Eggs for Sale?

If you want to know what’s going to go wrong in the culture, read the professional journals. A case in point: An article in the April 10 New England Journal of Medicine called for the creation of a commodities market for “made-to-order” human embryos.

The authors, I. Glenn Cohen and Eli Y. Adashi—university professors, of course—treat embryos as the equivalent of a prize cattle herd. They note that sperm and eggs are already bought and sold for in vitro fertilization (IVF) and, further, that New York legalized buying eggs for use in biotechnological research a few years ago. Hence, “it is not clear” (an oft-used phrase in bioethical advocacy that frees the author from actually having to prove a point) why we should not also allow companies to make “made-to-order embryos” for profit, since that activity would be “more similar to the sale of gametes than the sale of children.”

As a matter of basic biology, that isn’t true: A human embryo is an organism, a nascent human being, while an egg or sperm is just a cell. But what’s a little sophistry in the cause of deconstructing ethics? After all, to use a movie idiom, there’s gold in them thar hills!

The authors engage in misdirection by focusing on special-order embryos as just another service to be offered in the already ethically wide-open infertility industry. But expanding IVF opportunities isn’t really what their proposal is about. Rather, the primary customers of a future embryo manufacturing industry would be biotech companies and their university affiliates, which would pay top dollar for merchandise possessing desired genetic traits, just as they now do for genetically engineered research mice.

But designing the embryo product line will not be easy. Fertilization is an inexact process. Sure, some desired attributes—sex or certain genetic defects—could be obtained through using specifically selected or altered eggs or sperm and genetic testing of embryos to find those that possess the desired characteristics. But made-to-order embryos would be hit and miss, limiting the industry’s growth potential.

The real money would come from human cloning, which would permit the manufacture of tailor-made, genome-specific embryos—and in theoretically virtually unlimited numbers. Indeed, the authors give away the game when they write, “It is not clear how the sale of made-to-order embryos differs from the sale of oocytes [eggs] for the manufacture of embryos by somatic-cell nuclear transfer”—SCNT being the cloning process used to make Dolly the sheep. In other words, an egg is a fertilized embryo is a cloned embryo, with each presenting distinct mercantile potential.

Advocacy of this sort arouses the suspicion that human cloning must be getting very close. Further evidence comes from California, where a bill aimed at increasing the number of human eggs available for use in experiments easily passed the Assembly on May 2, 54-20. The bill, AB-926 aims to repeal the ban on paying women to supply eggs for research (beyond expenses) and allow university or other institutional review boards to establish compensation rates to pay women for their “time, discomfort, and inconvenience.”

“Discomfort” is a tactful word for what women experience when submitting to mass egg extraction. The process—known as superovulation—requires administering supercharged doses of hormones that stimulate the ovaries to release 20 to 30 eggs in a cycle, instead of the usual 1 or 2. After that, the donor’s (or seller’s) eggs are harvested under anesthesia via a needle inserted through the vaginal wall.

Most extractions do not harm the egg supplier. But some women are wounded: Potential side effects include infection, the swelling of ovaries to the size of a melon, infertility, stroke, some cancers, and, in rare cases, even death.

Why the sudden need for eggs in biotech? They are the essential ingredient in cloning, one egg per cloning attempt. And since women are far less likely to risk superovulation to make cloned embryos for use in experiments than they are to enable the birth of a baby, research eggs are currently in very short supply. Indeed, this “egg dearth” has materially impeded the development of cloning, which has scientists champing at the bit to obtain a bounteous supply. If—or when—human cloning is finally accomplished, egg demand will go vertical. Scientists are unlikely to have access to a sufficient supply unless they pay.

AB 926 will also provide new business opportunities for the infertility industry by allowing qualified IVF companies to sell embryos and eggs “in excess of those needed for fertility.” Not only that, but the bill authorizes institutions to pay more to the IVF companies than they pay women directly, so long as the patient undergoing infertility treatment decides she does not need them “for her own reproductive success.” Once she signed a waiver, the clinic would be entitled to sell the remaining eggs or embryos for research at whatever price the market would bear. Talk about creating a financial incentive to make excess quantities.

There’s an irony here. Those pushing for egg and embryo selling tend to be on the political left, e.g., politicians and advocates who claim to be most supportive of “choices” for women. Indeed, assemblywoman Susan Bonilla, the author of AB 926, claims that the bill is about guaranteeing “equal treatment” for women in research.

But establishing egg and embryo commodities markets would actually lead to unequal exploitation opportunities for buyers. Those lining up to be superovulated for pay are unlikely to be members of the professional class. Rather, they would primarily be the poor and/or unemployed, women in such dire financial need that they are willing to risk their health, fecundity, and lives for a relatively small stipend. The real money in the embryo/egg industry would be made by the companies and scientists who succeeded in using the reproductive substances of women and embryonic cells to achieve fame and fortune.

And if eggs and embryos can be transformed into commodities, once artificial wombs are developed, why not also create a market in human fetuses? Scientists are already experimenting with the ovaries of later-term aborted female fetuses to determine if they can be used as sources of eggs. If fetal organs ever prove to be useful in transplant medicine, companies manufacturing genetically designed fetuses for harvest could be worth a fortune.

I can imagine an advocacy article in the New England Journal of Medicine 10 years or so from now asserting: “It is not clear how the sale of made-to-order fetuses differs ethically from the sale of made-to-order embryos or oocytes.” Why not? Once we demolish ethical barriers against the commercialization of nascent human life, there would be no end to the entrepreneurial possibilities.