Reproductive technologies have a long history of freedom from government regulation in the United States, but that record could now face a setback thanks to new embryonic stem-cell research guidelines released this week.
Health, not money, should be the priority of women hoping to sell their eggs to science, the National Academies concluded in a 240-page report published Tuesday. As a result, researchers should be barred from paying women for their eggs.
The recommended prohibition contrasts with the vibrant commercial market already established for human eggs in reproductive medicine. For baby-making, women are now paid handsomely -- in some cases $15,000 or more -- for selling eggs to an infertile couple. And sperm banks routinely pay men from $65 to $500 for their sperm depending on how much is donated and whether the sperm owner releases his identity.
To produce many eggs instead of just one or two in a given month, women take hormones to induce "superovulation." Those drugs, such as Lupron, can cause complications such as ovarian hyperstimulation syndrome, and bleeding or rupture of ovarian cysts.
Those health risks exist regardless of how harvested eggs are ultimately used. But some ethicists reason the intent matters in the long run. If the goal is to offer an infertile couple the chance to become parents, that end is more morally acceptable than for an experiment that may or may not one day lead to human therapies.
"It's really a bind because if you're not paying women, then you're not paying them for something that's burdensome, invasive and time-consuming," said Marcy Darnovsky, associate director of the Center for Genetics and Society. "But if you pay them, you're giving them an inducement to put themselves at risk and to discount the risks that they might know about but feel they have no other option."
The National Academies report could prove influential in the longstanding political fight over embryonic stem-cell research, a growing area of medical science that has shown some promising results for treating spinal injuries, diabetes and other irreversible conditions.
The report comes as Congress is weighing competing bills that would restrict and expand federal funding for embryonic stem-cell research. The battle has seen some strange bedfellows in lobbying circles, with some feminist groups siding with longstanding enemies on the religious right. Both groups want to limit therapeutic cloning, a technology necessary for some types of embryonic stem-cell research.
Deborah Ortiz, a California state senator who supported Proposition 71, which granted $3 billion to stem-cell research over the next decade, has written bills that would require doctors to provide written warnings of the potential health risks egg donors might face.
Hard-line opponents of embryonic stem-cell research, including Sen. Sam Brownback (R-Kansas), criticized Tuesday's report for creating a roadmap for ethical stem-cell research. Brownback drafted cloning bills since 2001, but none have gotten past the Senate.
Scientists say they need human eggs to create cloned human embryos for research. They want to use therapeutic cloning, also called somatic cell nuclear transfer, to create human embryos that carry the genetic traits of specific ailments such as Lou Gehrig's and Alzheimer's diseases. Watching the development of stem-cell lines extracted from those embryos could teach researchers how to fight the disease. Scientists also believe cloning could be a method for creating cell therapies that would be an exact genetic match for any given patient, reducing the risk of immune rejection.
Fertility clinics that offer thousands to women for their eggs will likely continue to do so. Xytex Ovations pays all egg donors a flat fee of $5,000. The National Academies guidelines shouldn't affect Xytex's business, said Holly Fowler, a company spokeswoman. But if questions arise, the company might add a line in its contract stipulating that people who buy eggs from Xytex cannot use them for research.
The issue highlights a gray area when it comes to compensating people for their biological materials.
Sujatha Byravan, president of the Council for Responsible Genetics, said her organization is "opposed to the sale of embryos and gametes," but she declined to comment on whether women should be compensated for offering up their reproductive material.
In some minds, the issue is not whether payment is made, but how much the payment is. In recent years, couples have offered amounts up to $50,000 for eggs from women with superior physical appearances and IQs, a practice Caplan calls "Ivy League egg trade."
As the payment amount increases, so does the chance that women might be dishonest about health problems they might have that could put them at increased risk for complications, Caplan said.
"People could be paid reasonably for their time and effort," he said. "But I don_t think they should be turned into egg incubators as a career choice."
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