"Monetary incentives are never to be considered as adequate," says
Norsigian. That's true of institutional review policies governing human subjects
in clinical trials, and clinics (like CHR) that are members of the Society
for Assisted Reproductive Technology (SART) follow similar guidelines.
Egg donors are compensated for their time and effort, and clinics' ethical
review committees set amounts that they consider fair, but not so large that
they might be a donor's sole incentive. In fact, Lanza says Advanced Cell's
ethics committee recommended that when the company recruits egg donors for
its human ES cell research, it should set its compensation low enough that
"we wouldn't be pulling from the pool" of egg donors who donate
to couples trying to have a child.
Phoebe Osman has been through the egg
donation process at CHR three times, and is now being tested for a fourth.
The 26-year-old gets $7,000 each time she donates, but claims the satisfaction
she gets from helping infertile couples to conceive children is her true motivation.
"I just thought it was really sad that some people weren't able to have
children of their own," says Osman. "And if there's something I
can do to help them with that, I'm gonna do it." As a matter of fact,
Osman says, "even without the money, I'd still do it."
Gleicher says screening egg donors according to SART standards—not just
medically but also psychologically—ensures that donors' motivations
are altruistic. SART also recommends women be allowed to go through a maximum
of six stimulated ovulation cycles in their lifetime, although the society
states that there are no known risks
of repeated egg donation. CRT sets the limit at four.
"We are quite well-regulated but we are self-regulated, we are not regulated
by the government," Gleicher says.
He says government oversight would be unnecessarily intrusive. "We are
today basically able to achieve pregnancy for almost any couple that has infertility.
To give you an analogy, if in cancer care the same kind of success had been
achieved over the last 15 or 20 years, 95 percent of cancers would have been
cured," Gleicher says.
"I find it quite paradoxical that in a field of medicine which—through
self-regulation, without any government intervention, without any government
support for research—has achieved all of this progress without any major
mishaps happening in terms of social concerns, of abuse, of procedures...
in that field there are the loudest voices about increasing government regulation."
He adds, "that kind of doesn't make sense."
Lanza is optimistic that ES cell research will bring about tangible benefits.
"The way I would actually see the egg donation occurring in the future
for medical purposes is very much like we do today for transplantation of
say a heart or a kidney," he says. "I think that anyone who has
a life-threatening disease, certainly there may be one or two individuals
who'd be willing to subject themselves to this minor procedure if this were
to save the life of this individual, or alleviate them from having, for instance
in the case of diabetes, of going blind or having their limbs amputated. Again,
there would be no exchange of money, this would be an altruistic gesture on
the part of someone who loves another individual."
In the meantime, for companies like Advanced Cell to proceed with ES cell research,
they'll most likely rely on IVF clinics for donated eggs.