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PubMed2006

Attitudes of patients, healthcare professionals and ethicists towards embryonic stem cell research and donation of gametes and embryos in Germany.

Due to the Embryo Protection Act, creation of supernumerary embryos, as well as egg and embryo donation, is prohibited in Germany. Human stem cell research is regulated through the Act on stem cells that came into force in 2002. A cross-sectional survey of 101 IVF couples (n=202) in two fertility centres, and representative samples of healthcare professionals and ethicists (n=879), was carried out, and their attitudes towards embryonic stem cell research and donation of gametes and embryos compared. A clear majority of IVF couples favoured legalization of egg and embryo donation and embryonic stem cell research for various purposes. The willingness of couples to donate was related to purpose and to other independent influences. The majority of physicians voted for legalization of embryonic stem cell production from surplus embryos. Most human geneticists and obstetricians approved egg, but not embryo, donation to other couples. Ethicists and midwives were opposed to every kind of donation and research on surplus embryos. The IVF couples surveyed have positive attitudes towards donation and research using surplus embryos, whereas the healthcare professionals and ethicists are predominantly sceptical about most research activities destroying human embryos. This difference should be considered carefully in legal and ethical discussions on reprogenetics.

Attitude of Health Personnel↗
PubMed2006

Delivery of a healthy baby following the transfer of embryos cryopreserved for 13 years.

Although embryos can theoretically be frozen for an unlimited period of time, there is still uncertainty about how long embryos can be cryopreserved without compromising pregnancy outcome. Following transfer of fresh embryos obtained after IVF, surplus embryos are usually frozen for personal use in later treatments. A 40-year-old woman was admitted to the centre's embryo adoption programme. She had a 7-year-old son, was diagnosed with ovarian factor infertility and her husband had secretory azoospermia. They underwent two cycles of IVF with donor spermatozoa and one cycle of donor intrauterine insemination that ended in spontaneous abortion. At this point, the couple was admitted to the embryo adoption programme. Six frozen embryos, obtained from a couple that had had a pregnancy through IVF at the centre and that had abandoned their surplus frozen embryos, were assigned to this patient. All six embryos were cryopreserved for 13 years. Of these, three were transferred and the patient became pregnant and delivered a healthy boy. Thanks to the embryo adoption programme, these embryos, rather than being left frozen for an indefinite period of time, were transferred to a couple that was willing to adopt them, resulting in the birth of a healthy newborn.

Adult↗
PubMed2002

Human embryonic stem cell lines: the ethics of derivation.

In Canada it is permissible to proceed with stem cell research using human embryos created by in vitro fertilization (IVF) provided: these were originally created for infertility treatment; they are no longer required for such treatment; and there is an appropriate consent for their research use. As such, IVF human embryos in excess of clinical need are a valuable resource for embryonic stem cell researchers. A point often overlooked, however, is that these excess IVF human embryos are also a scarce resource. Their scarcity suggests the need to develop sound policies and procedures, in a timely and coordinated fashion, to ensure that the few human embryos available for embryonic stem cell research are not used in less important research endeavours or used when other biological materials are appropriate. Injudicious use of the few human embryos available for research use may risk the following consequences: no ongoing research in Canada to derive human embryonic stem cell lines; a reliance on the importation of stem cell lines from other countries for any research on the use of embryonic stem cells; and pressure from Canadian researchers to remove the prohibition on the purposeful creation of human embryos for research use.

Canada↗
PubMed2004

Embryo disposal practices in IVF clinics in the United States.

BACKGROUND: The moral status of the human embryo is particularly controversial in the United States, where one debate has centered on embryos created in excess at in vitro fertilization (IVF) clinics. Little has been known about the disposal of these embryos. METHODS: We mailed anonymous, self-administered questionnaires to directors of 341 American IVF clinics. RESULTS: 217 of 341 clinics (64 percent) responded. Nearly all (97 percent) were willing to create and cryopreserve extra embryos. Fewer, but still a majority (59 percent), were explicitly willing to avoid creating extras. When embryos did remain in excess, clinics offered various options: continual cryopreservation for a charge (96 percent) or for no charge (4 percent), donation for reproductive use by other couples (76 percent), disposal prior to (60 percent) or following (54 percent) cryopreservation, and donation for research (60 percent) or embryologist training (19 percent). Qualifications varied widely among those personnel responsible for securing couples' consent for disposal and for conducting disposal itself. Some clinics performed a religious or quasi-religious disposal ceremony. Some clinics required a couple's participation in disposal; some allowed but did not require it; some others discouraged or disallowed it. CONCLUSIONS: The disposal of human embryos created in excess at American IVF clinics varies in ways suggesting both moral sensitivity and ethical divergence.

Cryopreservation↗
PubMed2002

[The stem cell debate: in favor of ethical clarification].

Stem cell research raises ethical issues, the grounds for which however are fairly unclear. As a form of fundamental research, it should be assessed according to the same classical ethical criteria. The strategic scientific question of the priority of adult stem cells versus embryonic stem cells cannot be dogmatically answered in advance, but rather contextually. The question of the moral status of the embryo outside the woman's body will always involve personal beliefs. But legislation will have to regulate this issue from a "middle-of-the-road" position reflecting the convictions of most of the citizens (e.g., embryos will be protected, but not the same as already-born persons).

Adult↗
PubMed2002

[Ethical aspects of embryonic stem cell research].

Research using embryonic stem cells raises a variety of ethical questions, which will be explored in this article. At the core of the ethical controversy is the question of the status of the embryo and its availability for research. A range of countries have approved the use of "supernumerous" embryos from in-vitro fertilization. But ethical problems also arise in reproduction medicine, the informed consent of affected couples, and the targeted production of embryos and egg cell donation for research. The author discuss some of these neglected issues and develops suggestions for comprehensive ethical reflection.

Adult↗
PubMed2002

[Embryos and embryo-like entities: problem of definition in the draft of the Swiss embryonic research law].

At the end of May 2002, the draft of the Swiss "Federal Act on Research on Surplus Embryos and Embryonic Stem Cells" (EFG, Embryonic Research Act) reached the pre-legislative consultation stage. Under certain conditions, it would allow research on "surplus" embryos from in-vitro fertilization, and the derivation of embryonic stem cells from surplus embryos for research purposes. The EFG draft defines an embryo as "the developing organism from the point of nuclear fusion until the completion of organ development". New technological developments show that embryo-like entities can also be created without nuclear fusion having taken place. It remains unclear how to treat embryonic entities that don't fall under the draft's narrow definition of an embryo. Expanding this definition would be a welcome improvement.

Animals↗
PubMed2006

Studying potential donors' views on embryonic stem cell therapies and preimplantation genetic diagnosis.

Embryo experimentation raises many ethical questions, but is established as acceptable practice in the UK under the Human Fertilisation and Embryology Act 1990. The development of preimplantation genetic diagnosis (PGD) and embryonic stem (ES) cell research is dependent on couples undergoing in vitro fertilization (IVF) donating for research embryos that are unused in, or unsuitable for, treatment. Rarely is the role of these donors acknowledged, let alone studied. One concern is whether couples feel an obligation to donate embryos because of their gratitude for the IVF treatment they have received. This article, based on an ongoing study investigating the similarities and differences between the views and values of those IVF couples who agree to donate embryos for research and those who refuse to donate embryos, explores the broader issues around embryonic research. Discussions such as this, embedded in a background of empirical research, will assist practitioners and policymakers in assessing the social and ethical contexts of this very important aspect of current and future scientific developments.

Embryo Disposition↗