In the U.S., the debate about embryonic stem cell
research has centered on whether human embryos should be used for
research. It has left nearly untouched a number of important social,
political and ethical issues unrelated to the moral status of embryos.
Among these are: (1) ensuring the health and safety of research
subjects, including women who provide eggs for research; (2) preventing
the emergence of a commercial market in women’s eggs; (3) establishing
appropriate oversight and regulation of stem cell research.
Background
Currently,
most researchers working to produce human embryonic stem cells use
embryos that were created but not used during vitro fertilization
procedures. Some scientists are attempting to use another technique,
known as research cloning or somatic cell nuclear transfer (SCNT). SCNT
involves merging an adult body cell with an egg whose nuclei has been
removed to create specialized stem cell lines. The process requires a
large number of women’s eggs. In order to procure eggs, researchers
typically give women hormonal treatments to first “shut down” and then
“hyper-stimulate” their ovaries, followed by surgical extraction of
multiple eggs. This is a time-consuming and invasive process associated
with potentially serious health problems.
Key Concerns
It’s Still Early
Treatments
based on embryonic stem cells and SCNT are at an early stage of
development, and are still hypothetical. Therefore, multiple egg
extraction poses risks to women’s health without a clear and
demonstrated benefit to scientific advance.
Financial Incentives
Offering
payment beyond direct expenses would commercialize reproductive
material and create a market for human eggs, which could lead to the
exploitation of women.
Lack of Regulation
The
U.S. has no federal legislation prohibiting the misuse of human embryos
(such as efforts to produce a cloned or genetically modified child),
and a patchwork of unclear and inconsistent regulations addressing
embryonic stem cell research.
Effects of Drugs
The
drug most often used to shut down the ovaries, Lupron, can cause side
effects such as severe joint pain, difficulty breathing, chest pain,
depression, amnesia, hypertension, and asthma.
The
drugs used to hyperstimulate the ovaries can lead to Ovarian
Hyperstimulation Syndrome, which, in the most severe cases, can lead to
death.
Recommendations
 Researchers should be required to adopt the safest and most ethical approaches to procuring eggs for SCNT.
More and better quality data should be gathered and reviewed by an independent oversight body.
Egg extraction procedures should be conducted by physicians who have no
financial conflicts of interest with the research for which the eggs
will be used.
Women who provide eggs for research should be reimbursed only for
direct expenses, in order to prevent the creation of a market in eggs.
Researchers or their funding agencies should cover medical costs of
treating adverse reactions associated with egg extraction procedures.
A regulatory body with authority to enforce the above standards should be established.
News Articles
Ian
Sample and Donald MacLeod, "Cloning plan poses new ethical
dilemma," The Guardian (July 26, 2005)
Claudia
Kalb, "Ethics, Eggs and Embryos," Newsweek (July
20, 2005)
"Longest
frozen embryo baby born," BBC News, 6 July 2005
"Safety
of egg donor 'unclear,'" BBC News (June 30, 2005)
Alex
Barnum, "Stem cell scientists debate finer points of research
ethics: Should egg donors be paid? When are animal studies OK?"
San Francisco Chronicle (June 26, 2005)
Karen
McVeigh, "Police probe clinic under suspicion of 'exploiting'
egg donors," The Scotsman (March 10, 2005)
"IVF
Treatment killed my daughter" BBC News, 30 June 2005
"UK
woman killed by rare IVF risk." BBC News, 13 April 2005
Kay
Lazar, "Medical miracle turns nightmare; Wonder drug for
men alleged to cause harm in women," The Boston Herald
(August 22, 1999)
Kay
Lazar, "Women seek answers on drugs suspected side effects;
Women battle for answers to post-drug health problems."
The Boston Herald (August 23, 1999)
Kay
Lazar, "Women outraged over drug's ill effects." The
Boston Herald (August 24, 1999)
Commentary
In the last six months, there has been a rise in awareness
on egg extraction for research purposes as many women's health
advocates and others express hesitations about surgical egg
extraction for stem cell research in many local and national
news sources.
"Egg
donation and morality." Ellen Goodman. The Boston Globe,
7 April 2005
"Stem
cell research: Women who donate eggs for research also deserve
premium care." Rebecca Dresser, St. Louis Post-Dispatch,
1 March 2005
"Risk
to women in embryo cloning." Judy Norsigian, The Boston
Globe, 25 February 2005
"Donors
Need Defenders." Ann Elisabeth Samson, The Globe and Mail,
9 March 2004
Articles and Testimony by Women's Health Advocates
Women's health advocates have been at the forefront of the
debate on egg extraction for research purposes. Many have concerns
about an 'egg market' that could be created by the dire need
for eggs for stem cell research.
"ReproKult:
Position on the harvesting and marketing of egg cells,"
by ReproKult Women's Forum on Reproductive Technologies. June
2005
ReproKult is a nation-wide feminist network of women from the
social and natural sciences, politicians, and women from professional
organizations involved with women's health and counseling centers,
activist groups, and the media.
"Egg
donation for IVF and stem cell research: Time to weigh the risks
to women's health," by Judy Norsigian. Different Takes.
Spring 2005
Judy Norsigian is the executive director of Our Bodies Ourselves.
"Testimony
of Francine Coeytaux, MPH, Pro-Choice Alliance for Responsible
Research," at the Oversight Hearing on the Implementation
of Proposition 71, the Stem Cell Research and Cures Act, Joint
Hearing of the California Senate Subcommittee on Stem Cell Research
Oversight, Senate Health Committee, and Assembly Health Committee.
March 9, 2005.
Francine Coeytaux is a public health and reproductive health
expert and advocate.
"Is
this any way to have a baby?" Barbara Seaman, O Magazine,
February 2004
Barbara Seaman is the co-founder of the National Women's Health
Network and an active women's health advocate. .
Response
to "Is this any way to have a baby?" American Society
for Reproductive Medicine, 29 January 2004
Guides for and about Women Undergoing Egg Extraction
There are currently very few comprehensive materials aimed
at women undergoing surgical egg extraction for stem cell research.
This list is a small compilation of what is out there for women
undergoing surgical egg extraction, but most guides focus on
egg 'donation' to produce a child.
"Egg
donation." Human Fertilisation and Embryology Authority.
May 2003
This short guide is meant for women within the United Kingdom
considering donating eggs to fertility patients or to IVF research.
The guide provides a short overview of egg 'donation', explains
who needs the eggs, describes how 'donors' remain anonymous
and articulates egg provider responsibility and the egg extraction
process.
The Human Fertilisation and Embryology Authority (HFEA) is
a British non-departmental Government body set up under the
Human Fertilisation and Embryology Act 1990 that regulates and
inspects all United Kingdom clinics providing IVF, donor insemination
or the storage of human ova, sperm or embryos.
"Assisted
Reproductive Technologies: A Guide for Patients." American
Society for Reproductive Medicine. 2003
This document is meant as a guide for fertility patients going
through assisted reproduction. The guide covers the procedures
for most types of fertility treatment and focuses on pregnancy
and associated risks.
The American Society for Reproductive Medicine (ASRM) is a
multidisciplinary organization serving as a platform for new
ideas, education and advocacy in fertility and reproductive
medicine issues.
"Thinking
of Becoming an Egg Donor? Get the Facts Before You Decide"
The New York State Task Force on Life and the Law Advisory Group
on Assisted Reproductive Technology. 1998.
This guide was created in 1998 by infertility specialists,
consumers, ethicists, after some research revealed that many
egg donors were not fully informed before they became providers.
The guidebook provides unbiased information for women undergoing
egg extraction to provide eggs for a baby and also presents
many questions to ask and ideas to understand before becoming
an egg provider.
The New York State Task Force on Life and the Law was created
in 1985 by the New York State Department of Health to develop
public policy on issues arising from medical advances. The Task
Force includes leaders in the fields of law, medicine, nursing,
philosophy, consumer rights, religion and ethics.
"Financial
incentives in recruitment of oocyte donors." The Ethics
Committee of the American Society for Reproductive Medicine.
2002
Bedford
Stem Cell Research Foundation:
Scientific Articles
Dr.
Suzanne Parisian, former Chief Medical Officer of the FDA, memo
on egg extraction risk. February 2005
"Issues
in oocyte donation for stem cell research," by David Magnus
and Mildred Cho. Science, 19 May 2004 [PDF]
"Epidemiology
and prevention of ovarian hyperstimulation syndrome (OHSS):
a review," by Annick Delvigne and Serge Rozenberg. Human
Reproduction Update, vol. 8, no. 6, pp. 559-577. 2002
"Continuation
of GnRH agonist administration for 1 week, after hCG injection,
prevents ovarian hyperstimulation syndrome following elective
cryopreservation of all pronucleate embryos," by Toshiaki
Endo, Hiroyuki Honnma, Takumi Hayashi, Manabu Chida, Kiyohiro
Yamazaki, Yoshimitsu Kitajima, Atsushi Azumaguchi, Hirofumi
Kamiya and Ryuichi Kudo. Human Reproduction, vol. 17, no. 10,
pp. 2548-2551. October 2002.
Websites
There are hundreds of "egg broker" organizations
that advertise for egg donors and egg recipients online. Payment
for being an egg donor range from $2,000 to $50,000 and couples
are able to select from a large range of criteria for a donor,
from hair and eye color to favorite hobbies, food and education.
Because egg donation is a highly unregulated practice, most
egg brokers often do not disclose all of the possible risks
involved in the surgical egg extraction procedure.
GlobalARTusa,
"Egg Donation from Eastern Europe."
The
Egg Donation Program Dream
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