Scientists who want large numbers of women's eggs for cloning-based stem cell research face widespread objections and concerns because of the risks that egg retrieval poses for women and the speculative nature of benefits from research cloning (also called somatic cell nuclear transfer or SCNT). The past month has seen many new developments in the eggs-for-research controversy.
UK to allow egg retrieval for research and reimburse women for expenses
The UK's Human Fertilization and Embryology Authority ruled on February 21 to allow egg retrieval for research. The move was reported worldwide, often under headlines about the approval of payment for eggs. A CBS News report, for example, was headlined "Britain to Pay Women for Ova to Research," and the Los Angeles Times ran a news wire account titled "Britain to pay women who donate eggs."
Paying egg providers has been a hotly contested issue since payment may encourage some women to agree to the procedure without fully considering its risks. California law, regulations adopted by the California stem cell agency, and recommendations issued by the National Academies of Sciences limit payment to reimbursement for direct expenses.
HFEA Chief Executive Angela McNab said in a statement that this is also the case under the new ruling. "There has never been any question of women receiving payment for donating their eggs for research at any stage of our deliberations," she said. McNab also listed the safeguards that will be required, which are similar to those in California law.
According to news reports, the HFEA will allow up to £250 (about $500) compensation for lost earnings, with further uncapped payments to cover travel costs and childcare. This has prompted concerns: "It's exploitative because there will be women attracted even by the thought of getting 250 pounds from this," said Dr. Stephen Minger, director of the Stem Cell Laboratory at King's College, London. "I'm very uncomfortable with the idea of selling tissue and body parts."
Donna Dickenson, Emeritus Professor of Medical Ethics and Humanities at the University of London, said that £250 would be enough to encourage women from eastern Europe to travel to Britain to undergo the procedure. "That's clearly turning eggs into an object of trade, and that's disturbing," she said. Even though the HFEA insists "that women doing this would do so for purely altruistic reasons," she added, the new ruling "could be unwittingly opening the door to barter or sale of eggs."
Report on egg procurement reaches conclusions unsupported by its findings
A new Institute of Medicine report on egg retrieval for research, based on a scientific workshop commissioned by the California Institute for Regenerative Medicine, concludes that the risks are "minimal." Linda Guidice, co-chair of the CIRM-commissioned panel that produced the report, told Bloomberg that egg retrieval "is a remarkably safe procedure."
But Susan Fogel of the Pro-Choice Alliance for Responsible Research (PCARR), who attended the workshop and served as an invited pre-release reviewer of the report, points to many statements in the document itself that belie this conclusion.
For example, the report states that "one of the most striking facts about in vitro fertilization is just how little is known with certainty about the long-term health outcomes for the women who undergo the procedure," and that even "that limited knowledge is not directly applicable to the safety of ooctye donation for research."
Fogel said in a press statement that the report "misses an important opportunity to lead the way by requiring critically important safety evidence before we ask women to take potentially serious unknown risks with their health."
The report "elevates [somatic cell nuclear transfer] over other avenues of research in the development of future stem cell therapies," she said. "By suggesting that researchers must have thousands of women's eggs now, despite the critical absence of safety data, the report does women a great disservice."
New study documents additional risks of egg retrieval
Researchers at the University of Padua (Italy) have published a new study in the journal Thrombosis and Thrombolysis on egg retrieval's risks, finding that the hormonal drugs used to stimulate egg production can cause paralysis, limb amputation and even death. As reported in the Telegraph (UK), these researchers analyzed doctors' reports since the early 1990s and identified 34 women-most of them previously in good health-who suffered severe reactions to the drugs. Sixty percent of these involved blood clots in the head and neck.
Industry group wants weaker rules on compensation in egg procurement
The International Society for Stem Cell Research (ISSCR) is a membership organization of stem cell scientists and biotechnology companies that recently issued a set of recommended guidelines [PDF] for stem cell research. In a February 2 article in Science, its task force on human embryonic stem cell research reported that it was divided as to whether paying women to provide eggs for stem cell research would induce women to take risks they otherwise wouldn't. The group decided to leave the decision to mostly local oversight committees that are often affiliated with institutions sponsoring the research they are charged with regulating.
One member of the task force justified this move by citing "cultural and political differences" among countries with stem cell programs. Such relativism could easily endorse "tissue tourism," in which researchers arrange to obtain women's eggs wherever the rules are most lax. As CGS's Jesse Reynolds told New Scientist, "It's unfortunate that the ISSCR is choosing to water down what was becoming a de facto international standard of prohibiting the payment of women for eggs."
Of the 31 ISSCR task force members, eight are bioethicists, lawyers, or other non-researchers. Stanford bioethicist David Magnus criticized the non-enforceable guidelines as "too little, too late." He also thought they needlessly replicated other committees' and regulatory bodies' work.
The shortcomings of the ISSCR guidelines highlight the need for truly representative bodies that work toward effective and enforceable regulation of human biotechnologies.