Last week researchers announced that they had created stem cell lines using human eggs for the first time. The goal of this research, funded by the private non-profit New York Stem Cell Foundation (NYSCF), is to create stem cells that could be transformed into tissues and organs for use in transplants and other procedures where a perfect genetic match greatly increases the chances of success.
In this case, the researchers added the nuclei taken from donors’ adult skin cells to unfertilized human eggs. The stem cells they produced this way contain three sets of chromosomes rather than the standard two; what researchers call triploid rather than diploid. While these triploid cells are therapeutically useless, the researchers believe that studying them will lead to breakthroughs that will enable them to produce transplantable cells some day.
Heretofore, researchers have been able to produce cloned stem cells for lots of different animals but not for humans. One reason for this difference is that animal eggs for use in stem cell research are much more plentiful than human eggs.
Why is there a shortage of human eggs for research? In part, because bioethicists endorse the National Academy of Sciences (NAS) guidelines that forbid paying women more than their expenses for donating eggs for research. (In contrast, women are free to sell their eggs for thousands of dollars for use in assisted reproduction.) Fortunately for the NYSCF researchers, New York changed its regulations in 2009, allowing researchers to pay women for their eggs. This enabled the NYSCF researchers to obtain 270 eggs from 16 women.
The New York researchers paid the women $8,000 each for their eggs. They even jumped through another ethical hoop by working with a Columbia University fertility clinic that paid the women for their eggs. The women were paid in advance and were only asked after harvesting to choose between directing them to either reproductive or research purposes.
Nevertheless, many bioethicists agree with the NAS prohibition and still oppose paying women for their eggs. “This new form of research cloning, like the old one, still represents a highly speculative approach to stem cell research,” declared Marcy Darnovsky, the associate executive director of the Center for Genetics and Society, in California. “We should not put the health of young women at risk, especially to get raw materials for such exploratory investigations.”
According to The Washington Post, University of Pennsylvania bioethicist Jonathan Moreno worries that the new stem cell research gets into “paying-for-organs controversy,” adding, “I've always felt it would be better to keep this field out of those areas of debate. We've got enough problems." Executive director of the Boston-based women’s health group, Our Bodies, Ourselves, Judy Norsigian agreed, “I do have some very serious concerns about such wholesale solicitation of young women for their eggs at such very attractive prices.”
The main risk that women run is ovarian hyperstimulation syndrome (OHSS), in which the ovaries become swollen and fluid can leak into the belly and chest area. In the NYSCF research, one woman actually produced 26 eggs. The good news is that a review of the medical literature published in the current issue of the American Journal of Bioethics (AJOB) finds that the risk of ovarian hyperstimulation syndrome among women who donate their eggs is very low. Ellison and Meliker note that when proper precautions are taken into account the risk of OHSS is “diminished even further to almost zero.”
Stony Brook University bioethicist Brooke Ellison and preventive medicine professor Jaymie Meliker note that many opponents of egg buying argue that poor women would disproportionately subject themselves to this risk. After reviewing the OHSS data, they conclude the risk of “OHSS for women of any socioeconomic status does not appear to be so great as to warrant policies preventing women from donating eggs.” They also point out lots of activities that society encourages people to undertake including participation in clinical trials and some forms of manual labor are far more risky than egg harvesting. Note also that another recent study estimated that the risk of death from ovarian hyperstimulation is between 1 in 45,000 and 1 in 500,000, comparable to your lifetime risk of dying of a lightning strike (1 in 80,000). These mortality estimates are based on an earlier version of the treatment. Newer protocols cut the risk even more.
So if risks of selling eggs for research are not all that great, why is there so much opposition to it? Ellison and Brooke mention in passing the possibility of “the existence of paternalism in denying women the right to donate their eggs if they so choose.” In another AJOB article, University of Washington bioethicist Kathryin Hinsch and Univeristy of Miami bioethicist Robin Fiore, note that paying women for eggs used in assisted reproduction is routine. Reason Contributing Editor Kerry Howley chronicled her experience selling a dozen of her eggs in 2006 for $10,000.
“The only difference between providing oocytes [eggs] for reproduction and providing oocytes for research is that only the former can be compensated,” observe Hinsch and Fiore. They add, “Since fears of commoditization and exploitation apply equally to both, the ban on compensation for research oocytes can only be explained by the politics of stem cell research.” There is a whiff of paternalism wafting off the statements of Darnovsky, Moreno, and Norsigian against allowing women to sell their eggs for research. If the risks of producing eggs for ressearch are, as recent data suggest, minimal, then surely Hinsch and Fiore are right when they assert: "It is actually prohibiting payment that is exploitative of women: not paying them fairly for their time, inconvenience and risk, and their contribution to financially rewarding science."
Ronald Bailey is Reason's science correspondent. His book Liberation Biology: The Scientific and Moral Case for the Biotech Revolution is now available from Prometheus Books.