Embryonic Stem Cell Research

I’ve been intrigued this week with the hoopla over President Obama’s Executive Order allowing federal grants to support research using embryonic stem cell lines developed after August 9, 2001. Although this is a big deal, especially as a symbolic gesture, it isn’t an earth shattering, research altering development, since federal funding for research in which embryos are “destroyed, discarded or knowingly subjected to risk of injury” is still banned by a federal law known as the Dickey-Wicker amendment. This Congressional ban is the elephant in the stem cell research living room.

Stem cell lines, the basic building block of this type of research, are created by removing the inner cell mass from five-day-old embryos, thus destroying the embryo. Since embryos are destroyed, the Congressional ban prohibits the use of federal grant money to create these lines. Obama’s Executive Order opens the door for researchers to use stem cell lines created from private funding. From a practical standpoint, it makes life easier for stem cell researchers by removing the logistical and accounting nuisance of separating the funding sources. It does not open the floodgate for stem cell research as has been reported. Only removing the Congressional ban would accomplish that, and the Obama administration has implied that they’re staying clear of this debate. I suspect we are a long way from repealing the Dickey-Wicker amendment.

Last year, I spent about three months developing a book proposal on the subject of what to do with the over half a million frozen embryos stored in the US. I interviewed many infertility patients, researchers, embryologists, ethicists, religious leaders, and legal experts in order to fully understand the issues involved. This subject absolutely fascinates me, and I was amazed at how little information is available for couples facing the decision of what to do with their extra frozen embryos. Unfortunately for me, I wasn’t able to find a publisher equally as fascinated in this subject, but my research did result in a three part series of Creating a Family radio shows. For these shows, I gathered panels of leading experts to discuss the various options. This Creating a Family show was devoted to embryonic research. I think it is the best thing available to explain this complex issue.

What to do with these cyropreserved embryos is the decision of the people who created them. A recent study by Dr. Anna Lyerly of Duke University found that the majority of people with frozen embryos leftover after their infertility treatment would prefer to donate them to research. (You can hear her discussion of this research on this Creating a Family show.) It is surprisingly hard for infertility patients to donate their extra embryos to research, and it remains to be seen whether President Obama’s recent Executive Order will make it any easier.

Although truly at its infancy, embryonic stem cell research holds amazing promise. The panel for the Creating a Family show discussing this topic consisted of the following top experts in this field.

• Judith Daar, Professor of Law at Whittier Law School, Professor of Medicine at University of California Irvine College of Medicine, and author of the leading textbook on this subject, Reproductive Technologies and the Law
• Dr. Marie Csete, Chief Scientific Officer at the California Institute of Regenerative Medicine
• Dr. Shuhua Shen, an embryologist and fertility researcher with University of California at San Francisco
• Dr. Geoff Lomax, Science Officer to the Standards Working Group at the California Institute of Regenerative Medicine

Dr. Csete and Dr. Shen talked at length about what type of research could develop from leftover frozen embryos. One possibility is to develop disease specific cell lines (for example, a stem cell line with the gene for Parkinson disease) to understand better the cause and possible cures of that disease. Stem cells might also be used to find better ways to deliver drugs to specific parts of the body. In the future, stem cells could be coaxed into “growing” replacements for defective or diseases body parts. And since stem cells share some common characteristics to cancer cells, learning to control stem cells would increase our understanding of cancer biology, and may someday lead to promising treatment or prevention.

Perhaps the most interesting “use” for embryo research is to help us understand the early development of human life. In many ways, we know more about the early development of flies than we do of people. The practical application of this knowledge is huge. Although not getting much attention, research on embryos can also improve the results of assisted reproduction technology, for example, by testing various growing cultures and freezing techniques.

By the way, the panel also talked about the legalities of conducting research using embryos, creating stem cell lines without destroying the embryo, and creating stem cells from adult cells rather than embryo cells. While research into forcing adult cells to assume the characteristics of embryonic stem cells is exciting and holds great promise, it will not replace research using embryonic stem cells. Interestingly, these adult cells are more likely to develop tumors. Also, using poor quality embryos—those likely to not survive to the five day stage—is not a replacement for stem cell lines developed from healthy embryos. I asked about the possibility of removing just one cell from an embryo for research, which would not destroy the embryo. So far, scientists have not been successful in growing stem cell lines from only one embryo cell.

I would love to dwell on only the promise of embryonic stem cell research, focusing on the images of the lame walking, the blind seeing, and the Parkinson sufferer living a long and tremor free life. But to fully appreciate the complexity of this issue, I think it is equally important to clearly acknowledge that embryos are destroyed for this progress to be made. Failing to acknowledge this cheapens life regardless whether you believe embryos are life, potential life, or tissue.

Opponents of stem cell research are right: we are on a slippery slope. But it seems to me that we are on this slope regardless whether we allow research on embryos. We have been on this slope for years, ever since the first embryo was created outside a woman’s body. This slope is litterd with the over half million embryos in cryopreservation labs and warehouse throughout the United States. Every day, embryologist, reproductive endocrinologist, and especially infertility patients navigate this slope. I welcome the light and attention of public debate because I think it can make decisions clearer for the slope dwellers.

Creating and using embryos is fraught with complicated medical and ethical issue, and guidance should be welcomed. Unfortunately, by forcing this debate to take place in the abortion arena, I fear that the forthcoming discussion will sling mud, rather than shed light.