New York OKs paying women who donate eggs for research
■ Donors may get up to $10,000, an amount critics say could induce women to take unnecessary medical risks.
By Kevin B. O’Reilly — Posted July 27, 2009
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The board that administers New York's stem cell research funding program recently approved using state money to pay women who donate fresh oocytes for an experimental technique called somatic cell nuclear transfer, also known as therapeutic cloning.
The policy makes New York the first American government body, state or federal, to use taxpayer dollars to do more than reimburse egg donors for direct expenses incurred in donating. Opponents of the move said it would encourage women to undertake a painful, sometimes risky procedure for speculative research.
The board, however, "felt it was a good thing to step forward and move in that direction and perhaps be viewed as a leader," said David C. Hohn, MD, vice chair of the Empire State Stem Cell Board's ethics and funding committees.
"We looked seriously at the fact that there are places where direct expenses are reimbursed, and the number of people who are coming forward as donors is extremely small," said Dr. Hohn, executive director of health policy at the Roswell Park Cancer Institute in New York. "The clear lack of funding seemed to be presenting a barrier to donation for those kinds of activities."
The board, responsible for handing out $600 million in research grants over 10 years, said the payments should not exceed compensation standards set by the American Society for Reproductive Medicine for women who donate eggs to help infertile couples conceive.
ASRM says $5,000 is OK, payments between $5,000 and $10,000 require specific justification, and anything more than $10,000 is inappropriate. The New York board requires an institutional review board to examine any proposed egg-donor payment policy, and all applications for stem cell grants are evaluated by scientists from outside the state. The national average payment to egg donors is $4,217, according to a 2007 survey published in Fertility and Sterility, the journal of the American Society for Reproductive Medicine.
The New York board said in its resolution that "there is no significant difference in the risks associated with oocyte donation solely for research purposes and oocyte donation for reproductive purposes."
The biggest risk from egg donation is ovarian hyperstimulation syndrome, according to a 2007 National Academy of Sciences report. Symptoms include nausea and vomiting, bloating, hemoconcentration, breathing difficulties, hospitalization and kidney failure in rare cases. In 2005, the academy adopted ethical guidelines limiting egg-donor compensation to direct expenses, which usually fall far short of $5,000.
New National Institutes of Health rules that took effect July 7 bar spending federal dollars on somatic cell nuclear transfer. In SCNT, the donor egg is fused with the nucleus of a diseased cell to create a genetically identical blastocyst. Stem cell lines can be derived from the embryo and studied for clues about how the disease develops and how to treat it.
Researchers experimenting with SCNT in California and Massachusetts have complained that restrictions limiting egg-donor compensation are impeding their scientific endeavors.
The New York stem cell board's decision, announced in June, was not unanimous. One member of its ethics committee, the Rev. Thomas Berg, PhD, voted against the egg-donor payment policy.
The board "has unconscionably, and on behalf of the taxpayers, set in place a plan that will put women at risk and lets the state pay them off with lots of money," said Berg, a senior fellow at the Westchester Institute for Ethics & the Human Person, in a statement. "Ovarian stimulation is a dangerous and sometimes fatal procedure. This plan is a gross exploitation of women for speculative research."
Marcy Darnovsky, PhD, associate executive director of the Center for Genetics and Society in California, also objected to the New York compensation plan. She said there is a difference between paying women to donate eggs for in vitro fertilization and doing the same for stem cell research.
"In the case of providing eggs for someone else's fertility treatments, we know at this point there's a pretty reliable chance that a baby will result," she said. "But in the case of somatic cell nuclear transfer, it's completely speculative research, and more and more scientists have determined it's not worth pursuing at this point."
Several breakthroughs in the reprogramming of adult skin cells to behave like embryonic stem cells have led some scientists to put therapeutic cloning research on the back burner. But Dr. Hohn said the New York board wanted to encourage all promising avenues of research.
"Do we know what the value of this research is going to be? No," Dr. Hohn said. "But there are theoretical reasons why it could be profoundly helpful for a variety of diseases on the radar screen. ... The logic for the use of these cells is compelling, and we shouldn't stand in the way."