Elsevier

The Lancet

Volume 364, Issue 9429, 10–16 July 2004, Pages 115-118
The Lancet

Comment
Clinical challenges in providing embryos for stem-cell initiatives

https://doi.org/10.1016/S0140-6736(04)16649-XGet rights and content

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Supernumerary embryos

Supernumerary human embryos (ie, extra to those required for the treatment of the patient in a fresh cycle) are routinely generated during the in-vitro fertilisation procedure. The UK legislative framework is such that these embryos can be donated for research, for treatment of another couple, cryopreserved, or discarded.

The current model of using cryopreserved supernumerary embryos for the generation of human embryonic stem-cell lines has been successful.1 Consequently, with the large numbers

Generation of embryos for research

In view of the limitations of only using supernumerary embryos, it is likely that high-quality fresh embryos will be required in some circumstances—eg, in the development of specific embryonic stem-cell lines for therapeutic use. Such embryos can be donated for research in several ways. One model is to use patients who would normally have ovarian stimulation and egg recovery and who would be willing to donate eggs that can be fertilised (with fertile sperm donors) for research. An example is

Somatic-cell nuclear transfer

Undoubtedly the most controversial area in human embryo research is the development of somatic-cell nuclear transfer for therapeutic cloning. Previously, in view of the implied difficulty in somatic-cell nuclear transfer in human beings,20 therapeutic cloning was perceived to be an interesting but distant possibility, specifically because human cloned blastocysts had not been developed. However, the breakthrough by Hwang et al21 in the derivation of human embryonic stem cells from cloned

Clinical implications

With the clear benefits that can be derived from embryonic stem-cell research and the focus of this research theme as a national priority in several countries (eg, UK, Australia), patients' care must not be compromised. The bond between the clinician and nurse and the patient is important and must not be exploited to increase the number of eggs or embryos for research, independently of the pressure created by national priorities. There might be a risk that patients donate embryos to research

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References (24)

  • JM Sperger et al.

    Gene expression patterns in human embryonic stem cells and human pluripotent germ cell tumors

    Proc Natl Acad Sci USA

    (2003)
  • E Neuber et al.

    Sequential assessment of individually cultured human embryos as an indicator of subsequent good quality blastocyst development

    Hum Reprod

    (2003)
  • Cited by (21)

    • Motivation to donate or not donate surplus embryos for stem-cell research: literature review

      2008, Fertility and Sterility
      Citation Excerpt :

      However, their successful use as a source of embryonic stem cells has been reported (29). It has been argued that the advantage of using such embryos would be that they would allow the generation of disease-specific embryonic stem-cell lines (23). One study suggested that although such embryos are unsuitable for implantation, there tends to be a degree of mosaicism that develops and allows the possibility of establishing normal embryonic stem-cell subclones from embryonic stem cells that are harvested from such embryos (30).

    • Stem cell research and the collaborative regulation of innovation

      2013, Stem Cell Research and the Collaborative Regulation of Innovation
    • Human embryos in stem cell research: Property and recompense

      2012, Stem Cells: New Frontiers in Science and Ethics
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