Crib Sheet: Hyperstimulating the Controversy
The ethics of the egg-donor business, despite conservative warnings, has little bearing on embryonic stem cell research.
By Sam Berger, American Progress
Thursday April 13, 2006
Current concerns among lawmakers, advocacy groups and the media over the exploitation of, and dangers posed to, egg donors are misleading the public into thinking the issue has a strong connection to embryonic stem cell (ESC) research. Opponents of ESC research have attempted to twist the issue of egg donors to reflect negatively on the research and have found unusual allies in women’s health groups with genuine concerns regarding the egg donation process, such as Our Bodies Ourselves.
The reality, however, is that ESC research will not lead to the exploitation of egg donors because the majority of the research does not require eggs. Existing standards from the National Academies of Science (NAS) prohibit payment to donors for eggs, and the demand for eggs will not be greatly affected by those areas of ESC research that need them. The real concerns around egg donation arise from the government’s lack of regulation of reproductive health technologies. The potential for exploitation of egg donors in ESC research can be alleviated by federal funding and regulations.
There is now a lucrative U.S. market for female egg donors, particularly women in college, causing some concern that the egg-donor business will lead to the exploitation of college women for their eggs. The term egg donor is really a misnomer; while fertility clinics do not purchase the eggs, they do pay women exorbitant sums of up to $35,000 for their time. There are also some dangers associated with the fertility drugs women take for egg donation; around two to five percent of women suffer from ovarian hyperstimulation syndrome, which causes nausea, diarrhea and in rare cases requires hospitalization. Some people worry that increased ESC research will exacerbate these problems by creating a new market for egg donors; they are concerned that additional eggs will be needed for use in somatic cell nuclear transfer (SCNT), a process in which an egg whose nucleus has been removed is used to create stem cells that match the patient’s DNA.
Conservative opponents of ESC research, realizing that the majority of Americans support ESC research, have seized on concerns surrounding egg donation. They argue that an increased demand for egg donations will lead to the exploitation of egg donors. Dave Weldon of the conservative Center for Bioethics and Human Dignity (CBHD) claims that “research cloning will undoubtedly lead to exploitation of women,” while Joe Carter of CBHD argued in testimony before the Illinois State Legislature that “the women of Illinois must not be allowed to be treated as lab animals for speculative research purposes.”
Surprisingly, conservatives are joined by some women’s health groups. Judy Norsigian, executive director of the women’s health organization Our Bodies Ourselves, said that although her group supports most ESC research, “We have deep reservations about ESC research that involves somatic cell nuclear transfer.” In particular, she worries that women will be unable to give informed consent because data on the dangers of fertility drugs is incomplete. Norsigian is careful to point out, however, that conservatives have sought to conflate women’s health groups’ concerns about SCNT, a procedure for producing certain kinds of stem cells, with concerns about ESC research, which these groups strongly endorse.
Regardless of the arguments around egg donation, fear that ESC research in general or SCNT research in particular will lead to the exploitation of donors is unfounded. The National Academy of Sciences (NAS) Guidelines on Embryonic Stem Cell Research, which have been adopted by the California Institute for Regenerative Medicine and endorsed by a number of science organizations and universities, specifically prohibit paying donors for eggs. Far from being treated as “lab animals,” egg donors are treated like other altruistic human donors, undergoing a rigorous pre-donation process that is dictated by medical and ethical norms. The guidelines require that donors undergo a lengthy informed consent procedure involving independent review boards to ensure that they understand the risks of the egg donation procedure and the potential benefits of the research; in fact, there are stricter standards for egg donors in research than those that govern donation of eggs for in vitro fertilization (IVF). Since women can meet the lower standards of informed consent for IVF egg donation based on existing medical data, they can certainly do the same for ESC research.
The NAS guidelines will not be difficult to follow because ESC research will not create a large demand for egg donors. Basic embryonic stem cell research will not require the donation of eggs, and the eggs needed for SCNT can be provided by altruistic donors or the donation of excess eggs from IVF. Basic research using SCNT will not require too many eggs; dire predictions of the number of eggs needed for SCNT are based on using the procedure in therapeutic treatments, not its current use to research genetic disorders for potential cures. In order to head off potential future need, however, scientists have begun looking for alternatives to egg donation, including culturing immature eggs, developing eggs from embryonic stem cells and using non-human eggs. Although none of these techniques have been perfected, ESC research can continue without any additional supply of eggs.
To ensure egg donors are not exploited, the government should learn from its past mistakes with IVF and actually fund and regulate ESC research. The problems associated with egg donations for IVF were caused by the government not funding the research, allowing it to flourish unregulated in the private sector. As a result of the lack of funding and regulation, no industry standards were systematically developed. Worried that his anti-abortion constituency would object to IVF research, President Reagan ignored the advice of the Ethics Advisory Board (EAB) of the Department of Health, Education and Welfare to fund nascent research under certain circumstances. Instead, he allowed the EAB’s charter to expire in 1980, thereby creating a de facto moratorium on funding for IVF. Reagan’s approach did not prevent the development of IVF technology, however; it simply allowed research to proceed in the private sector with minimal regulation and no mandated ethical review processes. We cannot allow the same mistake to be made with ESC research; President Bush’s restriction on federal funding, which amounts to a ban on federal monies for ESC research, will mean research only continues privately, without regulation. Instead of burying its head in the sand, the government should start funding ESC research, not only to spur on the development of cures but also to provide the necessary ethical and regulatory framework.
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Comments
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Sorry Sam, but egg donation and embryonic stem cell research are inextricably linked, and egg donation is not an easy option as those women who have lost their reproductive capacity, ended up in intensive care, or most tragically died demonstrates.
— Josephine Quintavalle - Jul 26, 08:37 AM - #Even Gerard Schatten acknowledged at a public meeting in London last year that the risks for egg donors are for the moment heavily outweighing (in ethical balancing) the potential for benefit from embryonic stem cell research.
What is for absolute sure is that the need of the biotech industry for eggs should not be minimised. The ideal stem cell is developed from the eggs of healthy non-patient donors, in large quantities to ensure consistency for the scientific research involved. And young healthy donors are the very women most susceptible to ovarian hyperstimulation syndrome.
In the UK the shortage of eggs has lead desperate scientists to propose the creation of animal/human hybrids instead, using non-human mammalian eggs.
In my opinion neither choice is desirable.
I was an Egg Donor in 1999 & developed Ovarian Hyperstimulation Syndrome. I was very ill & unable to work for 6 months. The directer of the clinic told me (when I was alone in my hospital room) “you’re lucky- women have died from this.” The clinic was at a public, state-funded University. Why is government funding potentially-lethal experimentation on financially-coerced young women’s bodies?
— R. Donor - Sep 5, 01:00 PM - #Thank you so much for this description of how IVF works. I strongly believe IVF should be made available to single women without legal restrictions as to where the sperm is to come from. I am a 44 year old woman who has never had the joy of conceiving. The thought of this process being available through the NHS seems like an unbelievable gift one that, depending on time and eventual outcome, I may or may not ever get to experience. But at least positive moves are being made to avoid women with fertility problems going through the extreme sadness that is caused by not being able to bear a child without medical intervention.
— James - Nov 20, 09:04 AM - #