Stem-Cell Research.

THANK YOU FOR PUBLISHING the article "Stem-Cell Research and the Affirmation of Life" (Autumn 2007). Since 1978, more than 1 million babies have been born through the use of assisted reproductive technologies. This experience often includes a heartfelt and challenging decision regarding what to do with any surplus embryos, particularly given the few options available--frozen indefinitely, destruction, embryo adoption or donation or research.

Despite what embryo adoption proponents advertise, embryo adoption is a far cry from "the perfect solution where everyone lives happily ever after." In addition to the reasons Rosemarie Tong so eloquently points to, embryo adoption has a very low success rate and is extremely costly for the recipient family, easily exceeding $20,000 for a single attempt.

These realities, coupled with new research led by Duke and Johns Hopkins Universities highlighting that more than 60 percent of infertility patients who have frozen embryos would be likely to donate to stem-cell research, suggest that there are many more embryos potentially available for stem-cell research than originally thought. This could result in a hundredfold increase in the number of existing stem-cell lines.

Ignoring the preferences and moral judgment of infertility patients not only harms the families struggling with these difficult decisions, but also has severe effects on the more than 100 million Americans who suffer from cancer, Alzheimer's, diabetes, Parkinson's, spinal cord injuries, heart disease, ALS and other debilitating diseases and disorders that could benefit from stem-cell research. I wholeheartedly agree with Dr. Tong--the most moral decision is to allow these embryos to be donated to research so that lives will indeed be saved.

EVELINA W. STERLING,

PHD, MPH, CHES

Public-health consultant

Marietta, Ga.

THE DEBATE ABOUT EMBRYONIC-STEM-CELL research often focuses intently on the moral status of embryos, yet omits other significant ethical and social questions. Unfortunately, Rosemarie Tong's article is no exception to the pattern.

As supporters of embryonic-stem-cell research, we share in hopes for treatments and cures. But exaggerating their likelihood and imminence--as Tong does by echoing the biotech industry's dubious claims about stem-cell cures for tens of millions--is unhelpful. That's what Princeton University President Shirley Tilghman meant when she warned against "succumbing to irrational exuberance" in discussing stem-cell research.

Tong quickly dismisses concerns about asking women to provide eggs for the cloning technique known as somatic cell nuclear transfer (SCNT)--a high-profile aspect of stem-cell research, but one that is still very much speculative. She acknowledges that egg retrieval is "an arduous and risky process," but doesn't explain the risks or consider the reasons that they are especially problematic in the research context.

Data on the possible hazards of egg extraction are seriously inadequate, as are effective regulations to minimize the known dangers. For example, the drugs used to suppress ovarian function (before controlled hyper-stimulation of the ovaries to produce multiple eggs) have powerful effects that have not been adequately explored.

Research using stem cells derived from conventional embryos faces persistent problems with tumorgenicity and the inability to control cell differentiation. Why not use otherwise-discarded embryos from IVF clinics to solve these, and avoid asking young women to undergo egg extraction?

Tong claims that there is no "good moral reason that a woman who sells her eggs for research purposes should not be paid the same amount as a woman who sells her eggs for reproductive purposes." Leaving aside the question of whether body parts and tissues should be bought and sold for any purpose, it's important to note that eggs used for reproduction will result in a baby at least some of the time, while benefits from SCNT research are unknown.

We hope that Tong and others will give these concerns the consideration they deserve.

MARCY DARNOVSKY

Associate executive director

Center for Genetics and Society 

Oakland, Calif.

JUDY NORSIGIAN

Executive director

Our Bodies Ourselves, Boston

The author responds:

ALTHOUGH THE COMMERCIALIZATION of egg "donation" does merit continued societal scrutiny, so long as it exists, I think egg donors should be paid in research as well as reproductive contexts. Helping an infertile couple have a baby can be, and most often is, a rewarding emotional experience; but so too is helping scientists find a treatment and even cure for a disease that has plagued loved ones or humanity in general.

ROSEMARIE TONG, PHD

University of North Carolina 

Charlotte, N.C.