Could an international stem cell consortium make San Francisco the center of an emerging market in human ova?

IT'S CLOSE TO impossible these days to avoid the debate over the ethics of stem cell research. George W. Bush raised the curtain on his presidency in 2001 by barring federal funding for research on new stem cell lines. Last month, South Korean cloning pioneer Hwang Woo-suk announced a global initiative designed, in part, to circumvent some nations' squeamishness about this promising research.

But for all the discussion, the origins of those controversial embryonic stem cells are rarely acknowledged.

"It's as if these embryos just came from nowhere," Susan Berke Fogel, head of the nascent California activist group the Pro-Choice Alliance for Responsible Research (PCARR), told the Bay Guardian.

Actually, they come from the eggs of women – living, breathing women who will have to undergo risky procedures to have their eggs removed in the name of science.

That's because scientists have placed much of their hope in customized embryonic cells they grow themselves, using a technique called nuclear transfer. The process involves extracting genetic material from an easy-to-obtain skin cell, placing it inside an oocyte that has had its genetic material removed, and then prompting the cell to develop into a clonal embryo, from which stem cells can be extracted.

What's not evident from that description – and is so often left out of such explanations – is that an oocyte is a human egg.

That may not seem like a big deal: Women have been offering their eggs for use in fertility treatments for a quarter century. But experts say the prospect of hundreds of women undergoing egg extraction in order to supply researchers with custom-made stem cells raises novel ethical and medical questions.

Many women's health advocates believe egg extraction causes medical problems that the largely unregulated fertility industry has never been forced to address – and they worry that if this research is not handled carefully, there could be significant health risks to donors.

Bioethicists also warn that great care must be taken to ensure that donors don't have an unrealistic idea of the impact their donated ova could have on ailing friends or family.

Some even fear that without careful regulation, market forces could someday drive this whole process – and that low-income women would bear the brunt of this commercialized market in human eggs.

Until now, experts concerned about egg donation have been focused on the California Institute for Regenerative Medicine, which was set up by last year's Proposition 71 and is poised to distribute $3 billion in grants for stem cell research. Assuming the CIRM would effectively be in charge of how egg donation happens here in California, these activists have lobbied the institute to establish strict donor guidelines. Although many of the stickiest issues have yet to be worked out, both the advocates and the institute's officials have been feeling pretty good about their progress.

But nearly all were taken by surprise last month when Hwang's team announced its plan for an international network of labs that will supply new stem cell lines to researchers around the world. Dubbed the World Stem Cell Hub, the consortium will include a lab right here in the Bay Area, which could begin collecting ova from local women as early as January. And it would not automatically be subject to CIRM rules.

What will keep lab operators from offering high prices for eggs? And how can we be sure local women will get an accurate sense of the risks?