Quest for human eggs carries ethical price

What if you could get it for half-price, by agreeing to donate half the eggs you produce for stem-cell research?

Interested?

British women may get a crack at that deal in a few months, under a plan pursued by Dr. Alison Murdoch of Newcastle University.

This concept, which resembles a strategy sometimes used to get eggs for fertility treatment, is just one of several new efforts to boost the supply of human eggs needed for research. The shortage has triggered an ethical debate on both sides of the Atlantic: Should women be paid for supplying eggs?

Scientists need eggs for a process called therapeutic cloning, which creates stem cells genetically matched to an individual. It may be used someday to create tissue to treat illnesses like diabetes and Parkinson's disease, providing transplant material that's genetically matched to the patient so that it won't be rejected.

Time-consuming process

Therapeutic cloning may also help scientists develop better drug treatments.

The process involves transferring DNA into human eggs and growing them into 5-day-old embryos, from which stem cells are harvested.

It's not clear just how many eggs scientists need for this research. But it is clear that for a woman, donating eggs is a significant undertaking.

By various estimates, a woman can spend 40 to 56 hours in medical offices, being interviewed, counseled and subjected to a surgical procedure, under sedation, that retrieves eggs from her body. Before that procedure, she takes hormone injections daily for more than a week to stimulate egg development.

Women donate thousands of eggs in the United States every year to help other women have babies. They are paid. The American Society of Reproductive Medicine doesn't recommend a figure but says $5,000 or more requires some justification and that $10,000 is too much. (In fact, some ads for eggs offer far more).

Risks not fully understood

The medical group also says it's fine to pay women for producing eggs for stem-cell research. But other guidelines and laws on that topic favor just reimbursing women for expenses. That's the word from the law books of California and Massachusetts and a committee of the National Research Council, a congressionally chartered nonprofit organization that advises the federal government.

In fact, the compensation question has split American feminists and advocates for reproductive health and rights, said Marcy Darnovsky, associate executive director of the Center for Genetics and Society. One side says offering money beyond reimbursement risks exploiting disadvantaged women by offering undue inducement to participate, while the other side calls that stance paternalistic, she said.

Darnovsky said her center has no position on paying women to provide eggs for fertility clinics, but holds that if women give eggs for stem-cell research, they should be reimbursed only for expenses, including lost wages.

Why the difference? It's a matter of a woman's gauging the risks and benefits of donating her eggs, Darnovsky said.

On the risk side, there's been too little follow-up of women to know for sure how safe the egg-retrieval process is, she said.

On the benefit side, while donating eggs to a fertility clinic often produces a baby, the potential payoff in stem-cell research is promising but only speculative at the moment, Darnovsky said. But women, like society, have so bought into the expectation of "miracle cures" from stem cells that they overestimate the benefit from donating eggs, she said.

The result? If stem-cell researchers offer the kind of money that fertility clinics do, "I think any woman who's trying to pay the rent and put food on the table, and people who don't have a lot of money to spare, are going to be tempted to discount the risks and overvalue the benefits," she said.

Similarly, ethicist Laurie Zoloth of Northwestern University believes that paying compensation could exploit some women. Women who give eggs to fertility clinics are doing it for the money, she said, and as a society, "we don't … want the bodies of the poor used for the needs of the wealthy."

"You do not see many full professors or CEOs selling eggs to secretaries or housecleaners," she said in an e-mail.

Zoloth, who emphasized that she strongly supports stem-cell research that would use the eggs, said she believes women donating eggs for such research should be reimbursed only for expenses. Giving up eggs, like donating organs, should be an altruistic act, she said.

But others believe women should be paid.

Participants in other kinds of biomedical research are compensated for their time, inconvenience and the rigors of participating, says Kathy Hudson, director of the Genetics and Public Policy Center at Johns Hopkins University. So why, she asks, should egg donors be treated any differently?

There are ways to guard against exploitation of vulnerable women, she said. One would be for local boards that oversee research to make sure that donors are recruited from a wide variety of groups rather than just the economically disadvantaged, she said. And limits can be set on the number of times any one woman can participate, she said.

So far, the track record for altruistic donations is mixed. On one hand, hundreds of women volunteered to donate eggs in South Korea for research by the now-disgraced scientist Hwang Woo-suk, who fraudulently claimed success in therapeutic cloning.

Altruism in short supply

But Dr. Robert Lanza, vice president of research and scientific development at Advanced Cell Technology Inc. of Alameda, Calif., said he has given up trying to get donations without compensation.

After more than a year of pursuing that strategy and about 100 advertisements, ACT was able to get only one woman to donate eggs, he said in an e-mail.

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In April, Gov. Janet Napolitano vetoed a bill to make it a crime for women to sell — or for doctors or researchers to buy — human eggs that would be used for cloning research.