Permit payment to egg donors in New York State

In the spring of 2007, the New York State Legislature and the Governor committed $600 million over 11 years to be spent on stem cell research. Their intent was to sponsor a strong research community in New York State that could explore the potential of stem cell technology to alleviate disease and improve human health.

This initiative could not have occurred without the support of the medical, scientific, voluntary health and patient advocacy communities who urged the state to embrace this promising field of science.

You can play your part by convincing New York's Empire State Stem Cell Board Ethics Committee to permit compensation to egg donors. Policies that limit compensation to women for the time, discomfort and risks involved in egg donation is impeding research progress, scientists say. Send a message to express your concern to New York State Health Commissioner Richard Daines, who chairs the Empire State Stem Cell Board.

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Dear Commissioner Daines

I understand that at the state level the issue of compensation of oocyte (egg) donors is arising in the deliberations of New York’s Empire State Stem Cell Board which was created legislatively in 2007 to provide state funding for stem cell research. In this letter, I urge you and the other members of the Empire State Stem Cell Board Ethics Committee to permit compensation to women who donate their eggs for stem cell research that seeks to use somatic cell nuclear transfer (SCNT) - sometimes referred to as “therapeutic cloning” to distinguish it from reproductive cloning research - to produce embryonic stem cells.

There is no sound, persuasive ethical reasons why New York State funds should not be available to compensate egg donors. This view was endorsed at the Ethics Committee meeting of 22 February 2008 by Dr Henry Greely, who is the Deane F and Kate Edelman Johnson Professor of Law at Stanford University and chairs the California Advisory Committee on Human Embryonic Stem Cell Research. He suggested New York should allow some compensation for gamete donation because it is not unethical for women to receive some compensation for their pain, suffering and time. However, he also recommended establishing some type of limit on the amount of compensation paid to donors.

On 27 June 2008, Dr Catherine Racowsky, Director of the Assisted Reproductive Technology Lab at Brigham and Women’s Hospital in Boston and an Associate Professor of reproductive biology at Harvard Medical School, presented information to the Ethics Committee on the risks of ovarian stimulation, surgical risks, psychological risks, cancer risks, and risks to future fertility. Committee members were advised that Dr Racowsky served on the Institute of Medicine’s Committee on Assessing the Medical Risks of Human Oocyte Donation for Stem Cell Research (IOM Committee) that developed the report by the same name that was distributed to Board members in May.

Dr Racowsky concluded that with appropriate selection and careful monitoring of stimulation, ovarian hyperstimulation syndrome should be preventable in all or almost all egg donors; that the anesthetic and surgery risks are very low; that there are potential psychological risks that can be addressed in most cases with appropriate counselling; and that most cancer studies are reassuring in not showing a strong association between fertility drug use and cancer rates, although some have shown increased risk with greater drug use or when patients have been followed over a longer period of time. In response to questions from Board members, Dr Racowsky stated that she thought egg donors should be compensated, but noted that how that is done is very tricky in light of the potential for undue inducement.

Moreover, Dr Carl Coleman, who is the Director of the Health, Law and Policy Program at Seton Hall Law School and was previously Counsel, and then Executive Director, to the New York State Task Force on Life and the Law, suggested to the members of the Ethics Committee on 4 September 2008 that thinking of an egg donor as a research subject makes sense and that the compensation for research subjects and IVF donors often includes consideration of the time, inconvenience, and discomfort, and in some cases, the risk.

It is important to include in the ethical analysis the potential for good that can come from SCNT. The Coalition for the Advancement of Medical Research (CAMR) is the USA’s leading bipartisan pro-cures coalition. In a report released on 12 January 2009 entitled “A Catalyst for Cures: Embryonic Stem Cell Research”, CAMR states: “Somatic cell nuclear transfer (SCNT) is another example of a technology with promise that has faced unexpected challenges. Oocyte availability, for example, has been problematic. Yet the challenges are worth overcoming. ‘SCNT is the only known procedure for completely and normally reprogramming a cell,’ says John Gearhart, University of Pennsylvania. Because SCNT is more efficient than iPS cell technology for reprogramming cells, and can be done without inserting new genes, continued studies of SCNT could help scientists find the linchpin to make reprogramming factors more efficient and effective. SCNT will also provide fundamental insights into how an egg reprograms that will teach a great deal about basic biology.”

Yours sincerely