Australia's Cloning Amendment Bills: Think twice! Where do the eggs come from?
By Dr Renate Klein FINRRAGE 0438 00 29 79
WHERE DO THE EGGS COME FROM? Current debate both in the media and among politicians mostly centres around two angles: 1. Against embryonic stem cell research because it destroys embryos (the religious view); 2. For embryonic stem cell research because it offers hope for sufferers of genetic diseases (the pro-technology view).
What both sides forget to consider is the question: where does the raw material for this research - the eggs and embryos - come from?
Answer: they are needed in the thousands and they come from within women’s bodies: egg cells don’t just ‘plop’ from heaven but need to be ‘harvested’ through an invasive procedure from women’s ovaries after weeks of debilitating and dangerous hormonal stimulation that may have serious short- and long-term consequences for the women, their own future fertility and their health.
FINRRAGE (the Feminist International Network of Resistance to Reproductive and Genetic Engineering), together with other groups such as WFA (Women’s Forum Australia) and HOOO (Hand Off our Ovaries, an international pressure group, www.handsoffourovaries) urge you to reject the two Cloning Amendment Bills (by Senators Patterson and Stott Despoja). We believe one cannot attempt to do good, ie find cures from embryonic stem cells, by first doing harm, ie violating the health of thousands of women who provide the necessary egg cells without any benefits to themselves.
Proposing to build Australia’s wealth through an elusive national biotechnology industry (so far a great tax loss!) by mining parts of women’s bodies – their egg cells – we believe is deeply unethical and reprehensible.
In the 33-page long Majority Senate Committee Report (Chapter 3) only a few paragraphs (p. 45) deal with the central question: where do the eggs come from? Egg ‘donation’ is dismissed as being regulated like ‘any other tissue donation’ which is a gross misrepresentation. Unlike in a kidney donation, an egg donor’s whole ovary is irreversibly bombarded with at least 3 different types of hormones thus risking possible long-term damage to all remaining egg cells. Further, unlike in kidney donation where the recipient is often known to the donor, any cures derived from embryonic stem cell lines are decades away (if they eventuate at all) and/or could even be sold back to the altruistic egg donor as invariably patents will be taken out on any potential results!
In the Majority Report it is even suggested that ‘relatively few [egg cells] would be required’ (p. 45). This flies in the face of evidence: disgraced Korean researcher Hwang reportedly used 2061 eggs from 129 women for his research (in Steinbrook, N Engl J Med 354:4, 2006) which later was found to be fraudulent and also exposed serious professional breaches of getting his junior female researchers to produce some of these eggs (Korean women have lodged a number of law suits). Also, in the UK, where embryonic stem cell research has been permitted for a few years, eggs have been so difficult to obtain from ‘voluntary donors’ that, beginning in 2006, women are now offered half-price IVF if they ‘donate’ some of their eggs for research. Such incentives are currently ruled out in Patterson and Stott Despoja’s Bills but could no doubt be revisited in 3 years’ time.
In the Senate Hearing (24.10.06) Senator Patterson claimed that research on egg cytoplasm would within short time make redundant the huge number of eggs necessary for SCNT or egg/sperm embryo creation. However, not only is there no solid new research to substantiate this claim, we believe that with this statement Senator Patterson gave the perfect rationale for leaving the current legislation in place: let researchers in other parts of the world provide solid and replicable results that viable stem cell growth can be triggered from cytoplasm’s mitochondrial DNA instead of damaging the health of thousands of Australian women.
Indeed, health concerns for the donors rate so low on the agenda that Senator Patterson’s Amendment Bill’s proposal for a Review in three years’ time does not even contain an item to evaluate the health of the women who have donated the eggs. Had it not been for the collective effort of women’s groups to draw attention to the central item necessary for any research cloning – women’s eggs – the whole Australian debate might have remained one of religious vs scientific values!
We fully understand why an embryonic stem cell researcher might want the proposed legislative changes as it allows them access to fresh egg cells rather than the frozen excess embryos from IVF programs currently permitted. Firstly, frozen material is always second rate - even fresh embryos are preferable: this too is asked for in the proposed Bills! Freezing extra eggs from IVF has never properly worked due to egg yolk properties that are not conducive to freezing. Secondly, women on IVF programs are usually older and they - or their partners - have chromosomal abnormalities: not good starting material for researchers’ foray into the unknown land of embryonic stem cell research.
An embryonic stem cell researcher’s dream might well be petri dishes full of young freshly harvested eggs from teenage women who have had very few divisions of their egg cells. Get them young, they are the best.
FINRRAGE urges you to read Chapter 4 in the Senate Committee Report (The Case Against) and to consult WFA’s Katrina George and my own Testimonies to the Senate Committee (both 24.10.06) as well as our respective Submissions to the Senate Inquiry (FINRRAGE No 3; WFA No 80).
In order to understand what egg ‘donation’ entails, we now briefly detail the process:
The Egg ‘Donation’ Procedure After various blood checks and scan of ovaries, drug taking begins.
Please note that there are many drug combinations and times used in different clinics and they may also vary each time a woman undergoes egg ‘harvesting’ but here is one example:
1. A GnRH Agonist (that’s a gonadotrophin releasing hormone such as Buserelin or Lucrin – Lupron in the USA) is given as nasal spray every 4 hours for approximately 14 days or administered as subcutaneous injections for up to 25 days. After an initial (potentially dangerous) flare up of egg cell growth through an LH surge (luteinizing hormone), it de-sensitizes the pituitary and stops egg cell growth. The idea is to shut down the ‘normal’ egg cell growth, turn off hormone production and block ovulation. *Put differently, the GnRH Agonist puts the woman in a temporary chemical menopause.*
2. Once the egg cell production has stopped, women are then given follicle stimulating hormones (FSH) such as Perganol, Metrodin HP, Gonal-F (the last two are genetically engineered). This process of stimulating egg cell growth - called ovarian hyperstimulation - leads to enlarged and painful ovaries and at times to the formation of cysts. In 5-10% of women it leads to ovarian hyperstimulation syndrome (OHSS): excessive fluid from painful ovaries is released into the abdomen, vomiting or extracting fluid causes dehydration and thickening of the blood. This may lead to serious thrombosis such as stroke and even death.
In order to avoid this, the woman needs to have daily or twice-daily scans – the aim is NOT to hyperstimulate too much but stimulate enough to get lots of near-to-mature egg cells ready for harvesting.
This is an important point, because in women ‘donating’ eggs for research the aim for scientists is to retrieve as many eggs as possible… So it might be tempting to perhaps administer a bit more FSH and wait a bit longer until starting the administration of hCG (human chorionic gonadotropin) and starting the egg retrieval procedure.
(Moderate to severe OHSS is treated in hospital with fluid administered intravenously; an older drug protocol which is still frequently used, combines Clomiphene and Pergonal before hCG injection. Clomiphene has a multitude of well documented mild as well as severe adverse effects.)
3. After all of this, the egg ‘harvesting’ starts. Following the administration of hCG (human chorionic gonadotrophin eg Profasi) 38 hours later, the eggs are retrieved using a special vaginal ultrasound probe with an instrument attached to it so that the doctor can pierce the wall of the vagina, access the ovaries and retrieve the eggs. This is painful, may require general anaesthesia and has led to extensive bleeding. Given the hormonal cocktail involved, the whole ’donating’ procedure leads to sometimes severe mood swings, water retention, and just plain feeling ill.
Question: - does this sound like an ‘easy’ and quick ‘donation’ that you/your partner – or your daughter(s) - would like to undergo? And how do you feel - as has been suggested - that young women who have a disease such as cystic fibrosis or juvenile diabetes - should be the ones asked to ‘donate’ these eggs? Or that young women from families where a relative has a genetic disease should be altruistic and put their own health at risk?
Answer: FINRRAGE believes that egg ‘donation’ must be publicly acknowledged as a drawn out, painful and dangerous procedure with the possibility of not only short-term but also long-term adverse effects including uterine, ovarian or breast cancer and fertility problems. In other words, the preferably young ‘donor’ woman might jeopardize her own fertility and long-term health.
FINRRAGE contends that this contravenes the principle that medicine should do no harm. Together with WFA and Hands Off Our Ovaries we ask for a MORATORIUM on egg harvesting and - as a consequence - on embryonic stem cell research. Because, just to repeat our central point:
No eggs, no embryos (SCNT or sperm/egg), no embryonic stem cells. In other words, without women there is no research cloning.
In addition, we are also critical of some of the other Amendments in Senator Patterson’s Bill such as Amendment 21 (on p. 10): to create via cytoplasmic transfer a human embryo that contains mitochondrial genetic material produced by more than 2 persons – that’s actually 2 women. What it means is that in IVF, an egg ‘donor’ has her egg yolk injected into an older woman’s egg (or from a woman who has a genetic disease) because it is precisely the mitochondrial DNA in the egg yolk that enables the production of stem cells. In fact, we are puzzled about this Amendment: it seems that such research would benefit IVF treatment rather than stem cell research so with due respect, who is pushing this Bill? The convenient fact that many IVF clinics are linked to Stem Cell Research Centers (which of course is a must as ‘harvested’ eggs con be transferred quickly)?
Importantly, FINRRAGE’s objection to embryonic stem cell research does not mean the end to all stem cell research. Indeed, only a small number of researchers focus on embryonic stem cells and as the Senate Report (especially Chapter 4) indicates, adult stem cell research is much less problematic.
We also urge you to remember the hype of the promises of Gene Therapy that abounded at the end of the 1980s. Exactly the same words (including threats by researchers to leave Australia!) are re-used in 2006 to conjure up the wondrous cures that embryonic stem cells will provide. Sadly, gene therapy never lived up to its promises and its image was severely damaged in 1999 when 18-year-old Jesse Gelsinger died when he was a volunteer in a US gene therapy experiment (he was not seriously sick). How many women have to be rendered severely ill - or die - before our concerns are heeded? Other gene therapy projects in France and in Germany were abandoned in 1999 and 2006 when patients undergoing these experimental therapies died (Gen-Ethischer Informationsdienst, 2006, p. 35). Why, in the wake of this stunning failure, should we yet again trust researchers’ promise of embryonic stem-cell cures?
FINRRAGE urges you not to sacrifice real live women’s health to spurious promises of utopian cures. Please keep researchers’ Hands Off Our Ovaries. Reject the two proposed Amendment Bills.