Mitochondria( diseases & reproduction. Clinical, legal, ethical and anthropological issues

Mitochondria are cytoplasmic organelles that generate the entire energy of the cell. Mitochondrial activity depends on the nuclear DNA but also on a specific mitochondrial DNA (DNAmt). This DNAmt is maternally inherited and exposed to mutations that cause a broad range of severe debilitating and fatal pathologies, commonly affecting energy-demanding tissues. Assisted Reproductive Technologies provide a new way for limiting the inheritance of pathogenic mtDNA by mitochondrial donation under very strict regulations. In addition, DNAmt biogenesis is particularly marked during oogenesis and could play a pivotal role in the control of oocyte competence and embryonic development. Consequently, several publications have pointed that quantitative changes in DNAmt synthesis could be correlated with poor oocyte/embryonic quality in women whose infertility is related to age or multiple IVF failure. Therefore, in these situations, supplement with heterologous or homologous DNAmt has been proposed and proved to be successful. The development of these new technologies paves the way for new options of treatment to couples affected by rare but inherited diseases but also to numerous women whose infertility is still improperly treated. Nevertheless, a strict assessment of both efficacy and safety of these new technologies is absolutely required as well as the legal, ethical and anthropological issues they generate. (C) 2021 l'Acadernie nationale de medecine. Published by Elsevier Masson SAS. All rights reserved.