It’s 10:30 p.m. in Kyiv, Ukraine, and Dr. Valery Zukin is at the hospital with a patient who needs emergency surgery. The patient is 31 weeks pregnant and has intestinal obstruction — a rare complication that’s potentially fatal in pregnant women. Zukin says the situation is under control, but he’s exhausted, and the stakes are high.
Earlier that day, Zukin had been at a fertility conference in Barcelona, where his groundbreaking fertility treatments made him and his colleagues the stars of the show. Now he’s sitting in a pale-yellow room at the Leleka Maternity Hospital, where he is CEO. Zukin is conferring with a team of doctors about how to save the young woman’s life — and her baby’s.
Zukin is accustomed to this kind of emergency. He’s one of the first embryologists in Ukraine, and as a leader in assisted reproductive technology, he’s part of a small cadre of doctors specializing in a revolutionary fertility technology known as mitochondrial replacement techniques (MRT). It’s promise: to make healthy babies possible for couples who are infertile or carry debilitating genetic disorders.
Though tonight’s patient got pregnant the old-fashioned way, Zukin and his colleagues are breaking new ground in radical fertility tech what seems like every other month. No stranger to controversy, Dr. John Zhang, Zukin’s partner at the aptly named clinic Darwin Life-Nadiya, is the first-known scientist to help a woman give birth to a baby who has three genetic parents using one of these techniques. In the United States, where Zhang works, the technique is regulated by the Food and Drug Administration (FDA) and is illegal — so Zhang went to Mexico.
Using MRT, Zhang created the embryo in New York and then flew back to Mexico with the fertilized egg and implanted it in a patient there. The announcement of the baby’s birth in 2016 rattled the world, but the blowback hasn’t deterred them. Zukin and Zhang are already working on the next crop of so-called three-parent babies — they’re just doing it beyond the short arm of U.S. law, in places like Ukraine and Mexico.
Forty years after the birth of Louise Brown, the first “test-tube baby,” we are living in a golden age of fertility tech.
To date, at least five babies who have the DNA of three people have been born using MRT (and at least one is a girl, which means that her genome changes will be heritable). Experts don’t know if there other MRT babies are out there, but with ongoing regulated clinical trials of the techniques in the UK, there may soon be more.
Forty years after the birth of Louise Brown, the first “test-tube baby,” we are living in a golden age of fertility tech. Even its detractors agree that MRT is an astonishing development in medical science — human genetic engineering in action. And it’s just one among a rash of new fertility techniques that stand to fundamentally change how humans procreate: live-donor uterus transplants, preimplantation genetic testing and selection, egg freezing, hyperprecise in vitro fertilization (IVF), CRISPR genome editing, in vitro gametogenesis (which uses reverse-engineered stem cells to make eggs and sperm from men), and the list goes on.
The U.S. government has made it clear it has no interest in approving MRT anytime soon, stalling the industry stateside, but the international fertility industry is booming. Medical tourism is a global market valued at $68 billion, and experts say a growing portion of that business comes from people traveling overseas to get frontier fertility treatments that are illegal at their home base. There’s no data on how many women from the United States travel abroad for fertility treatments, but experts think medical tourism already explains why some countries, such as Denmark, Spain, and Israel, have double the rate of babies born from reproductive tech than the United States.
“Sometimes it’s the people with an unusual vision who change the world,” Zukin says.
MRT is controversial, no doubt. It’s unregulated in most parts of the world, and many contend that it’s unethical. But the babies are coming anyway.