diseases and the frequencies are significant. The ethics are a forgone conclusion. We’ll debate the ethics of taking the healthy nucleus from Jane’s egg and putting it into the egg of Lisa (which has had its nucleus removed), and then fertilizing that hybrid with Jane’s husband’s sperm. In this way, they will have children with 99% DNA from Jane and hubby, and only 1% DNA residing in the mitochondrion.

What effect will this have on the offspring, and will there be complications? We won’t know until we manufacture these babies and await the results not only over the course of the manufactured baby’s life, but in the lives of the descendants.

It won’t stop there.

The next step will be the genetic engineering of nuclear DNA by either replacing entire chromosomes, or at the least, defective nuclear genes. The guiding ethical principle?

Suffering is bad, and the noble end of preventing suffering justifies the means.

Emanating from this nobility comes the evil of intolerance of those who suffer, and who afflict us with their suffering. Consider the following from U.S. Supreme Court Justice Oliver Wendell Holmes, Jr. in his infamous majority opinion in the 1927 Buck v. Bell case which upheld the forced sterilization of the developmentally delayed:

Carrie Buck is a feeble minded white woman who was committed to the State Colony above mentioned in due form. She is the daughter of a feeble minded mother in the same institution, and the mother of an illegitimate feeble minded child…

An Act of Virginia, approved March 20, 1924, recites that the health of the patient and the welfare of society may be promoted in certain cases by the sterilization of mental defectives, under careful safeguard, &c.; that the sterilization may be effected in males by vasectomy and in females by salpingectomy, without serious pain or substantial danger to life; that the Commonwealth is supporting in various institutions many defective persons who, if now discharged, would become [p206] a menace, but, if incapable of procreating, might be discharged with safety and become self-supporting with benefit to themselves and to society…

We have seen more than once that the public welfare may call upon the best citizens for their lives. It would be strange if it could not call upon those who already sap the strength of the State for these lesser sacrifices, often not felt to be such by those concerned, in order to prevent our being swamped with incompetence. It is better for all the world if, instead of waiting to execute degenerate offspring for crime or to let them starve for their imbecility, society can prevent those who are manifestly unfit from continuing their kind. The principle that sustains compulsory vaccination is broad enough to cover cutting the Fallopian tubes. Three generations of imbeciles are enough.

There’s nothing new in our age.

When suffering is to be avoided at all costs, the question becomes, “WHOSE suffering?”

The answer to that question then determines the lengths to which we will go to prevent that suffering.

The next step will be designer babies, and on what grounds could parents possibly be stopped? That it’s unethical to manufacture human beings in a lab? Are they humans in that Petri dish? If yes, why do we discard so many during normal IVF? Is that not murder? If the answer is no, then what harm is there? Isn’t genetic engineering for traits just a cleaner and more precise version of picking up a blonde-haired, blue-eyed stud in a bar, or picking out an Ivy-League sperm donor?

What is being lost in the process that now gives people pause?

That’s the only question whose answer matters.

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Over at Jill Stanek’s blog there is an interesting debate going on over IVF and pregnancy reduction. Catch it here.

A woman named Maria who has had three IVF babies, has been arguing in favor of the procedure, using all of the proabort definitions of when life begins, etc., and took strong exception to my statements from the post linked here. What follows is Maria’s response, and my rejoinder:

Maria:

Dr. Nadal,

Excuse me for my bluntness but I think you are crazy. I am completely aware of what happens during an IVF cycle because I did it TWICE. The fact that you keep calling embryos in its earliest form, before they even get transferred into a human body CHILDREN is ridiculous. Given shots to produce more eggs in my body is not SELFISH on my husbands part. In fact I am grateful for that since I was hardly able to produce any on my own.

And yes I am comparing what happens in a petri-dish to what happens naturally after intercourse because its the same damn thing, except sane people don’t call all these initial embryos that dont result in squat CHILDREN, either inside the womb or out!

Those who have engaged in this need to repent of the evil they have done, to themselves, their marriages, and most of all their children. There’s no sugar-coating this issue. It’s abortion on steroids, practiced by desperate couples who have entirely lost their perspective.

Dr Nadal, I have no need to repent for my 3 living children for having them via IVF. Having IVF to conceive them was the best decision I have ever made in my entire life! How you can refer to anything that happens outside of the female body as “abortion on steroids” is insane.

I originally found Jill Stanek’s website because I admired the courage she had to uncover the horrible live birth abortions that were taking place in the same hospital where I gave birth to my babies. However, seeing as there are a bunch of freaks on this site, I will probably take a peek at her posts now and then, but I will never associate with the weirdo’s on this site who make insane comments such as yours by commenting along with them.

And with that, I am out!

It is interesting to note that nobody ever told Maria to repent for her three children born of IVF.

My Response:

Maria,

LOL!! You aren’t the first person here to call me crazy, and you won’t be the last. That’s the sort of thing that happens when ideological worlds collide. The fireworks can be spectacular!!

Now, on to the reasons why I am crazy.

Calling embryos children. You’ll forgive my colloquial use of children to refer to your embryonic offspring. The colloquial usage is not sloppiness, or insanity on my part, but actually exactly how people use the language. When asked how many children a pregnant mother of four has, she does not respond with,

“Two actual children, one toddler, one infant and one embryo.”

Get real, Maria. A normal woman says,

“Four, and one on the way.”

She may then go on to break down the clan by sex and age. In truth, it is your response that sounds insane. Now, for the next issue regarding sanity.

I’m a scientist, specifically, a biologist. We are the ones who tell you what a living thing is, or is not. The field of embryology clearly teaches that a new human organism, a new human animal with its own genetic identity, its own body, set on its own dynamic developmental trajectory comes into being at the moment the egg is fertilized by the sperm. There is no such thing as potential or partial life in biology.

Either a thing is its own organism, or it is not. Either it is alive, or it is not. Your embryonic offspring are each a separate and distinct human being. You actually have even less place to hide than the post-abortive trolls here, because you can’t claim bodily autonomy and Roe v Wade’s protections in the killing of your offspring. They weren’t attached to you in the first place.

The fact is, that IVF IS abortion on steroids. You are people’s exhibit A of its callousness and cruelty:

Your offspring are only human beings when YOU say they are, not when science says they are.

Your offspring are merely property to be disposed of as you see fit.

Your offspring are only humans entitled to rights if YOU say they are.

Your body is yours to do with as you please, and not subject to any restrictions imposed by either morality or a well-informed bioethic.

Gee, where have we heard all of that before?

Yes, I do think your husband either terribly naive, or terribly selfish. In our desperation for a child of our own, I was not prepared to go to a fertility clinic and see my wife juiced up with frightening levels of hormones that would have increased her odds of developing cancer down the road. Even if she wanted to, I would not have consented.

There is such a thing as moral and ethical limits, Maria. There is also such a thing as human greed, and no shortage of scientists and physicians who are perfectly willing to cast morality and ethics to the wind as they prey on the desperation of childless (or, in keeping with your nomenclature, shall we say embryoless) couples.

Finally, you say:

“Dr Nadal, I have no need to repent for my 3 living children for having them via IVF.”

You will one day realize that those three children have quite a few dead siblings who never made it out of the lab, and that’s where our paths diverge.

I’m with science, you are not (though you are with technology). From the moment of fertilization a new human being comes into existence. You were evidently okay with killing as many as it took to get to where you are now. I’m not.

This process has less to do with marriage and family, and more to do with hi-tech animal husbandry in marriage (if you’ll excuse the pun).

Does that make me crazy? Perhaps from where you sit it does, but then, deviance distorts the lens of perspective.

It is becoming increasingly clear to me that parents resorting to IVF require the same preconditioning (desensitization) as do parents resorting to abortion. Once we do not allow ourselves to be hindered by embarrassed “manners over morals” from enjoining these folks, we see this preconditioning rage to the surface almost instantly.

More to come.
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Photo via N.Y. Times

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Late to this story:

The New York Times published a story last weekend about the practice of what is euphemistically known as ‘reducing’ a pregnancy. It’s the barbaric practice of killing one or more babies in a multiple-birth pregnancy, usually through lethal injection, and leaving the dead sibling(s) with the living until birth.

The practice was initially engaged during IVF when four or more embryos implanted and a certain number were culled in order to produce more robust survivors with the least complications for the mother. As with all depravity, there are no absolute limits, just a series of yellow lights. We now have a debate about reducing pregnancies of twins to what are called ‘singletons’. Listen to one mother in the article and her rationale:

If I had conceived these twins naturally, I wouldn’t have reduced this pregnancy, because you feel like if there’s a natural order, then you don’t want to disturb it. But we created this child in such an artificial manner – in a test tube, choosing an egg donor, having the embryo placed in me – and somehow, making a decision about how many to carry seemed to be just another choice. The pregnancy was all so consumerish to begin with, and this became yet another thing we could control.

What we glimpse here is the underlying malignancy of IVF, and the reason why we ought not allow our sympathy for the childless to cloud our reason and judgement.

Regina and I both lived the bitter and sorrowful disappointment of not being able to conceive for over four LONG years. We went into our marriage agreeing that, come what may, we would abide the teaching of the Church. We would not do IVF, nor would I see my wife juiced up with ghastly levels of cancer-inducing hormones, all in the name of having a biological keeper.

It was after we stopped trying and agreed to proceed to adoption that our first child was conceived.

That said, the grotesqueness that the desperate swallow in the pursuit of biological progeny is evident in this article. The euphemistic reductions are the most noticeable tip of the iceberg.

In the process of IVF, several eggs are harvested after pumping women full of hormones to stimulate hyper-ovulation. The consent to this by any husband ranges between ignorance to unspeakable selfishness.

Then, the husband is handed a specimen cup and shown a room where he must manually produce a semen sample. At this point, the procreative work is no longer that of husband and wife, but rather that of a team of lab technicians who will facilitate the union of egg and sperm. Husband and wife are relegated to the sidelines as mere observers.

Once the clutch of eggs is fertilized, the embryos are sorted and graded according to ‘viability’. At this point, a cell may be taken from the embryo to test for genetic and potential developmental anomalies. The poorer candidates are thus tossed away, the best implanted, and the rest frozen at -320 degrees F in liquid nitrogen. This process is abortion on steroids.

Thus, the entire process of IVF treats the child as an accessory in the lives of he parents, with little to no regard for that child’s weaker siblings who are simply thrown away, or immersed in liquid nitrogen indefinitely, a process that kills half of all who are frozen. No amount of desperation can ever justify this hideous mockery of God’s wise design. The experience that Regina and I had shows the value of respecting and obeying the Church as a matter of habit, so that when the storms hit, one has a safe refuge.

People may ridicule the Church and the teaching handed down by our celibate bishops, but as this article demonstrates, perhaps it takes a celibate to help the rest of us weather the storms.

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