GRESHAM LECTURE I

Reproductive Technologies and the birth of Regulation

A UK First

The First IVF Baby

• Born in England 1978• Sparked off global

debate• Became a nursery

nurse• Has her own child

In vitro fertilisation

The Warnock Report

• 1984: people need principles

• Moral consensus• Regulate

Human Fertilistion & Embryology Authority UK

• Established by 1990 Act

• Licences and monitors clinics and laboratories, IVF and embryo research

• 21 members appointed after advertisement

Benefits of regulation

• Protection of the embryo

• Welfare of the child

• Record of treatments and donors

• Control of market forces

• Answerable and representative

• Looking ahead

The Realities of Regulation

• The constraints of the legal framework

• Resources need to enforce and defend in court

• The power of the media and images

• The pressure from politicians

Fertility For Ever

• Frozen eggs give hope to young cancer patients

As Fertile as a Man

• Career women can put their eggs on ice until the time and the man are right

ICSI

• Cure for male infertility – 50% of cases

Preimplantation genetic diagnosis

• Unite sperm and egg in the laboratory

• Fertilised egg grows to 8 cell size

• Remove 1 cell and test for disease

• Test also for compatibility (HLA)

PGD

Cloning Dolly

Cloning

Human cloning

USA

• Anti-regulation and federal control

• No federal funds for new stem cell lines

• Private clinics uncontrolled

• Council on Bioethics

• Democrat-Republican differences

California

• Proposition 71, 2004, state funding for stem cell research

• California Institute for Regenerative Medicine

• Independent Citizens’ Oversight Committee

Categories of Regulation

• I Prohibition of all human embryo research

• II Use of stem cell lines already in existence

• III Use of embryos surplus to IVF for stem cell research

• IV Allow creation of embryos for stem cell research

Procedural Safeguards

• Health monitoring and risk warnings• Integrity of statistics• Secure database• Information for patients• Limits on the number of embryos used• Length of storage• Disposition of embryos on divorce• Regulation, licences and sanctions

A Legislative Minimum

• Prohibitions on cloning, experiments in the womb, genetic manipulation

• Inspection of clinics and laboratories

• 14-day rule for keeping embryos

• Commerce in gametes

• Control patenting

Animal-human embryos for research

The Future

• Artificial wombs from week 2 to 26 or longer

What are Stem Cells?

• Derived from early human embryos of a few days’ growth

• Adult stem cells derived from bone marrow, skin, umbilical cord, blood

• They are the origin of all our cells

• Will help us to understand disease

• Might make cells and tissue for transplantation and renewal

Therapeutic cloning

Stem Cells and Cures

• Nerve cells might cure Parkinson’s, Alzheimer’s, spinal cord injury, stroke

• Embryo cells might help infertility

• Heart muscle cells for heart disease

• Blood cells for cancer, leukaemia

• Skin cells for burns and wounds

• Bone cells for osteoporosis