WASHINGTON (BP)–If Missouri voters approve therapeutic cloning as part of their state constitution Nov. 7, they also will be opening up a potentially massive market for egg donations from women whose health risks are uncertain.
Missourians will decide the fate of Amendment 2, titled the Missouri Stem Cell Research and Cures Initiative, on Election Day. The measure would amend the state constitution to protect embryonic stem cell research (ESCR), which requires the destruction of a human embryo.
In addition, it would shield human cloning for research purposes, also requiring the destruction of days-old embryos. Though the initiative would ban cloning to produce a child carried to term, it would allow “somatic cell nuclear transfer” (SCNT), a term used for cloning and the method by which Dolly the sheep was cloned.
Sometimes lost in the debate over the Missouri initiative is the number of eggs required for such research, the means of acquiring the eggs, its potential impact on donors and the financial inducement for donations.
Cloning, or SCNT, involves removing a nucleus from an egg and replacing it with the nucleus of a body cell. The cloned cell is stimulated to develop into an embryo. In therapeutic, or research cloning, stem cells are extracted, and the embryo is destroyed.
Stem cells are the body’s master cells that can develop into tissues and other cells, providing hope for the treatment of numerous afflictions. Research using embryonic stem cells has yet to provide therapies for any ailments in human beings and has been plagued by the development of tumors in lab animals.
“Embryonic stem cells will be needed for each patient,” Southern Baptist bioethicist C. Ben Mitchell told Baptist Press. “So that the patient’s body does not reject the foreign tissues, embryos will have to be created using each patient’s cells. Since not all SCNT procedures are successful, many eggs will be needed for each patient. The number of eggs needed will be nothing short of astronomical.”
Mitchell, director of the Center for Bioethics and Human Dignity in suburban Chicago, used diabetes patients as an example. There are about 17 million diabetes patients in the United States. A conservative estimate would be that 10 to 100 eggs would be needed for each patient, meaning 170 million to 1.7 billion eggs would be required to treat American diabetes patients, he said. A normal extraction would result in 10 to 20 eggs from each donor, meaning at least 8.5 million donations and possibly as many as 170 million donations would be needed.
Extracting eggs from a donor is “not a simple process,” said Mitchell, also a consultant for the Ethics & Religious Liberty Commission and an associate professor of bioethics at Trinity Evangelical Divinity School.
The process involves daily injections for as many as two weeks of strong hormones into the donor to produce many more eggs than normal in a month, a series of blood tests and ultrasounds to discern when the eggs are prepared for extraction, Mitchell said. When the eggs are ready, a procedure known as needle aspiration is used to extract usually 10 to 20 eggs, he said.
“If all goes well, the bloating and discomfort will only last a few days,” Mitchell said. “Needle aspiration may cause bleeding. In rare cases, it is possible to puncture the bowel, bladder or nearby blood vessels. Though unlikely, major abdominal surgery may be needed to repair serious damage to the pelvic organs.”
Ovarian hyperstimulation syndrome (OHSS) –- in which too many eggs develop — is another potential complication, he said. A 2002 study showed as much as 14 percent of the patients who undergo ovarian stimulation experience OHSS. The effects of OHSS may vary from abdominal pain and swelling to, in rare cases, blood clots, kidney failure, shock, infertility and death, Mitchell said.
“Add to this mix the emotional baggage of relinquishing parental rights, and the fallout can be substantial,” Mitchell said.
Some supporters of ESCR, as well as foes, are concerned enough about the short-term and long-term effects of egg extraction to call for a moratorium on egg extraction for research purposes. The coalition, known as Hands Off Our Ovaries (www.handsoffourovaries.com), consists of both pro-life and pro-choice advocates.
Diane Beeson, chair of Hands Off Our Ovaries and sociology professor emerita of California State University, told a congressional subcommittee in March “informed consent to participate in egg extraction for research purposes is not possible” currently. An advocate of abortion rights and some ESCR, Beeson cited not only the health risks to egg donors but also warned that the process might result in “serious abnormalities in their children.”
“We are being asked to make women the servants of biotechnology, rather than insisting on a biotechnology that promotes the well-being of all people,” Besson said in her written testimony.
Some observers predict it will be years or decades before the long-term effects of the process are known.
Critics of the Missouri initiative also decry the potential for exploitation of low-income women. Though the first page of Amendment 2 prohibits the sale or purchase of eggs, the fifth page permits payments to egg donors by fertility clinics or compensation allowed by federal law.
Patricia Heaton, Emmy Award-winning actress and honorary chair of Feminists for Life, warned in a television commercial opposing Amendment 2 that poor donors “will be seduced by big checks.”
Marcia Darnovsky, associate director of the Center for Genetics and Society, told Wired News, “[I]f you pay [women], 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.”
Some donors, usually in the 20- to 35-year-old range, have received as much as $50,000 from couples who sought women matching their physical and academic traits.
Unlike research using embryos, extracting stem cells from non-embryonic sources -– such as umbilical cord blood, placentas, fat and bone marrow -– does not harm the donor and has produced treatments for at least 72 ailments, according to Do No Harm, a coalition promoting ethics in research. These include spinal cord injuries, rheumatoid arthritis, lupus, multiple sclerosis and sickle cell anemia.