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Egg donation for stem cell research: reconciling scientific progress and women's welfare

26 June 2006
By Heidi Mertes
Department of Philosophy and Moral Science, Ghent University, Belgium
Appeared in BioNews 364
In the wake of the Hwang scandal, it became clear that the future success of developing patient-specific stem cell lines by SCNT (cloning technology) will depend primarily on a sufficient supply of human oocytes (eggs). However, oocyte donation after ovulation induction presents certain risks for the donor, and therefore concerns for women's welfare are rightly vocalised. Some interest groups try to reinforce the idea that science and women's welfare are conflicting to the extent that they seem incompatible, thus creating the impression that regulators' choices are limited to either supporting the exploitation of women or hampering scientific progress. It is important that a third way out of this dilemma is explored that reconciles a vital subfield of embryonic stem cell research and women's wellbeing by formulating conditions under which research donation can withstand ethical scrutiny.

As is the case for scientific research involving human research subjects, any risks that are taken need to be minimal and need to be outweighed by the benefits of the research. Oocyte donors are subjected to risks and discomfort ranging from ovarian hyperstimulation syndrome (OHSS) to infections, bleeding and possible currently unknown long term effects. However, a number of measures can be taken to minimise these risks. 

Although the severe form of OHSS is less common in donors than in IVF patients (because pregnancy normally does not ensue and thus there is no second wave of hCG, the pregnancy hormone), it has been observed in donors and should be avoided. When predisposing factors such as young age, low body weight and the presence of polycystic ovaries are present in a candidate research donor, their donation should be discouraged or refused. Furthermore, ovulation induction regimens can be adjusted to safer levels and donors should be closely monitored so that regimens can be cancelled when a donor has a strong response. 

Follow-up care ought to be provided and uncertainties about the long term effects of the drugs and procedures used during ovulation induction need to be resolved. Another possibility to reduce the number of women undergoing these ovulation induction regimens is to ask women who are undergoing an IVF-procedure for their own reproduction to donate some of their oocytes should they produce a great amount. Not everybody agrees on the appropriateness of such requests however, since IVF patients are a vulnerable group and conflicts of interest may arise. A perfection of in-vitro egg maturation techniques may partly resolve this dilemma, by making immature oocytes available that are currently not being used for infertility treatments. 

A final way to reduce the number of donors needed (and thus the risks) is to further explore the use of alternative sources of oocytes. Depending on the kind of research, oocytes retrieved from surgically removed ovaries, cadavers, animals, aborted fetuses or even embryonic stem cells could be used. The improvement of in-vitro maturation techniques is tantamount to expand these possibilities.

Besides reducing the risks, the risk-benefit ratio can be optimised by maximising the benefits that can result from oocyte donation. The benefits of personalised stem cell treatments are for the time being only a possibility in the distant future and it remains uncertain if they will ever be widely available. Therefore experiments should be carefully selected based on their promise and projects with a more concrete benefit in the immediate future, such as the development of in vitro disease models, may deserve preference. Coordination rather than competitiveness between researchers is to be encouraged to prevent unnecessary duplication of research. This can be reached by sharing knowledge and exchanging stem cell lines.

Whether oocyte donation is acceptable for a certain research project will have to be decided on a case-by-case basis. However, if research projects are carefully selected and the necessary safety measures are applied to prevent health complications in donors, there is a real possibility that science and women's welfare can be reconciled.

7 January 2007 - by Heidi Nicholl 
The UK's Human Fertilisation and Embryology Authority (HFEA) has, for the first time, amended a licence for stem cell research to be carried out, which allows women to donate eggs without needing the donation to be linked to ongoing in vitro fertilisation (IVF) or sterilisation procedures. The...
21 September 2006 - by Veronica English 
The British Medical Association (BMA)'s Medical Ethics Committee (MEC) recently had a long and fascinating debate about egg donation for research. The debate was much broader than the Human Fertilisation and Embryology Authority (HFEA)'s consultation document, looking also at related issues such as payment for donation of other...
11 September 2006 - by Dr Kirsty Horsey 
The UK's Human Fertilisation and Embryology Authority (HFEA) has launched a public consultation on the donation of eggs for scientific research purposes. The consultation was announced in May after discussions at an HFEA public meeting failed to reach a conclusion on the issue. It will run...
14 August 2006 - by Heidi Nicholl 
A leading bioethicist, Dr Insoo Hyun of Case Western Reserve University, Ohio, US, has called for women to be paid to donate eggs for stem cell research on the same basis that research participants are compensated for taking part in other medical research. In a Nature commentary...
31 July 2006 - by Heidi Nicholl 
A controversial scheme to extend the practise of 'egg sharing' has been approved by the UK's Human Fertilisation and Embryology Authority (HFEA) to provide greater numbers of eggs for embryonic stem (ES) cell research. The practise of egg-sharing is currently allowed where a woman may receive discounted...
9 June 2006 - by Dr Jess Buxton 
Researchers at Harvard University in the US have been granted permission to produce embryonic stem (ES) cells from cloned human embryos, two years after they first sought approval for the work. One research team, led by Doug Melton and Kevin Eggan, plans to ask women living...
18 May 2006 - by Dr Kirsty Horsey 
South Korean stem cell scientist Woo Suk Hwang has been formally prosecuted on charges of fraud and embezzlement - if convicted he could spend up to 10 years in prison. He was charged with accepting two billion won (about $2.1 million) in private donations based on his...
15 May 2006 - by Dr Kirsty Horsey 
At its open meeting held on 10 May in Belfast, the UK's Human Fertilisation and Embryology Authority (HFEA) announced that it will 'prepare a proper consultation programme' on oocyte (egg) donation so that it could assess the whole range of views and ethical issues that the...
20 February 2006 - by Dr Jan Deckers 
The UK's Human Fertilisation and Embryology Authority (HFEA) is reported to be considering allowing women to donate eggs specifically for cloning research. Three issues must be considered to address this question: firstly, if creating life to kill it is justifiable; secondly, if the expected benefits outweigh the costs; and thirdly...
4 July 2005 - by Dr Jess Buxton 
In this week's BioNews, we report on the case of a woman set to receive damages after she had a stroke following IVF. The patient, left brain-damaged, had developed a rare side effect of fertility treatment called ovarian hyperstimulation syndrome (OHSS). In its most severe form, OHSS can be potentially...
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