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Thousands of women donate their eggs for infertile couples, but eggs also hold
the promise of cures for many diseases.
This ScienCentral News video reports that as the demand for eggs grows, womenâ€™s
health advocates are already worrying about how to protect egg donors.
Where will the eggs come from?
If embryonic stem (ES) cell therapies actually fulfill their promise, the
demand for human egg cells could skyrocket. Advanced Cell Technologies' Robert
Lanza says millions of patients with Alzheimerâ€™s, Parkinsonâ€™s
disease, diabetes and heart disease could benefit from future cell therapies.
Lanza says a major benefit of using ES cells cloned from patients' own cells
is that there would be no risk of rejection.
"We have the ability for instance to, by using therapeutic cloning, to
create insulin-producing cells that could be used to treat a disease that
affects over 200 million people worldwide," Lanza says.
But if such therapies required just one egg cell per patient, that vision of
the future would take many millions of eggs.
"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 womenâ€™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.