Commentary of "The Use of Mitochondrial Replacement in IVF: A Call for Expansion"

by Lillian Ringel • Briana’s op-ed calling for expansion of mitochondrial DNA replacement in IVF was an interesting read. She starts her op-ed with a description of what mitochondrial DNA is, and though it may seem rudimentary to some, since I have a very basic understanding of biology I found this paragraph essential to my comprehension of her argument. In general, the piece is well organized, and easy to follow. That said, I wish Briana had expanded on a few of her interesting points. One example is when she describes potential abuses of mitochondrial DNA replacement therapy. She could have made this point even stronger by adding – after she writes, “[mitochondrial replacement] simply replaces one set of mitochondrial DNA for a non-infected set,” – a statement indicating that moreover, “the non-infected set gives children the chance to live normal lives.” I think this would have driven her point home. Throughout, Briana does a great job of highlighting opponents’ potential arguments to mitochondrial replacement. Given the limited length of this assignment, she goes both as broad and as in-depth as possible into examining and refuting her opponents’ arguments. However, if she has the chance to expand this essay in the future, I would like to read more about what the ethical implications are given that the United Kingdom currently has a monopoly on mitochondrial replacement therapy. Moreover, if mitochondrial DNA replacement were available in more countries than just the U.K., I would like her to explore who the potential women would be to receive testing. As it is, IVF – to say nothing of determining which women carry mutated mitochondrial DNA – is expensive and, to my knowledge, more or less limited to relatively wealthy people in developed nations. Thus, I wonder what ramifications, if any, mitochondrial DNA replacement therapy would have if it expanded outside of the U.K. Would we have to first ensure that all women who demonstrate need have affordable access to IVF? Perhaps these are points to consider in a longer paper. Overall, I appreciated Briana’s confrontation of a complex topic. Her writing flowed well, and I would be very interested to read any expansion of this op-ed that she writes. by Amy Scharf Briana makes some excellent arguments in favor of expanding the practice of mitochondrial replacement prior to IVF. I agree that, ethically, the replacement seems to meet the standards of autonomy when both parents agree to the pro