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In this article, we explore the legalisation of mitochondrial donation in the UK as the latest iteration of an established sociotechnical imaginary of permissive yet highly scrutinised human embryo research in the country. The focus of our analysis is the work of the UK House of Commons Science and Technology Select Committee as it contributed to the debates and ultimately played a role in enabling the UK to become the first country in the world to legalise clinical use. Mitochondrial donation is a reproductive technology which could allow women with mitochondrial disease to have healthy, genetically related children. From 2011, an extensive process of inquiry was launched in the UK to assess safety, ethics and public attitudes. We analyse video and transcripts of the meeting, and interviews with panellists to explore three themes: contesting scientific interpretation, the labour of alignment and resolution. We demonstrate how micro-interactions during the meeting, and the broader structure of the meeting itself, aligned with the UK sociotechnical imaginary of a permissive but scrutinising approach to human embryo regulation. We conclude that the event was one element of a larger process of review that together worked to render mitochondrial donation as knowable, ethical, desirable and sanctionable. [ABSTRACT FROM AUTHOR]

Summary: According to the World Health Organization, the female reproductive age lasts up to 49 years, but problems with the realization of women's reproductive rights may arise much earlier. Significant numbers of factors affect the state of reproductive health: socioeconomic, ecological, lifestyle features, the level of medical literacy, and the state of the organization and medical care quality. Among the reasons for fertility decline in advanced reproductive age are the loss of cellular receptors for gonadotropins, an increase in the threshold of sensitivity of the hypothalamic-pituitary system to the action of hormones and their metabolites, and many others. Furthermore, negative changes accumulate in the oocyte genome, reducing the possibility of fertilization, normal development and implantation of the embryo and healthy offspring birth. Another theory of ageing causing changes in oocytes is the mitochondrial free radical theory of ageing. Taking into account all these age-related changes in gametogenesis, this review considers modern technologies aimed at the preservation and realization of female fertility. Among the existing approaches, two main ones can be distinguished: methods allowing the preservation of reproductive cells at a younger age using ART intervention and cryobanking, as well as methods aimed at improving the basic functional state of advanced-age women's oocytes and embryos. [ABSTRACT FROM AUTHOR]

Study Question: Does an informed group of citizens endorse the clinical use of mitochondrial donation in a country where this is not currently permitted?Summary Answer: After hearing balanced expert evidence and having opportunity for deliberation, a majority (11/14) of participants in a citizens' jury believed that children should be able to be born using mitochondrial donation.What Is Known Already: Research suggests that patients, oocyte donors and health professionals support mitochondrial donation to prevent transmission of mitochondrial disease. Less is known about public acceptability of this novel reproductive technology, especially from evidence using deliberative methods.Study Design, Size, Duration: This study comprised a citizens' jury, an established method for determining the views of a well-informed group of community members. The jury had 14 participants, and ran over one and a half days in 2017.Participants/materials, Setting, Methods: Jurors were members of the public with no experience of mitochondrial disease. They heard and engaged with relevant evidence and were asked to answer the question: 'Should Australia allow children to be born following mitochondrial donation?'Main Results and the Role Of Chance: Eleven jurors decided that Australia should allow children to be born following mitochondrial donation; 7 of whom added conditions such as the need to limit who can access the intervention. Three jurors decided that children should not (or not yet) be born using this intervention. All jurors were particularly interested in the reliability of evidence, licensing/regulatory mechanisms and the rights of children to access information about their oocyte donors.Limitations, Reasons For Caution: Jurors' views were well informed and reflected critical deliberation and discussion, but are not intended to be representative of the whole population.Wider Implications Of the Findings: When presented with high quality evidence, combined with opportunities to undertake structured deliberation of novel reproductive technologies, members of the public are able to engage in detailed discussions. This is the first study to use an established deliberative method to gauge public views towards mitochondrial donation.Study Funding/competing Interest(s): This study was funded by a University of Sydney Industry and Community Collaboration Seed Award (2017), which was awarded contingent on additional funding from the Mito Foundation. Additional funding was provided by the Mito Foundation. The Foundation was not involved in jury facilitation or deliberation, nor analysis of research data.Trial Registration Number: Not applicable. [ABSTRACT FROM AUTHOR]

Background The first live birth following the use of a new reproductive technique, maternal spindle transfer (MST), which is a mitochondrial replacement technique (MRT), was accomplished by dividing the execution of the MST procedure between two countries, the USA and Mexico. This was done in order to avoid US legal restrictions on this technique. Sources of data Academic articles, news articles, documents obtained through freedom of information requests, laws, regulations and national reports. Areas of agreement MRTs are new reproductive techniques that present novel ethical and legal challenges, since genetic material from three people is employed to create a child. Areas of controversy Could the first MST procedure that culminated in a live birth negatively impact reproductive medicine in Mexico? Growing points The USA and Mexico need specific and clear legislation on MRTs, in order for such techniques not to be governed by prior existing legislation on assisted reproduction that is inadequate for dealing with the new challenges that these techniques present. Areas timely for developing research There is a pressing need for work to be done on the international governance of new reproductive techniques. [ABSTRACT FROM AUTHOR]

The development of any novel reproductive technology involving manipulation of human embryos is almost inevitably going to be controversial and evoke sincerely held, but diametrically opposing views. The plethora of scientific, ethical and legal issues that surround the clinical use of such techniques fuels this divergence of opinion. During the policy change that was required to allow the use of mitochondrial donation in the UK, many of these issues were intensely scrutinised by a variety of people and in multiple contexts. This extensive process resulted in the publication of several reports that informed the recommendations made to government. We have been intrinsically involved in the development of mitochondrial donation, from refining the basic technique for use in human embryos through to clinical service delivery, and have taken the opportunity in this article to offer our own perspective on the issues it raises. [ABSTRACT FROM AUTHOR]

With an increasing number of ways to 'assist' reproduction, some bioethicists have started to wonder what it takes to become a genetic parent. It is widely agreed that sharing genes is not enough to substantiate the parent-offspring relation, but what is? Without a better understanding of the concept of reproduction (and what it means to say that an organism has reproduced), our thinking about parent-offspring relations and the ethical issues surrounding them risk being unprincipled. Here, I address that problem by offering a principled account of reproduction--the Overlap, Development and Persistence account--which I believe best captures the meaning of 'genetic parenthood'. [ABSTRACT FROM AUTHOR]

Mitochondrial donation (or mitochondrial replacement techniques, MRT) is a special form of in vitro fertilisation involving the mitochondrial DNA (mtDNA) of a third (donor) party. This technique eliminates the risk of severe mitochondrial pathologies, genetically inherited from the mother, by replacing part of her mtDNA with healthy mtDNA from another woman, the donor. This paper explores the ethical dimensions of this technique and their impact upon policy decisions. In particular, it is argued that despite the spectacular fact that a child might have three genetic sources, the bi-parental paradigm is not truly challenged. The most important issue surrounding mitochondrial donation is the fact that it involves germline modification. To this extent, approval of such a technique sets a precedent. There is a wide and traditional international consensus on prohibiting human germ-line modification, and this paper examines whether the specific procedure of mitochondrial donation falls within this logic. [ABSTRACT FROM AUTHOR]

Reproductive rights in South Africa have traditionally focused on the rights of individuals to avoid reproduction. However, with an increase in the use of assisted reproductive technologies (ART), there has been a shift in the focus on reproductive rights from the rights of individuals to avoid reproduction to the rights of individuals to reproduce noncoitally. With the emergence of new technologies, reproduction by noncoital means and the right to engage in these new technologies is becoming more prevalent. This raises two questions. The first question is whether such a right exists. The recent Constitutional Court decision in AB v Minister of Social Development 2017 3 BCLR 267 (CC) suggests that it does, but only if the person claiming this right is physically involved in the reproductive process. Ostensibly this excludes those who cannot contribute to the reproduction of a child. The second question raised pertains to the impact of this right on specific forms of ART, namely mitochondrial transfer, posthumous reproduction and embryo donation. While the first two forms of ART would meet the criteria set down in AB, embryo donation would not. Individuals denied access to embryo donation could thus not rely on either the right to reproductive autonomy or the right to privacy to aid them. Fortunately the existing legal framework provides some assistance to these individuals, although sadly the same legislative framework does not support the use of mitochondrial transfer and posthumous reproduction. In this respect there is incongruence between rights and legislation, which has only been exacerbated by the recent Constitutional Court decision. What is thus needed is clarity on the meaning of certain rights in respect of certain forms of ART as well as legislative reform to reflect the clarified position. [ABSTRACT FROM AUTHOR]