Egg Extraction For Stem Cell Research: Issues for Women’s Health
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
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)
"IVF Treatment killed my daughter" BBC News, 30 June 2005
"UK woman killed by rare IVF risk." BBC News, 13 April 2005
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
"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 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.
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. .
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.
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.
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.
Bedford Stem Cell Research Foundation:
- "Guidelines For Research With Human Eggs"
- "Egg Donor Protocol and Risks"
- "Egg Donor Time commitments"
Scientific Articles
"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.