Mitochondrial donation program

Assisted reproductive treatments can be performed to help achieve pregnancy. Poor egg quality is one of the main causes of repeated failures in assisted reproduction treatments. The quality of the eggs is mainly determined by small organelles named mitochondria (the energy suppliers of the cells), together with other factors present in the cytoplasm of the eggs. Egg donation is always an easy alternative to achieve pregnancy but still physiological and ethical thoughts are not considering by specialists! Egg donation needs an alternative because every individual person has a right to have a child and carry up their genetic material during pregnancy.

Method and process

Mitochondrial donation involves removing the nuclear DNA from a patient’s egg containing faulty mitochondria and inserting it into a healthy donor egg, which has had its nuclear DNA removed. This can be done before the egg is fertilized (maternal spindle transfer) or post-fertilization (pronuclear transfer). The fertilized egg is transferred into the mother exactly as per current IVF practice. Once the battery is run down – the cell can not facilitate adequate growth and development which causes lower fertilization, higher aneuploidy rate, and low IVF outcomes.

Who is it recommended for?

  • Patients who are dealing with poor egg quality experience several IVF failed attempts due to impaired embryo development, and have to be treated with conventional egg donation programs to be able to have a child. Mitochondria degeneration will decrease a woman’s chances of getting pregnant. Age of egg, the mitochondria get run down.

  • They start to get mutations in their DNA, and that lack of energy doesn’t allow embryos to sustain fertilization. In this case, if we can solve the mitochondrial degeneration we will have a chance to repair nuclear function inside of oocyte. Given these factors, in some cases, a technology known as a mitochondrial donation may represent the only option for parents to have a genetically related child without mitochondrial DNA disease.

Pronuclear transfer program

Pronuclear embryo transfer consists of performing in vitro fertilization using the eggs of the affected woman whose mitochondria contain mutant DNA and the sperm of the future father, and subsequent extraction of the pronucleus on day 1 of development, leaving behind most of the mutated mitochondria. These pronuclei are transferred to an enucleated zygote with healthy mitochondria. They are transferred to an enucleated zygote, not an egg since the developmental state must be the same. The hybrid zygote is then developed in vitro until it reaches an appropriate state for transfer to the uterus.

Advantages of Pronuclear transfer

  • there is no risk of fertilization because transfer already between zygotes
  • it will give families affected by serious mitochondrial disease a chance of having healthy children free of a devastating and often life-limiting disease!
  • better blastocyst outcome

The pronuclear transfer gives a great chance for patients being previously referred for oocyte donation only to have the last chance of having their own genetically healthy baby.

  • Pronuclear transfer Success rates

    An important point that is primarily taken into account in this type of program is the level of AMH and counting the antral follicles of the patient. As well as the quality of the patient's oocytes themselves, because their nucleus (genetic part) will be used to create embryos. That is why it is impossible to call the exact numbers it is very individual according to the specific case of patients.

  • Pronuclear transfer risks

    Potential risks of mitochondrial donation to the resultant child have been highlighted by some commentators. Perhaps the most prominent being that some faulty mitochondria might nevertheless be passed on to children by mothers who have mitochondrial disease.

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