Reprogenetics and Public Policy: Reflections and Recommendations (Special Supplement‪)‬

At the first of the discussions that led eventually to this report, a respected researcher-clinician in the world of reprogenetic medicine referred to his field as "one big embryo experiment." The phrase nicely captures what this report is about. It is about the ethical issues and policy challenges that arise in the context of researchers and clinicians doing new things with embryos. The range of such activities is wide and growing: from studying embryos for the sake of basic knowledge about developmental biology; to using them as sources of embryonic stem cells that can be coaxed to cure disease; to creating, selecting, and altering them for the sake of producing children. This report focuses on that last set of aims and emphasizes the need for improved public oversight--a need that grows more urgent as reproductive and genetic medicine converge to produce the new field of "reprogenetics." (1) For a variety of reasons, research involving the use, creation, alteration, and storage of gametes and embryos is subject to little regulation in the United States. This situation is potentially dangerous. Unlike older in vitro fertilization (IVF) techniques, many new reprogenetic techniques make structural changes to cells, (2) and with structural changes arise concerns about the safety of the children produced by the technology. Further, both older and newer techniques raise concerns about the safety of the women who donate the eggs and the women in whom the fertilized eggs are implanted--the egg donors and the gestating mothers.