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I think this is a very thoughtful article that puts  human faces on the
controversy
FROM: The Boston Globe

After 2 children via IVF, pair faced stem cell issue
By Gareth Cook, Globe Staff, 4/4/2004

"WEYMOUTH -- When the letter arrived last spring at this gray-shingled
house by the water, it was a reminder of some of the most joyous moments,
and some of the most heartsick, that Marie Dooley had ever known.

The letter was from Boston IVF, the clinic that had helped Dooley and her
husband, Tom, conceive two children after an emotionally wrenching
struggle with infertility. Just seeing the logo on the envelope was a
surprise, because she never expected to hear from the clinic again. As
she tore the envelope open in her kitchen, she worried it was bad news.
What it said was more complicated than she had imagined.

"Our current inventory of cryopreserved embryos shows that you have a
total of 4 embryos," the letter began.

It had been three years since the clinic had created a set of in vitro
embryos to help the Dooleys bear children. Her insurance would no longer
pay to keep the unused embryos in the freezer. What, the letter asked,
did she want to do with them?

"I felt sick over it," she recalled. "Am I going to give these embryos a
life?"

And so, on that spring day, Dooley unexpectedly found herself in the
quiet center of one of the most difficult ethical debates of our time.
Unneeded embryos like the Dooleys' are the foundation of an entirely new
field of science.

Every experiment using embryonic stem cells -- and every argument about
their morality -- ultimately begins with one of these embryos, about the
size of the dot of an "i," conceived for a couple trying to build a
family. About 400,000 sit in freezers around the country, awaiting a
decision.

It was a decision that Dooley, who is Catholic, did not begin to know how
to make. She had thought she was done having children, but now she began
to wonder whether she should use the embryos to try for more. She could
have the embryos thrown away by a lab technician, or she could donate
them to research. Under these last two choices, an embryo's potential to
become a child would be extinguished.

In political debates, the argument about embryonic stem cells often falls
into easy certainties: An unwanted embryo is either a ball of cells
useful for medical research or a human life deserving of legal
protection.

But for the parents who created it, an embryo is not a simple thing. When
Marie Dooley, 37, received her letter, she had long since stopped
thinking about her leftover embryos. But she knew they were far more than
balls of cells. Two embryos from that clinic had become her children -- a
5-year-old daughter, Ava, who went out in a blue-and-silver Cinderella
dress last Halloween, and a 3-year-old son, Harry, who gets into new
mishaps daily.

Marie's husband, Tom, suggested that they pay the $500 to keep them
frozen for another year. But Marie knew that was just a way to delay an
inevitable choice. It felt a little wrong to make such a decision at all,
she said, but it felt more wrong to shirk the responsibility.

"I had the power to decide whether to bring a child into the world,"
Dooley said. "It was a huge burden."

Stem cell work at Harvard
Just 13 miles away from the Dooley home, in a cramped basement laboratory
on the campus of Harvard University, scientists were taking in human
embryos, growing them, and trying to pluck out the powerful embryonic
stem cells contained inside.

One of several universities conducting this research, Harvard has pushed
ahead despite federal restrictions. In 2001, President Bush stopped
federal funding for any experiment involving new embryonic stem cells.
Later this month, Harvard will publicly launch what could be a $100
million initiative to perform the research without government money.

Harvard scientists would be unable to create new lines of embryonic stem
cells without donated embryos supplied by Boston IVF. To interested
couples, Boston IVF sends a four-page consent form, which outlines "a
research project to establish human embryonic stem cell (hES) lines."

There would be no way to know it from that spare, clinical description,
but the scientist in charge of Harvard's embryonic cell research, Douglas
Melton, is driven by personal reasons. A little more than a decade ago,
Melton was a highly successful biologist exploring early frog development
when his 6-month-old son, Sam, was diagnosed with type-1 diabetes. So
Melton decided to shift all his research into a singular goal: finding a
cure for diabetes. To succeed, Melton became convinced he would need stem
cells from human embryos.

If anything in science can be considered magical, it is these cells,
formed a few days after conception. Over the course of nine months, they
will generate every living cell in the body. By studying this mysterious
process, Melton and other researchers hope to be able to grow cells that
produce insulin for Sam and other diabetics, or find ways to cure any
number of other diseases.

Four years ago, at a friend's barbecue in Lexington, Melton ran into
Douglas Powers, Boston IVF's scientific director, and began talking
excitedly about the rapid progress he and another researcher, Harvard's
Andrew McMahon, were making using stem cells from mice. Melton asked
Powers whether he would be interested in collaborating on future
experiments. Boston IVF, he knew, had many patients who would never use
the embryos they had frozen.

After consulting with ethicists, Boston IVF agreed to join the project.
Up to then, couples at Boston IVF could either discard their leftover
embryos or try to bring them all to term. Now they had another option.

When does life begin?
Answering the question about whether these embryos are human lives is
beyond the realm of science, at least for now. From the moment of
conception, a fertilized egg has the potential to be a child. Yet there
is no clear, scientifically agreed upon moment at which a human life can
be said to begin.

Legally, the rights to an embryo belong to the couple who created it --
and whose feelings about it have been shaped by the dark journey through
infertility.

Marie Dooley's journey began in 1996. The youngest of five children, she
always knew she wanted a family. But she was diagnosed with a disease
called polycystic ovarian syndrome, and doctors told her it would be
difficult to have children without medical help.

As she and her husband began trying to have children, she watched friends
and sisters get pregnant, seemingly effortlessly, while month after
month, she could not. She thought of all the teen mothers who have
children and don't want them. To her, it didn't seem fair. Every time she
got a phone call from her doctor's office, she would go into mourning,
she said. For days after, she fell into fits of uncontrollable crying.
Tom couldn't console her.

"It's me," Marie recalls telling him. As much as she loved her husband,
she could not help but feel that her body, at some physical level, was
rejecting him, and their love.

To create the embryos, Marie had to endure regular shots to increase her
egg production, and Tom had to learn how to give them, using oranges to
practice his technique. The night before she was scheduled to have some
of her eggs removed, the two of them had to wake in the middle of the
night to prepare an injection delivered at precisely 2 a.m. Three times
they went through that routine.

Under such procedures, once the eggs are removed and fertilized with the
husband's sperm, each resulting embryo is remarkably delicate. To keep
embryos growing outside the womb, Boston IVF lab technicians place them
in a dish filled with nutrients, and then store them in a wall of humming
incubators that maintain a steady temperature and constant levels of
oxygen and carbon dioxide. The lights in the laboratory are even kept
low, creating an environment as similar to the womb as possible.

A few days later, several of the developing embryos are placed back in
the woman, in the hopes that one will take. Dooley remembers the drive
home in 1997, a few days after Christmas. She had just had embryos
implanted and worried about every bump.

"I know it sounds pathetic, but I was worried they would fall out,"
Dooley said. Nine months later, she had Ava.

In another two years, she and Tom went through much the same ordeal to
have Harry. This time there were several good embryos left over.

Whether to expand family
The vast majority of the country's excess embryos are discarded: removed
from their freezer, dropped into an orange biohazard bag with the day's
used pipettes and Petri dishes, and thrown out with the day's medical
waste.

For Marie Dooley, that was never an option with her embryos. She thought
of all the work that went into creating them -- her own ups and downs,
the "humiliation" of her husband going into a room with adult magazines,
even the hours her father spent waiting for her in the parking lot for
clinic visits.

"It just seemed like such a waste to throw them away," Dooley said.

Dooley opposes abortion but believes it should be the woman's choice. One
option advocated by antiabortion groups -- offering the embryos for
adoption -- is surrounded by difficult legal questions in Massachusetts,
and felt impossible to Dooley to pursue. "I was looking at my children
and thinking, `that is like giving you away to a stranger,' " she said.

The choice that really weighed on her was whether to have more children.
For a week she struggled with this. If she did try to get pregnant again,
it would be emotionally difficult. Even if the embryos were implanted,
there was no guarantee they would lead to a pregnancy, a hard lesson she
had learned from previous failures.

Statistics show that fewer than one in four implanted frozen embryos
leads to a full-term pregnancy. On the other hand, there was the new life
that her children had brought her and her husband. In addition to the two
children she has from IVF, Ava and Harry, she has a 18-month-old
daughter, Lila, conceived naturally.

"You go and look at your children and say, `What would my life be without
you?' " she said.

Then there were the practical considerations, such as whether the house
had enough room for a fourth child -- or a fifth, too, because twins are
common in IVF patients.

Tom manages properties for Chestnut Hill Realty, which allows Marie to
stay home and care for the children. She worried a lot about the cost of
schools. They hope to send all their children to the private high school
Tom attended, and of course there is college. That, she said, is was what
drove her decision. "As gross as it sounds, it was the price of
education," Dooley said.

Last May, about a week after the first letter arrived, Tom signed the
release form, "Consent to Donate Human Embryos and Embryonic Cells for
Research." He headed off to work. After thinking about it a little more,
Marie signed it quickly and put it in the mail, eager to move on with her
life.

When patients' embryos are used for the Harvard project, a scientist
removes the plastic vials containing the embryos from the main storage
containers. She carefully thaws the embryos and places them in petri
dishes. She then puts these inside a portable incubator, a silver box
about the size of a car battery, and drives them to Melton's Cambridge
lab in her navy Subaru Outback.

Last month, Melton announced that his laboratory, using 344 donated
embryos, had managed to create 17 new lines of embryonic stem cells. In
the small, highly charged world of stem-cell science, it was the most
successful effort to date, doubling the number of lines that researchers
around the world have to work with. Melton plans to give the samples free
to any scientist who wants them.

Melton's announcement marked a tiny step toward his goal of curing
diabetes, and now the stakes are even higher for him: a few years ago,
his daughter Emma, now 17, was also diagnosed with the disease.

Marie Dooley cannot know the fate of her own embryos. The experiment in
Melton's lab was set up so that the cells can't be identified with the
donors. The embryos may have died when they were thawed or failed to
develop into a healthy blastocyst. They may have survived to become one
of the world's few healthy lines of embryonic stem cells. They may remain
at the clinic, frozen in a separate tank, awaiting a new experiment.

A year after getting the letter from Boston IVF, Dooley says she feels
happy with her decision. Dooley voted for President Bush in the last
election, and she plans on voting for him again, despite his opposition
to the work Melton is doing. The embryos don't have a heartbeat, she
says, and deciding what to do with them was an intensely personal choice.

As she has watched the political battle over stem cell research unfold,
she has sometimes thought of sending the president pictures of her
family.

"Science gave me a gift," she said, as her children circled around the
dining room table. "I felt I should give back."

Gareth Cook can be reached at [log in to unmask]

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