CommentClinical challenges in providing embryos for stem-cell initiatives
Section snippets
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
References (24)
- et al.
Research implications of embryo cryopreservation choices made by patients undergoing in vitro fertilization
Fertil Steril
(2004) - et al.
Cryopreserved embryos in the United States and their availability for research
Fertil Steril
(2003) - et al.
Preimplantation genetic diagnosis as a novel source of embryos for stem cell research
Reprod Biomed Online
(2003) - et al.
Embryonic stem cell lines derived from human blastocysts
Science
(1998) - et al.
Embryo donation for medical research: attitudes and concerns of potential donors
Hum Reprod
(2003) Patients' guide to in vitro fertilisation (IVF) clinics
- et al.
Derivation of embryonic stem-cell lines from human blastocysts
N Engl J Med
(2004) - et al.
Establishment of human embryonic stem cell lines from frozen–thawed blastocysts using STO cell feeder layers
Hum Reprod
(2004) - et al.
Blastocyst transfer
Clin Obstet Gynecol
(2003) - et al.
A culture system using human foreskin fibroblasts as feeder cells allows production of human embryonic stem cells
Hum Reprod
(2003)
Gene expression patterns in human embryonic stem cells and human pluripotent germ cell tumors
Proc Natl Acad Sci USA
Sequential assessment of individually cultured human embryos as an indicator of subsequent good quality blastocyst development
Hum Reprod
Cited by (21)
Fresh or frozen? Classifying 'spare' embryos for donation to human embryonic stem cell research
2010, Social Science and MedicineReflections by patients who undergo IVF on the use of their supernumerary embryos for science
2010, Reproductive BioMedicine OnlineMotivation to donate or not donate surplus embryos for stem-cell research: literature review
2008, Fertility and SterilityCitation 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 banking: The size of the task
2005, LancetStem cell research and the collaborative regulation of innovation
2013, Stem Cell Research and the Collaborative Regulation of InnovationHuman embryos in stem cell research: Property and recompense
2012, Stem Cells: New Frontiers in Science and Ethics