The Ethics Committee of the American Society for Reproductive Medicine has revised its report, “Donating spare embryos for stem cell research,” and reaffirmed its stance that donation for embryonic stem (ES) cell research is an ethically acceptable way for infertility patients to direct the disposition of embryos in excess of their clinic needs.
In its report, the Committee discusses ways in which patients’ interests and autonomy must be respected and protected. To begin with, it is essential that any embryo donation not take place until after the patients’ infertility needs are met or they have discontinued therapy.
A full, detailed informed consent process is a must. Patients should be informed that their decision whether or not to donate their embryos will have no bearing on their medical care and that any embryos they donate for research will not be transferred to a woman’s uterus for pregnancy. Ideally, the discussion about donating embryos for research should take place with a doctor who has not been involved in their fertility treatment. The Committee also advises that the decision to donate embryos not be made until after patients have come to a separate decision to discontinue storing their embryos .
Patients should receive an explanation of confidentiality policies and procedures that are in place to protect their privacy.
While embryos should not be bought or sold, patients should be informed that some embryonic stem cell research may have commercial value and they should be told of any financial incentives the physician has in the research.
They also should to be informed of the risks and benefits of their decision- the risk that they may later regret that they no longer have the embryos available and the benefits of knowing that their donation has advanced research that could someday bring cures to persons suffering disease. Embryo donors should be informed that they have the right to change their minds any time until the experiment begins.
If the nature of the research is known, patients should be informed of it. They should be given information on how ES cells are derived and of the potential clinical applications of the research their donation contributes to. And they should be informed that cell lines obtained from their embryos may exist and remain in use indefinitely into the future.
“With the expansion of Federal funding opportunities for embryonic stem cell research, we may expect to see more patients interested in donating embryos after completing their families. Our Ethics Committee has done a superb job describing the consent process to ensure that patients have the knowledge they need to be confident that donating embryos is the right decision for them, ”noted R. Dale McClure, ASRM President.
Ethics Committee of the American Society for Reproductive Medicine, Donating Spare embryos for research, Fertility and Sterility, Vol.91, No.3, March 2009.
Study Shows Sperm Quality Improves and Pregnancy Rates Increase in Male Factor Patients Receiving a Hormone-Antioxidant Combined Therapy
Egyptian researchers have identified a combination drug treatment that appears to significantly improve sperm count and motility in infertile men and result in increased pregnancy rates in their partners.
Sixty male factor infertility patients at Cairo University’s Department of Andrology were randomly assigned to one of two groups. One group received a daily dose of clomiphene citrate and vitamin E for six months; the control group received a placebo. At the end of the study, the treated group had achieved a significantly higher pregnancy rate than the control group, 36.7% versus 13.3%. The men in the treatment group also showed a significantly higher increase in sperm concentration and an improvement in sperm progression as compared to the placebo group.
Clomiphene citrate, commonly called clomid, is an anti-estrogen drug administered to patients with low sperm counts and poor sperm motility to stimulate spermatogenesis. Vitamin E is one of a variety of substances used to counteract oxidative stress, which is associated with sperm DNA damage and reduced sperm motility.
R. Dale McClure, MD, President of ASRM remarked, “The results of this study will be encouraging to male factor patients and their doctors. However, more research is needed to determine how the components of the combination therapy affect the different semen parameters observed, and the advantages of using these drugs singly or in combination with other drugs not used in this study.”
Ghanem et al, Combinaiton clomiphene citrate and antioxidant therapy for idiopathic male infertility: a randomized controlled trial, Fertility and Sterility, in press.
The American Society for Reproductive Medicine is a multidisciplinary organization dedicated to the advancement of the art, science, and practice of reproductive medicine. The Society accomplishes its mission through the pursuit of excellence in education and research and through advocacy on behalf of patients, physicians, and affiliated health care providers.
The American Society for Reproductive Medicine, founded in 1944, is an organization of more than 8,000 physicians, researchers, nurses, technicians and other professionals dedicated to advancing knowledge and expertise in reproductive biology. Affiliated societies include the Society for Assisted Reproductive Technology, the Society for Male Reproduction and Urology, the Society for Reproductive Endocrinology and Infertility and the Society of Reproductive Surgeons.