The dome did not blow off the Capitol, so to speak, at today's much-heralded conference on the medical risks of egg donation.
Probably nobody really expected an explosion anyway. But the meeting did force attention on a difficult and controversial issue – one that needs considerable tending not only for the sake of the women donors but for the general cause of embryonic stem cell research.
The occasion was the Institute of Medicine's "Public Workshop on Assessing the Medical Risks of Human Oocyte Donation for Stem Cell Research" – a title almost as heavy as the subject.
CIRM instigated the meeting, seeking more input for its efforts to craft solid standards for stem cell research. And CIRM was paying attention. Several staffers were there and at least one Oversight Committee member. CIRM President Zach Hall opened the session and was there for the entire day, taking copious notes during the end-of-the-session summary by Linda Giudice, chair of the session and chair of the Department of Obstetrics, Gynecology and Reproductive Sciences at UC San Francisco.
The bottom line on the meeting: The process of extracting eggs has risks, but they are minimal, as understood by medical science at this point. But weaknesses exist in the current data, which primarily involve women who sought IVF because of fertility problems. More study needs to be done on "healthy" individuals who undergo the process solely for the purposes of donating eggs.
Giudice noted that despite 20 years of IVF in this country, not much is known on the health outcomes of those treated. "Varied" and "limited" are how she described the studies.
Giudice outlined some "challenges" facing scientists. They include differences in the way ovaries are stimulated to produce large amounts of eggs, finding alternate sources (possibly cadavers) and organization of the donation process.
While the meeting was devoted to medical issues, lying in the weeds were policy questions. Minimizing risk to donors can translate to changes in CIRM's research standards. And creating a database on the health of donors could be the focus of a CIRM grant.
The meeting was Webcast by the Institute of Medicine and presumably will be available online for viewing at your convenience at some point. CIRM had a court stenographer making a transcript which may be accessible online in a couple of weeks. And the California Stem Cell Report will have more on the session in the next few days.
Meanwhile, for those of you who were there or even those who were not, your comments or questions are invited. Just click on the word "comments" below. They can even be posted anonymously with your identity concealed even from the otherwise all-knowing California Stem Cell Report.
I found Roberta Ness's presentation on cancer risks to be the most thoughtful, though also alarming. According to Ness and her colleague Louise Brinton (National Cancer Institute) there is currently no plan to continue long term study of women who have taken fertility drugs. Studies show that there does not seem to be any short term risk, but women who first took these drugs twenty years ago are only just now reaching the age when these cancers develop. The statistics rise the further out you look from the time of treatment. It seems unfair and irresponsible that CIRM and others expect women to donate eggs but have not planned for more study of long term health risks.
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