Saturday, October 08, 2005

IVF, Embryos & Giant Pink Elephants

If I didn't know better I would probably think that any embryos used in research had been collectively plucked from a future of bibs, baby food and spit up by the ruthless and immoral supporters of ESCR, when in reality, any embryo used in research was slated to die before it was donated to research.

Further, those who argue against permitting the use of excess in vitro fertilization (IVF) embryos in research, if you follow their reasoning to its logical conclusion, must also argue for the abolition of IVF as it is currently undertaken.

Increasingly, couples having trouble conceiving are turning to assisted reproductive technologies (ART) in their quest to have children. The most common type of ART is in vitro fertilization (IVF), which involves extracting a woman's eggs, fertilizing them outside of the body in a Petri dish (in vitro means “in glass”) and then transferring the resulting embryos into the woman's uterus with the hope that one of them will implant.

In most cases, however, more embryos are created than are used in the pursuit of implantation - and the right to determine the destinies of those embryos currently rests with couples who produced them. Ultimately, there are three options from which to choose: donate the embryos to another couple, donate them to research, or have them discarded by clinic personnel. There are those who would count leaving them in storage as an option, but storage is just an interim state; all of the frozen embryos will face one of those three aforementioned options eventually. And just so that we are clear, I will say that both donating an embryo to research and simply discarding it result in the destruction of the embryo.

If one believes that it is wrong to destroy an embryo in the course of research, then one must believe that it is wrong to destroy an embryo, period - whether it is in the course of research, or in the course of a day at the IVF clinic. From that it follows that if IVF were to be allowed to continue in an acceptable form, of the current three options available to couples - donate to another couple, donate to research, or simply destroy - the latter two would have to be eliminated, leaving only one option: donating to another couple.

However, that model, even if it were legally defensible, would only be acceptable if no other embryos were harmed in the IVF process - but other embryos are harmed. One IVF clinic describes in detail how the staff sifts through the embryos formed in one IVF procedure and decides which ones are viable for implantation - the others are discarded. And then there is the problem of freezing itself. There is a baseline attrition rate of anywhere from 10-25% when embryos are frozen and thawed. The attrition rate can be lowered by discarding embryos that may be viable under normal circumstances but are judged to be less likely to survive freezing. (Genetics & IVF Institute, Georgia Reproductive Specialists)

So, any way you slice it, if one argues that it is wrong to destroy an embryo in the course of research, one must ultimately argue for the abolition of IVF as it is currently undertaken.

6 comments:

Don Singleton said...

I dont know whether you realize it or not, but Rod's comment is what is normally called comment spam.

I have deleted a number of these from my http://donsingleton.blogspot.com/ blog, that are totally unrelated to the subject post. Their whole purpose is to increase the number of inbound links to a website, and increase its position in search engines.

I have enjoyed our exchange in http://donsingleton.blogspot.com/2005/10/stem-cell.html so I thought I would do you the honor of a response on your blog

If I didn't know better, I would think that all the fuss about embryonic stem cell research (ESCR) revolved around the question of whether it should be allowed at all, even with private funding.

Some may feel that way, but I have no opposition to private or even state funding.

In reality, the current debate is over whether or not federal funding for ESCR should be expanded.

And everyone is complaining about Bush limiting that funding, when he was the FIRST PRESIDENT to support any funding at all

And odds are better than even that I would think that the “embryo” referred to in the phrase “cloned human embryo” was created

Again I cant speak for everyone, but while I do not support making ESCR illegal (I just dont want to fund it) I do favor making human cloning illegal.

they are also arguing for the abolition of IVF as it is currently undertaken.

Perhaps. The reason there are so many embryos that need to be destroyed is that way too many eggs are harvested in IVF procedures, and if ANY use is found as a result of ESCR I suspect that IVF doctors will insist that any childless couple seeking IVF allow them to harvest even more excess eggs, so that they can create even more excess embryos that the lab can sell to the doctors making use of whatever they discover

anuket said...

Hi Don! Welcome to my blog! And thank you for both my first real comment and the tip about the comment spam.

Now… where were we…ah yes – hmmmmmm… now I am really confused. If you don’t support federal funding for ESCR but you have no opposition to other funding, then it couldn’t be the destruction of the embryo that troubles you about this, I don’t think. Could it?

I guess I should just ask flat out – why is it that you oppose federal funding for ESCR?

You say that Bush was the first president to “support” any funding for ESCR at all. Well, depending on what you mean by “support,” that could be true, just barely. If you mean “was in favor of” which does not necessarily mean any occurred, then it is not true. The truth is that On August 25, 2000, the Clinton Administration’s NIH Guidelines for Embryonic Stem Cell Funding were recorded in the Federal Register, and can be found on the President’s Council for Bioethics web site under Monitoring Stem Cell Research - Clinton’s guidelines allowed federal funding for research using ESCs from donated excess IVF embryos – therefore, he was in favor of federal funding before Bush was. And given that ESCs were only isolated for the first time in 1998, Clinton was the first president who had the opportunity to support federal funding for ESCR – it wasn’t as if 10 presidents before Bush refused to allocate federal money and Bush bucked the tide by turning around and allowing federal funding.

But if, by support, you mean allocated federal funds, then it is true, just barely. NIH was not far from awarding the first grants when Bush took office and banned ESCR for eight months until his decree, at which point he promised 60 or 78 cell lines. (just as an aside, there will only ever be 22, and something like 16 of the lines promised did not exist at all at the time he made the speech all of this is documented in my How Many Cell Lines Was That, Again? blog post)

Also, to say Bush is “supporting” federal funding for ESCR even from a financial perspective is another “just barely” situation. Take a look at the NIH Funding Estimates for 2003- 2006 – the actual amount spent on ESCR in ’03 and ’04 was a whopping $44M, and there are no budget figures for ’05 and ’06 – as compared to federal funding for all non-embryonic SCR, which, in ’03 and ’04 alone received $1.07 BILLION in federal funding, and is slated to received an additional $1.13 BILLION by the end of ’06.

When you add it up, ESCR is getting $44M to non-embryonic SCR’s $2.2 BILLION between 2003 and 2006. I wouldn’t exactly call that hearty support for federal funding for ESCR.

Regarding your thought on IVF, there is a reason so many eggs are harvested and they attempt to create so many embryos – the chances that an embryo will implant are so low that they transfer several at a time into the uterus in the hope of improving the chance of implantation.


Regarding the rest of your thoughts on IVF, to me they are the equivalent of me saying “Bush lied about WMDs and used 9/11 to manufacture a threat in order to justify an unprovoked attack on another country, and continues to use 9/11 as the basis for this charade he calls a “war on terror.”

In other words, I have no proof that any of that stuff I just said about Bush is true – so I wouldn’t say it in a forum like this (except to prove a point) – if you have any proof of the corrupt behavior you seem to think takes place in IVF clinics, I am very much interested in seeing it. Otherwise, your accusations are baseless.

Anyway, I am overjoyed that we at least agree on one thing – that ESCR should continue – with or without federal funding, though there is a strong case for NIH oversight of this type of research – not to mention having bucketloads of money.

Don Singleton said...

Hi Don! Welcome to my blog! And thank you for both my first real comment and the tip about the comment spam.

You are welcome. I have responded to your latest post on my blog

Now… where were we…ah yes – hmmmmmm… now I am really confused. If you don’t support federal funding for ESCR but you have no opposition to other funding, then it couldn’t be the destruction of the embryo that troubles you about this, I don’t think. Could it?

I don't like the idea of anyone doing ESCR, because I feel it is both immoral and unnecessary (since there are other ways to do stem cell research). But I would not urge making it illegal (I would urge making human cloning research illegal). Therefore I have no basis of opposition to private or other states funding research. If the Oklahoma legislature sought to fund it, I would be in opposition, just as I am for Federal Funding.

You say that Bush was the first president to “support” any funding for ESCR at all. Well, depending on what you mean by “support,” that could be true, just barely.

Just barely only counts in horseshoes, handgrenades, and nuclear weapons. Amount appropriated in Clinton administration: $0. Amount appropriated in Bush administration: Greater than $0.

How Many Cell Lines Was That

The number, whether it is 78, or 60, or 22, or just 16, is greater than zero. We are not talking about finding a cure for me, because if we were, we should be using stem cells that are as close to me as possible. Since my cord blood was not saved when I was born, if they wanted a stem cell to help me, they would need to make one from my adult cells. But if you want to study the difference between the way embryonic stem cells behave vs ones created from adult cells, 16 lines should be plenty.

When you add it up, ESCR is getting $44M to non-embryonic SCR’s $2.2 BILLION between 2003 and 2006. I wouldn’t exactly call that hearty support for federal funding for ESCR.

Sounds like a reasonable split to me. $44M for mad scientists to play God, and $2.2B for the development of real cures that can be applied to people alive today.

Regarding your thought on IVF, there is a reason so many eggs are harvested and they attempt to create so many embryos – the chances that an embryo will implant are so low that they transfer several at a time into the uterus in the hope of improving the chance of implantation.

If they are implanted, they are not available for research.

anuket said...

hi don,

my apologies for the delay in responding.

you said:

I don't like the idea of anyone doing ESCR, because I feel it is both immoral and unnecessary (since there are other ways to do stem cell research).

Whether it is immoral or not is clearly a matter of opinion, and we are each entitled to our own. However, whether it is unnecessary or not, that is a judgement that can only be made armed with more knowledge than that with which you have armed yourself - with all due respect.

The first thing I will mention - and perhaps I have mentioned it before - is a fact, and that is since the 60s when hematopoietic cells were found to be useful in treating certain disease of the blood, not a single other type of adult stem cell has made clinical use. Stem Cells and Diseases, NIH

Secondly, there is a scientist named Catherine Verfaillie at the University of Minnesota, who, judging from the research papers she has published, is devoting her career to the finding of cells other than ESCs that could be used in treating diseases.

Keeping that in mind, here is the conclusion she came to in her April 2004 editorial entitled “The Plasticity of Stem Cells.” First, she lays out the potential of ASCs and the challenges to overcome:

“Potential of adult stem cells
• treatment of degenerative disorders of many organs
• allows autologous transplantation thereby reducing immune rejection
• ex vivo gene correction of autologous stem cells in case of genetic disorders

Challenges to overcome
• confirm greater potential of adult stem plasticity by independent groups
• provide evidence that undifferentiated adult stem cells will not cause tumor
• types of cells to transplant, differentiated vs. undifferentiated cells
• homing of adult stem cells to the site of injury/engraftment
• immune rejection in case of genetically corrected allogeneic cells”

In other words, ASCR (ASC research) is not a slam dunk at this point, any more than ESCR.

She concludes by saying:

“ there remains a long road ahead in which investigators will need to learn more about the cells them selves, possible mechanisms underlying in vivo observations and long-term effects of such cells used in vivo.” (i don't have a link to the paper from which i am quoting, but i do have the paper, if you are interested in reading it.)

My goal here is not to put ASCR down.

My point is that all too often, those that argue for ASCR over ESCR (ES research) often represent ASCR as holding the key to miracle cures that are either here or right around the corner but that, for some reason, are being hidden. That is just not the case, as is confirmed by Dr. Verfaillie herself above.

You also said, with respect to my pointing out that the NIH under Clinton was on the verge of awarding grants in ESCR when Bush took office and banned it:

Amount appropriated in Clinton administration: $0. Amount appropriated in Bush administration: Greater than $0.

Which is something like telling all your friends you won the bike race but neglecting to tell them that you only won because the guy in the lead got a flat tire in the home stretch.

And with respect to the number of lines necessary to conduct effective ESCR, you said:

if you want to study the difference between the way embryonic stem cells behave vs ones created from adult cells, 16 lines should be plenty.

And I wonder if you have ever read a single abstract, even, never mind a study - or if you have read anything that the scientists themselves say or if you only read the stuff in the mainstream media, or the right wing media. Actually, your response reveals the answer to my questions loud and clear, as does the complete absence of any evidence to back up your assertions.

Finally, you say:

Sounds like a reasonable split to me. $44M for mad scientists to play God, and $2.2B for the
development of real cures that can be applied to people alive today.


First of all, yet again you provide zero evidence to support your assertion that ASCs are any more likely to yield therapies than ESCs.

Secondly, you boasted that Bush was the first president to fund ESCR. I pointed out that $44M was not exactly what one would call hearty support, particularly vs. $2.2 billion for ASCR. The discrepancy in the federal funding levels for ESCR and ASCR is not something I have ever heard someone on the anti-ESCR side point out – but then, I can see that it would be hard to represent ASCR is the underdog when it is receiving $1.8 Billion more in federal funding than ESCR between 2003 and 2006 (I realize that you didn't paint ASCR as the underdog - I mention it only because it is an instance of misleading omission, like your omission about Clinton.)

The omitting of the discrepancy in funding is used to falsely paint ASCR as the underdog. The omission of the fact that the only reason Bush was the first to fund ESCR was because Clinton’s term ended before he could is used to falsely paint Bush as the trailblazer. Pair that up with the omission of the fact that a good chunk of the lines Bush said were available on August 9, 2001 did not, in fact, even exist, never mind being available for research, and most of the rest were actually unavailable at the time he said they were available (and continue to be unavailable), and you begin to get a sense of the real picture.

You might find it educational to peruse NIH's website, some of the papers of the President's Council on Bioethics, some of the debates on bills up for vote in the House of Representatives, and some of the abstracts on Entrez Pubmed - if you do, you may discover information that supports your position, or you may find information that counters your position - both outcomes would be good.

I haven’t read your response to my last post on your blog yet, so I may respond to that, too.

anuket

Don Singleton said...

I responded to your statement on my blog

my apologies for the delay in responding.

No problem. I was wondering where you were.

you said:

I don't like the idea of anyone doing ESCR, because I feel it is both immoral and unnecessary (since there are other ways to do stem cell research).

Whether it is immoral or not is clearly a matter of opinion, and we are each entitled to our own. However, whether it is unnecessary or not, that is a judgement that can only be made armed with more knowledge than that with which you have armed yourself - with all due respect.


Perhaps, but I have answered your points point by point

The first thing I will mention - and perhaps I have mentioned it before - is a fact, and that is since the 60s when hematopoietic cells were found to be useful in treating certain disease of the blood, not a single other type of adult stem cell has made clinical use. Stem Cells and Diseases, NIH

So the score is ASC>0 ESC=0

Secondly, there is a scientist named Catherine Verfaillie at the University of Minnesota, who, judging from the research papers she has published, is devoting her career to the finding of cells other than ESCs that could be used in treating diseases.

Good

Keeping that in mind, here is the conclusion she came to in her April 2004 editorial entitled “The Plasticity of Stem Cells.” First, she lays out the potential of ASCs and the challenges to overcome:

“Potential of adult stem cells
• treatment of degenerative disorders of many organs
• allows autologous transplantation thereby reducing immune rejection
• ex vivo gene correction of autologous stem cells in case of genetic disorders

Challenges to overcome
• confirm greater potential of adult stem plasticity by independent groups
• provide evidence that undifferentiated adult stem cells will not cause tumor
• types of cells to transplant, differentiated vs. undifferentiated cells
• homing of adult stem cells to the site of injury/engraftment
• immune rejection in case of genetically corrected allogeneic cells”

In other words, ASCR (ASC research) is not a slam dunk at this point, any more than ESCR.


But there are no moral problems with ASCR. Or Cord Blood research.

She concludes by saying:

“ there remains a long road ahead in which investigators will need to learn more about the cells them selves, possible mechanisms underlying in vivo observations and long-term effects of such cells used in vivo.” (i don't have a link to the paper from which i am quoting, but i do have the paper, if you are interested in reading it.)


If you can email it to donsingleton@cox.net or snail mail it to 3311 South 127 East Place, Tulsa, OK 74146 I will be happy to read it.

My goal here is not to put ASCR down.

My point is that all too often, those that argue for ASCR over ESCR (ES research) often represent ASCR as holding the key to miracle cures that are either here or right around the corner but that, for some reason, are being hidden. That is just not the case, as is confirmed by Dr. Verfaillie herself above.


I realize research in both is required, as hopefully research in cord blood cells. I am willing to support federal funding of ASCR, and cord blood research, but not ESCR. I do not seek to make ESCR illegal, but I would like to make cloning illegal.

You also said, with respect to my pointing out that the NIH under Clinton was on the verge of awarding grants in ESCR when Bush took office and banned it:

Amount appropriated in Clinton administration: $0. Amount appropriated in Bush administration: Greater than $0.

Which is something like telling all your friends you won the bike race but neglecting to tell them that you only won because the guy in the lead got a flat tire in the home stretch.


Who crossed the finish line?

And with respect to the number of lines necessary to conduct effective ESCR, you said:

if you want to study the difference between the way embryonic stem cells behave vs ones created from adult cells, 16 lines should be plenty.

And I wonder if you have ever read a single abstract, even, never mind a study - or if you have read anything that the scientists themselves say


Yes

or if you only read the stuff in the mainstream media, or the right wing media. Actually, your response reveals the answer to my questions loud and clear, as does the complete absence of any evidence to back up your assertions.

Now who is being insulting.

Finally, you say:

Sounds like a reasonable split to me. $44M for mad scientists to play God, and $2.2B for the
development of real cures that can be applied to people alive today.

First of all, yet again you provide zero evidence to support your assertion that ASCs are any more likely to yield therapies than ESCs.


As indicated above ASC's have produced results, ESCs have not. Also if ESCs did produce results, because of rejection of foreign cells I suspect anyone needing a cure produced by ESCs would be faced with creating additional embryos within his family to be destroyed to make a customized cure. I wince when parents have a child they dont really want, so that bone marrow can be harvested for the child they really want to save, but at least that does not kill the marrow donor, and the parents may grow to love the donor child.

Secondly, you boasted that Bush was the first president to fund ESCR. I pointed out that $44M was not exactly what one would call hearty support, particularly vs. $2.2 billion for ASCR. The discrepancy in the federal funding levels for ESCR and ASCR is not something I have ever heard someone on the anti-ESCR side point out – but then, I can see that it would be hard to represent ASCR is the underdog when it is receiving $1.8 Billion more in federal funding than ESCR between 2003 and 2006 (I realize that you didn't paint ASCR as the underdog - I mention it only because it is an instance of misleading omission, like your omission about Clinton.)

The omitting of the discrepancy in funding is used to falsely paint ASCR as the underdog. The omission of the fact that the only reason Bush was the first to fund ESCR was because Clinton’s term ended before he could is used to falsely paint Bush as the trailblazer. Pair that up with the omission of the fact that a good chunk of the lines Bush said were available on August 9, 2001 did not, in fact, even exist, never mind being available for research, and most of the rest were actually unavailable at the time he said they were available (and continue to be unavailable), and you begin to get a sense of the real picture.


I do not understand. Would you have preferred that Bush not make the $44M available so you did not have to admit he was the first?

You might find it educational to peruse NIH's website, some of the papers of the President's Council on Bioethics, some of the debates on bills up for vote in the House of Representatives, and some of the abstracts on Entrez Pubmed - if you do, you may discover information that supports your position, or you may find information that counters your position - both outcomes would be good.

My plate is pretty full, but I may.

I haven’t read your response to my last post on your blog yet, so I may respond to that, too.

You did, and I responded to your responses on my blog

anuket said...

I said:
However, whether it is unnecessary or not, that is a judgement that can only be made armed with more knowledge than that with which you have armed yourself - with all due respect.

You said:
Perhaps, but I have answered your points point by point

I’m glad you acknowledge the possibility that you are not well-informed enough to judge whether ESCR is necessary. Perhaps you should, then, refrain from stating that it is not. And no, you have not answered all of my points, and you certainly haven’t admitted when I have made a point. You did not address my critique of your analogy, for example. Nor did you admit that you commented without knowing what you were talking about when you accused the people promoting alternative methods of obtaining ESCs of trying to divide the pro-life movement.

And simply answering is not enough, most of the time. The answer itself is critical. Take your response to my revealing the huge omission that there is only one ASC that is being used to treat only a very narrow type of disease, and this after some 33 more years of research and incalculably more funding than ESCR. You simply say:

So the score is ASC>0 ESC=0

Here is why that answer is unsatisfactory.

Your side often says what you just said – i.e, ACSs have yielded more therapies than ESCs. It is meant to support the argument that ESCR is unnecessary (which you yourself say straight out.)

The reason that answer is unsatisfactory is because it is misleading, and the reason it is misleading is because of the following omissions, which give the following misleading impressions:

OMISSIONS
- Only one type of ASC is currently used to treat disease

MISLEADING BECAUSE:
- Leaves it up to the reader to infer the number of types of ASCs that are being used

OMISSION
- that particular ASC only treats diseases of the blood

MISLEADING BECAUSE:
- at best, it leaves it up to the reader to infer the quantity and scope of diseases being treated by ASCs, and since they are being touted as so much better than ESCs, not many people would assume so narrow a scope as strictly diseases of the blood; at worst, sometimes a pro-life writer will even state a figure, i.e., anywhere between 50 and 140 diseases – and I have never seen anyone ever provide a source for any of those numbers

OMISSIONs
- ASCR has been going on for 40 years, ESCR has been going on for 7 years
- in the 40 years since ASCR has been going on, researchers have not succeeded in bringing one single other cell aside from hematopoietic into clinical use
- in the period between 2003 and 2006 inclusive, funding for ASCR is projected to be $2.2 billion to ESCR's $44million - and the federal government has been funding ASCR research for 40 years, not just since 2003, as with ESCR - and even with all that federal funding, ASCs STILL have only produced one type of cell that can help one type of disease

MISLEADING BECAUSE:
- leaves reader with the impression that aside from the fact that (unspecified) ASCs have yielded (unspecified) cures and therapies and ESCs have not, that all other things - such as
- number of years each field of research has been undertaken
- number of years during which research has been undertaken without yielding clinical therapies, and
- level of federal funding that each field has received .
are equal.

Given the quantity of omissions and the fact that any one of them would be detrimental to the argument that ASCs are more llkely to yield therapies than ESCs, i.e., that ESCR is unnecessary, it is extremely unlikely this information is omitted accidentally.

And that is why your answer, “So the score is ASC>0 ESC=0,” is unsatisfactory – with it, you continue ot refuse to acknowledge that there are gaping omissions and that they are misleading. Same goes for “who crossed the finish line” or whatever it was that you said. You are basically saying “Hey, doesn’t matter how you play the game, all that matters is that you win,” and therefore anuket can point out a million misleading omissions – it won’t change a thing that I say or purport to believe.

I will email the Verfaillie paper sometime this week.

You said:
I realize research in both is required, as hopefully research in cord blood cells. I am willing to support federal funding of ASCR, and cord blood research, but not ESCR. I do not seek to make ESCR illegal, but I would like to make cloning illegal.

I am glad to hear that you realize both avenues need to be explored, and understand that you don’t want to pay for ESCR – however, you say you don’t want to make it illegal, while at the same time, you clearly think that the destroying of an embryo is wrong. It seems like a contradiction to me.

You say you have read an abstract, or a study or what the scientists themselves say – what study did you read – or studies – but one will do – or what did the scientists say, and where did you read it?

Regarding being insulting, my apologies if it sounded that way – I was simply stating facts – you provide no sources for your information (except for the one instance in which I sort of demanded it) and your statement about 16 lines being enough is so far wrong that it is clearly evident that you don’t know what you are talking about. Facts. My apologies again if it sounded like I was insulting you.

You said:
As indicated above ASC's have produced results, ESCs have not. [see? There it is again!] Also if ESCs did produce results, because of rejection of foreign cells I suspect anyone needing a cure produced by ESCs would be faced with creating additional embryos within his family to be destroyed to make a customized cure.

Yes, it is possible that rejection could be an issue, but it is still too early to tell whether it would be surmountable – hence the need for further research. As far as people creating embryos within their own families to be destroyed for their stem cells, if you mean actual embryos, i.e., the product of egg and sperm, well I suppose that would be one way of getting around the rejection issue. It could also be avoided by using somatic cell nuclear transfer.

You said:
I do not understand. Would you have preferred that Bush not make the $44M available so you did not have to admit he was the first?

Oh please. Don’t waste either of our time with baloney like that.

But do peruse the NIH website, and other places I suggested, and when you find information that supports your argument and you can point me to it, then I will be happy to listen to what you have to say.