Women donating their eggs for use in fertility clinics are typically financially compensated for the time and discomfort involved in the procedure. However, guidelines established by the National Academy of Sciences (NAS) in 2005 state that women who donate their eggs for use in stem cell research should not be compensated, although the procedures they undergo are the same. In the October 7th issue of Cell Stem Cell, researchers at the Harvard Stem Cell Institute (HSCI) and the Department of Bioethics at Case Western Reserve University argue that this lack of compensation could prove to be yet another hurdle for human stem cell research in the United States.
"…[W]omen typically are not willing to endure hormonal induction for research simply in exchange for validated parking tickets, reimbursed meals, and a pat on the back," writes Insoo Hyun, Associate Professor of Bioethics at Case Western Reserve University in Cleveland, Ohio, in Cell Stem Cell. "…[W]e do not live in a world where our policy choice is between altruistic egg donation on the one hand and compensation on the other. In the actual world, our true alternatives are fair compensation or a dearth of eggs for research."
Due to the ethical and political issues related to embryonic stem cell research, scientists have searched for ways to produce stem cells that have similar potential but do not involve the use of embryos. One approach, called somatic cell nuclear transfer (SCNT), is to take the DNA from the cell of an adult, a skin cell for instance, and inject it into an unfertilized egg. The technique has been known for decades, and was used in 1996 for Dolly the sheep, but interest has waned in recent years because the feasibility of making human cell lines was not clear. The approach was also mired in controversy, as a group from South Korea led by Woo Suk Hwang reported success in 2005 but the work was later retracted. This month, however, a research group at the New York Stem Cell Foundation Laboratory report in Nature that they have created the first human stem cell line using SCNT. The paper is a breakthrough that could lead to dramatic advances in our understanding of how stem cells function, but the work is still at an early stage and more donor eggs will be needed to build upon it; the experiences of the HSCI team suggest that acquiring those eggs could be a serious barrier to future research.
In a letter in the October 7th issue of Cell Stem Cell, the Harvard researchers explain that the existing guidelines restricting compensation for egg donors effectively stalled their research, first begun in 2006, due to the difficulty in finding women willing to donate without compensation, termed 'altruistic donation'. The recent successful study was made possible by private funding from the New York Stem Cell Foundation, which allowed for financial compensation of egg donors.
"We found that it is not practical to recruit altruistic egg donors and it is likely that investigators working in other states or countries that limit compensation for egg donation would encounter similar difficulties," says Dr. Kevin Eggan, from the Harvard Stem Cell Institute in Cambridge, MA "Our discussions with potential donors suggested that compensation for time and effort would increase the number of women willing to participate in egg donation for research."
In a separate article in the same issue of Cell Stem Cell, Hyun provides an historical explanation for the NAS guidelines, which were established at a time of great uncertainty about the future of embryonic stem cell research in the U.S., and were likely motivated by a desire to shield researchers from additional political backlash. Given the recent findings, however, Hyun argues that the field needs more flexible guidelines that are focused on moving this research forward in an ethical manner.
"Regulators and funders must face up to reality" Hyun writes, "and challenge themselves to figure out how to compensate women fairly for donating eggs for research."
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