Monday, May 08, 2006

Egg Donors: The Ignored Party to Stem Cell Research

For many cash-strapped females, the chance of financing two years of tuition or a postgraduate degree with a simple operation seems like a no-brainer. And egg brokers know exactly how to target this money-hungry population. Campus dailies run large ads on a regular basis, and some newspapers, including The Stanford Daily and Columbia Spectator, devote entire online sections to couples’ searches for egg and sperm donors.


Many donors, keen to make a quick buck and confident in their health, pay little attention to the risks involved. A 2001 study by Dr. Andrea Gurmankin Levy, an assistant professor at the Harvard School of Public Health, found that many agencies do not provide complete information about the health risks involved.

Unlike sperm donation, the female procedure is both lengthy and invasive. First, the donor must take oral contraceptives to synchronize her menstrual cycle with the recipient’s. Then she must regularly inject the drug Lupron, which shuts down the normal ovarian stimulation process. After two weeks of self-administered shots, donors receive further injections that stimulate the ovaries. Finally, a needle is inserted through the vaginal wall to withdraw the eggs while the patient is anesthetized. The whole process takes approximately six weeks.

Donors not only make a lengthy time commitment—difficult enough when juggling classes and surgery—but may also face medical complications. Ovarian Hyperstimulation Syndrome occurs in one percent of all donation cases and can cause a life-threatening build-up of fluid around the heart and lungs. Donors also risk infection and adverse reactions to the anesthesia. Other may experience significant discomfort.

“The majority of egg donors can breeze through this,” says Dr. Mark V. Sauer, director of the Center for Women’s Reproductive Care and professor at the Columbia University College of Physicians and Surgeons. “But some people are going to have these complications and not everybody, especially younger women, thinks of this. A lot of programs don’t define who pays the bills if something goes wrong.” If things do go wrong, an 18-year-old donor could face major debt as well as ongoing health concerns. “I’ve seen donors quite upset to find they’re hospitalized with a $20,000 bill, which they assumed would be paid because they were an egg donor,” says Sauer.
-Newsweek, Babies To Order

Professor Marilyn Coors, a bioethicist for the University of Colorado Health Sciences Center and brewer Pete Coors' better half, brought this facet of human genetic engineering to my attention during her recent Theology On Tap discussion of embryonic stem cell research(ESCR). A neglected topic in the ESCR debate is where all these eggs are supposed to be coming from. Dr. Coors informed her audience that out of the hundreds of thousands of embryos on ice, only about 10% have permission from their parents or owners to be destroyed in scientific research. Leaving unanswered for the moment the grave question of whether such destruction is an evil in se, embryonic research will require thousands upon thousands of ova. The shortage is so acute that the Korean phony cloner Dr. Hwang Woo Suk used his own female subordinates as a source, an irregularity which led to his exposure as a fraud.

The New York State Health Department cheerfully lists the various complications of egg donation, giving an idea of what might create a $20,000 hospital bill:
In mild OHSS[ovarian hyperstimulation syndrome], you may have abdominal pain, pressure and swelling. This should go away after your next period. In moderate OHSS, you may require careful monitoring, bed rest and pain medication. Severe OHSS is rare but can cause serious medical complications, including blood clots, kidney failure, fluid build-up in the lungs, and shock. In rare cases, hospitalization is necessary and the condition can be life-threatening. One or both of your ovaries may have to be removed.

Meanwhile, Boston Globe columnist Ellen Goodman cheerfully papers over any downside to paying naive young women so much money for such an invasive and potentially fatal procedure. Her body, her choice. However, in the rare, unlikely, and improbable event of catastrophe, she's somebody else's problem.

These questions concerning the donors of human ova create a severe problem even for those anti-ESCR scientists and ethicists who have hoped that altered nuclear transference could provide a morally acceptable alternative to embryonic destruction. Casual ignorance is not an ethical option.

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