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Can a Child Have Three Biological Parents?

In today’s world of blended families, while a lot of kids have more than two people who love and care for them like parents, everyone knows that all children have two biological parents. As of 2016, however, that is no longer true. That year, a child was born using a process called Mitochondrial Replacement Therapy (MRT). MRT creates embryos with three genetic parents that can then be implanted through in vitro fertilization.

Mitochondrial Replacement Therapy

MRT involves taking a donor egg and an intended mother’s egg, fertilizing them both, and then taking the nucleus, where the DNA is stored, from the intended mother’s egg and using it to replacing the nucleus in the donor’s egg. This creates a fertilized egg that has main DNA from the intended mother, but the rest of the egg cell, including the mitochondria, from the donor.

Mitochondria contain their own separate DNA, so the embryo contains DNA from three people. MRT is typically used to allow women with mitochondrial disease, or a lack of healthy mitochondria, to have healthy children. Without healthy mitochondria, a child may have substantial medical difficulties and may not even be healthy enough to make it to birth. MRT could also potentially be used to create embryos that are genetically related to both partners in a lesbian relationship.

When a child with three genetic parents is born, who gets parental rights?

There are several approaches for determining parenthood in these situations. All three genetic parents can be given parental rights automatically unless the donor specifically waives those rights. Many people also argue that donation of mitochondria should be treated like an organ donor, with no rights to the mitochondria or the resulting child, since the mitochondria only contains 0.1% of the child’s total genes and doesn’t impact the way a child looks, acts, or develops.

Most courts use an intent standard. Under this approach, the legal parents of the child are the people who went into the process of creating the child intending to be the child’s parents. This may be the two people who provided nuclear DNA, one nuclear parent and the mitochondrial donor, or all three genetic parents.

If MRT becomes generally available, this is likely to be the approach North Carolina takes, since this is the standard the state uses to determine the legal parents of children born through assisted reproductive technology. Intent can be shown through actions, prior relationships, or other subjective evidence, but the best way to show intent and the best way to protect intended parents is to have a written agreement outlining the intent of all the parties.

Is MRT Available in the United States?

At present, MRT occurs overseas, usually only for women with mitochondrial disease, but currently is not legal in the United States. Medical procedures need to be cleared by the FDA before use, and Congress has banned the FDA from considering applications for MRT research, since MRT involves “a human embryo… intentionally created or modified to include a heritable genetic modification.” Many people worry about this creating dangerous medical tourism. The first child born from MRT was actually born to American parents who had traveled to Mexico with a doctor from New York to avoid US regulation.


While MRT can be a controversial practice, it can provide genetically related children for women with mitochondrial disease or women in same sex relationships. If and when MRT becomes legal in the US, it will likely operate much like surrogacy and other IVF-based reproductive technologies. As in those instances, the best way to protect yourself, as either a donor or an intended parent, is to consult with a family law attorney and make sure that you have a written agreement in place that protects your interests.