Egg Regs

"The demand for donated eggs is constantly increasing even from an infertility point of view," says Norbert Gleicher, chairman and medical director of the Center for Human Reproduction (CHR). He says CHR's two clinics, in Manhattan and Chicago, have one of the largest egg donation programs in the country.

"The amount of demand that we see in our practice is exponentially growing," he says. "If legislation allows the use of donated eggs for creating embryos, for example, for the purpose of establishing stem cell lines, then I'm convinced there will be an increasing demand for egg donation."

Although women’s health advocacy organizations like Our Bodies, Ourselves say they favor therapeutic cloning, they want government regulations to protect egg donors from potential exploitation. Until then, Judy Norsigian, executive director of Our Bodies, Ourselves, says, they have called for a moratorium on human embryo cloning research.

Norsigian says the risks to egg donors, including the risks of the main drug used in ovarian hyperstimulation, have not been thoroughly studied.

At issue, she says, is whether such risks are balanced by any benefit to the donor. "One might make the case that even though the risks are somewhat unknown, and they might be substantial, there are certainly women who would say, I'll take a lot of risk because I want to have a baby so badly that's related to me genetically," Norsigian says. "There's a tangible benefit to those women."

"We are a far cry from being able to say that for the women who undergo... harvesting numerous eggs so that they could be used in embryonic stem cell research," she says. We simply don't have... the research that says they, or someone they love, really could stand to benefit from this research at this point in time. We're far from that.”

What about financial benefits?

"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.