Egg donation for stem cell research -- balancing the risks and benefits

In the wake of the scandal involving fraudulent cloning research, concerns about the welfare of women donating eggs for research purposes have arisen. Finding a way to balance the welfare of donors and the promise held out by embryonic stem cell research is vital, a bioethicist will tell the 22nd annual conference of the European Society of Human Reproduction and Embryology in Prague on Tuesday 20 June 2006.

Mrs. Heidi Mertes, from the Department of Philosophy and Moral Science, Ghent University, Belgium, will tell the conference that specific concerns include informed consent, risks for the donors' health, distributive justice (will there ever be enough eggs for therapies and will treatments be affordable?), and the possibility of being offered undue inducement to donate. "Some interest groups and regulators regard these concerns as extra reasons to oppose human embryonic stem cell research," says Mertes, "and clearly, asking women to donate eggs for research purposes can only be acceptable if the benefits outweigh the risks. These issues need to be addressed as soon as possible, since the demand for eggs will probably rise as stem cell research progresses."

"In our research we set out to balance the bioethical principles at stake, and by doing so developed guidelines under which egg donation for stem cell derivation can withstand moral scrutiny," she says. Risks for donors should be reduced as much as possible by thorough screening of candidates to identify those at risk of developing severe ovarian hyperstimulation syndrome, such as young age and body weight, says Mertes and her co-author, Professor Guido Pennings. The use of ovulation induction medications should be limited and long term follow-up carried out to assess any adverse effects.

A third option, they say, could be to limit donors to IVF patients who are already undergoing ovarian stimulation and egg retrieval. If in vitro maturation of eggs and egg freezing become reliable techniques, a significant number could be obtained in this way. Finally, alternative sources of eggs should be sought, such as cadavers, aborted female fetuses, animals, surgically removed ovaries, and the production of eggs from existing stem cell lines.

"However, there are still a number of ethical issues which would need to be addressed," says Mertes. "For example, should donors be paid? It has been argued that payment would lead to undue inducement, exploitation and the commodification of human tissue. But if donors were reimbursed for their time and effort rather than for the number of eggs retrieved, this would largely avoid this problem.

"Many legislators are currently working on the regulation of stem cell research and deriving human embryonic stem cells through somatic cell nuclear transfer (SCNT)," says Mertes, "and we are concerned that the Korean scandal may persuade them to prohibit donation of oocytes for research and thus indirectly SCNT. We believe that it is important to illustrate that women's welfare and SCNT are not irreconcilable."

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