Saturday, August 9, 2008

[StemCells] It's not about 'extra embryos' anymore

Egg Shortages Stalling Stem Cell Research
BY DARRYN BENNETT

, Aug. 7, 2008 | In January, renowned scientists and researchers
lauded the success of Stemagen Corp., a small biotechnology firm in
La Jolla, when it became the first to document the successful cloning
of human embryos by fusing donated egg cells with the DNA from the
skin cells of an adult man.

Eggs Wanted

The Issue: Under state law, women are allowed to be paid thousands of
dollars for eggs they donate to fertility clinics, but compensation
for eggs donated for research is banned.
What It Means: Some scientists say there is a shortage of eggs fueled
by the payment ban. The result is a slowdown in medical
breakthroughs, they say.
The Other Side: Fans of the ban say paying women to donate eggs for
science would create a market for human eggs with so much demand,
women may not consider the risks when selling.

The research is widely considered a major step toward creating
embryonic stem cell lines from cloned human embryos. Those cells are
capable of evolving into the more than 200 different cell types in
the body and, in theory, could one day be used to replace cells that
have been destroyed by diseases, such as Parkinson's and Lou Gherig's
Disease.

The technique Stemagen used, known as therapeutic cloning, replaces
the genetic material of the donor egg with the DNA from a regular
adult cell. It is particularly promising, proponents say, because the
human body isn't likely to reject replacement cells that genetically
match its own.

But six months after the company's success, when the California
Institute for Regenerative Medicine was handing out $23 million in
research grants, Stemagen's application was denied. Dr. Sam Wood, the
company's chief executive, said the main reason the agency cited for
the denial was the lack of a guarantee that enough eggs would be
available for the research.

In 2004, voters approved Proposition 71, which created the $3 billion
regenerative medicine institute to regulate and fund stem cell
research in the state. However, the voter-approved ballot measure
explicitly bans compensating women for eggs donated for research,
even though fertility clinics have been allowed to pay donors for
eggs since the industry emerged about 30 years ago. Wood said the ban
should be scrapped because it has created a research-egg shortage
that has thwarted -- or at least slowed -- medical breakthroughs.

"I'm hoping there will be a rising up of public opinion here," he
said. "If there's not a change, this research will move to New York,"
where new guidelines for a $600 million stem cell research program
may allow payment for eggs.

Supporters of the ban and agency regulators, however, say it is
necessary to avoid the creation of a market for eggs that could
induce women to take hefty health and emotional risks.

According to some studies, donors have an increased risk of ovarian
cancer and complications, such as infection or bleeding, could reduce
the chances of pregnancy. Also, serious complications can arise from
the stimulation of the ovaries and in are cases, the condition can be
fatal.

"You can't offer a first-year college undergrad facing huge student
loans $25,000 and expect her to really contemplate the risks," said
Mike Kalichman, the director of the Research Ethics Program at the
University of California, San Diego. "And what will happen later if
they have difficulty conceiving a child after they've donated their
eggs to science instead of saving them for themselves?"

Kalichman, who didn't offer a personal opinion on the egg payment
controversy, said the ban boils down to the fear of coercion.

"The idea is that if a woman is paid enough, there's a point at which
she may not pay attention to the risks," he said. "The consensus has
pretty much been to err on the side of caution."

Wood balked at that notion.

"I think it's outrageous that anyone would tell a woman she can't
make her own decision," he said.

Some backers of the ban, including the Center for Genetics and
Society, an Oakland public policy group, say the egg-dependent
research approach should maybe be abandoned in favor of a newer
technique where scientists coax, or induce, adult stem cells to
behave like embryonic ones, sidestepping the need for the use of eggs
or embryos in research. But scientists are still struggling to
overcome some serious challenges with the induced cells, including
the risk of cancer triggered by viruses that are used in the coaxing
process.

"Embryonic stem cell research is where we've made the most headway,"
Kalichman said. "We shouldn't just jump out on another limb without
very good reason."

The payment ban is limited to eggs being donated for research
purposes and doesn't apply to women who give eggs to fertility
clinics. According to the American Society for Reproductive Medicine,
fertility clinic donors usually earn between $5,000 and $10,000 per
donation. If women elect to donate eggs to science, they are only
allowed to be reimbursed for any expenses they incur during the
procedure and lost wages.

Wood said between $3,000 and $5,000 would be reasonable compensation
for a woman who opted to donate eggs for research because the
donation process, identical to the one used in fertility treatments,
is an arduous one.

Women receive a series of roughly 40 injections of fertility drugs to
stimulate the ovaries to produce many eggs at one time. While using
the drugs, frequent medical tests and ultrasounds are required, and
removing the eggs from the ovaries involves a minor surgical
procedure.

"I don't see how they would expect any woman to do it without getting
paid for it," said Diana Batzofin, the administrator for La Jolla
IVF, a fertility clinic.

Wood may have a key ally in his effort to abolish the payment ban. In
February, Dr. Alan Trounson, the regenerative medicine agency's
president, told a committee that research into therapeutic cloning
was lagging because of an egg shortage.

Still, any effort to change the egg donation policy would be
difficult. The ban is written into the voter-approved ballot measure
that created the state agency and a 2006 law passed in the state
flatly bans researchers from paying for eggs. Stem cell specialists
said the issue won't likely get much attention in the national
elections because the next president will first have to grapple with
the question of whether to lift President George Bush's order that
limits federal research funding to a few pre-existing embryonic stem
cell lines.

Please contact Darryn Bennett directly at
darryn.bennett@voiceofsandiego.org with your thoughts, ideas,
personal stories or tips. Or set the tone of the debate with a letter
to the editor.

http://www.voiceofsandiego.org/articles/2008/08/09/economics/888eggs08
0708.txt

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StemCells subscribers may also be interested in these sites:

Children's Neurobiological Solutions
http://www.CNSfoundation.org/

Cord Blood Registry
http://www.CordBlood.com/at.cgi?a=150123

The CNS Healing Group
http://groups.yahoo.com/group/CNS_Healing
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