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With political dividing lines carved deep into the collective consciousness, wading through the ethical minefield of embryo creation and destruction is a challenge. A recent New England Journal of Medicine (NEJM) article, “Made-to-Order Embryos for Sale — A Brave New World?” by I. Glenn Cohen and Eli Y. Adashi tackles the controversial issue of for-profit embryo creation. Possibly in an attempt to come out on a particular side of the political line, it sweeps what is truly terrifying about the practice under the rug.

The issue gained prominence last November, when the Los Angeles Times covered a Davis fertility clinic, California Conceptions, and their falsely named Donated Embryo Program. “Donated embryos” typically refer to the gift of embryos left over from a couple’s IVF procedure to another, infertile couple. The embryos belong to the people whose gametes created them, and they make the decision about whether, when and to whom they should be given.

What California Conceptions does is completely different: It creates batches of embryos from donated sperm and eggs, keeps them in an embryo bank on site, and divvies them up to sell to multiple parties for a profit. As the LA Times reporter put it, “The clinic, not the customer, controls the embryos, typically making babies for three or four patients while paying just once for the donors and the laboratory work.”

The news about California Conceptions’ program caused a surge of public outrage (well chronicled here by Dr. Craig Sweet, medical and practice director of Embryo Donation International.) Andrew Vorzimer, a Los Angeles fertility lawyer said,

“Make no mistake, this is commodification. These are not donated embryos. Rather, they are embryos created from donors hand-selected by California Conceptions. It is one step removed from a mail order catalog. The only difference is that the product being sold is nascent human life.”

Cohen and Adashi do not share this concern. They compare the practice of creating and selling embryos to the sale of gametes and to the use of gametes and embryos for stem cell research. They conclude that, “viewed through a legal and ethical lens, the concerns raised by this potentiality appear to be similar to those associated with widely accepted and more common reproductive technologies.”

But made-to-order embryos present a different set of questions. Reverting to the reasoning behind other technologies or practices does not address what is unethical about this.

For example, they make the argument that embryo destruction for the purpose of stem cell research raises concerns about “respect for personhood” comparable to those raised about “made-to-order” embryos. But this is only the case if you believe that embryos inherently have a claim to personhood. If you do not share this view, then the authors are leaving out the crucial difference: the embryos used for stem cell research will never become people. However, the creation of an embryo that is implanted into a woman (with a pregnancy-or-your-money-back guarantee) is about “respect for personhood” because it turns actual nascent life into a commodity, sold for a profit just like any other.

That is what is unique about this practice. But the NEJM article dismisses this and concludes that there is really only one important difference: “the lack of clear legal guidance as to the parentage of the embryos in question.”

“Parentage” is plainly not the real issue. As is the norm with gamete donation, the sperm and egg donors that were used to create the embryo would not be likely to have any claim to parenthood. The embryos will actually not have any kind of “parentage” at all. They will rather be owned by the fertility clinic, until a woman implants one into her womb.

California Conceptions markets their service as cheaper than using third-party eggs and IVF, and less time consuming than adoption. But it’s important to note that along with the heightened element of commodification, an additional imperative for “design” has seeped into their approach. To offset their costs, they have to produce embryos that multiple couples will find desirable as products. Cohen and Adashi may not find these “eugenic overtones” worrying, but acknowledging their existence is telling enough.

There is no federal law governing the sale of embryos and Cohen and Adashi note that it “appears to be legal in all but two states.” Indeed, this was the justification offered by Jennalee Ryan, who gained notoriety several years ago after advertising “the world’s First Human Embryo Bank” online. That turned out to be a failed business plan, run from her living room, but as she explained, “You know how it works? If there is no law against it, it’s legal.”

It’s one thing for eccentric business entrepreneurs to try to exploit a poorly regulated system. The fact that established scholars have made the case that we should accept selling embryos as ethical is much more troubling.

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Judge John Roach

Carolyn Compton is in a three year-old relationship with a woman. Moreover, according to Compton’s partner Page Price, Compton’s ex-husband rarely sees their two children. That same ex-husband was also once charged with stalking Compton, a felony, although he eventually plead to a misdemeanor charge of criminal trespassing.

And yet, thanks to a Texas judge, Compton could lose custody of her children because she has the audacity to live with the woman she loves.

According to Price, Judge John Roach, a Republican who presides over a state trial court in McKinney, Texas, placed a so-called “morality clause” in Compton’s divorce papers. This clause forbids Compton having a person that she is not related to “by blood or marriage” at her home past 9pm when her children are present. Because Texas will not allow Compton to marry her partner, this means that she effectively cannot live with her partner so long as she retains custody over her children. Invoking the “morality clause,” Judge Roach gave Price 30 days to move out of Compton’s home.

Compton can appeal Price’s decision, but her appeal will be heard by the notoriously conservative Texas court system. Ultimately, the question of whether Compton’s relationship with Price is entitled to the same dignity accorded to any other loving couple could rest with the United States Supreme Court.

Yet another reason why marriage equality needs to be the law of the land.

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Growing up, Lindsey Dawson never pictured herself as a wife.

“I thought marriage was just an institution and that it was sexist,” said the 31-year-old public policy associate. And, although she believed same-sex marriage should be a right, Lindsey herself was “kind of disinterested.”

That was, until she met Jessica Chipoco. They met on an online dating site after Lindsey moved to Washington, D.C.

Six months later they were living together. At nine months, they were talking about getting a house, and 20 months into the relationship they were anxiously watching TV on election night to see if they could get married in their state of Maryland.

“I didn’t feel that [marriage] was something I needed for myself,” Lindsey said. “But when I met Jessica, we decided we wanted to be committed…It just became, I wanted to advance our relationship further.”

Marriage has always been evolving, but it’s changed more dramatically in the past 100 years than in the past 1,000. And not just concerning who can marry — also when people marry, and why.

A recent study sponsored by the National Marriage Project at the University of Virginia titled “Knot Yet” made a splash by analyzing how young people are viewing marriage as a “capstone” more than a “cornerstone” to their adult lives: Rather than the launching point for prosperity and happiness, marriage is more likely to be viewed as an endpoint after establishing “financial and psychological independence.” Other recent data points to marriage as no longer being necessary in a successful life: The Centers of Disease Control and Prevention found that almost half of all first births are born out of wedlock, and a 2011 Pew study reports that nearly four in 10 Americans believe marriage is becoming obsolete.

Although the number of adults getting married is at a record low and more are finding the institution archaic, the dream of one day saying vows before an altar persists for many. According to the Pew study, most people who have never tied the knot — 61 percent — say they’d like to marry some day. Traditions in marriage have changed a lot since Lindsey’s grandparent’s generation, but one thing remains consistent: the desire to make it official.

Hyman & Estelle

Everyone in Lindsey’s family knows the story of how her grandparents met. They danced for the first time at her grandfather’s cousin’s 25th wedding anniversary.

“Who’s that skinny girl you were dancing with?” a relative asked Lindsey’s grandfather, Hyman Sherman.

“That’s the girl I’m going to marry,” he replied.

Her name was Estelle. They were supposed to have a big wedding in April 1942, but there was a change of plans when Hyman was drafted overseas during World War II. Friends and family advised them to get married before he left — that way, when he was out fighting, he’d have “something to live for.”

Estelle and Hyman Sherman married in Estelle’s sister’s living room, just their siblings and parents to witness the moment of matrimony before a rabbi. The few wedding photos they have show two happy, glowing faces, his eyes locked on her smile — there is no trace of plans and hopes soon to be disrupted by war. He went overseas for four years, and like many WWII couples, their interactions immortalized in dozens and dozens of letters.

Hyman and Estelle tied the knot on the eve of what could be called a marriage boom. While they got hitched relatively late — both were 28 years old — the pressure to marry young heightened after the war. The rate of marriage spiked all through the 1940s, before reaching a record high in 1950: by then, 78 percent of American households were occupied by a husband and wife, according the Pew Research Center. The median age of marriage was at its youngest in 1950, too; it dropped from 21.5 to 20.3 for women and from 24.3 to 22.8 for men within the decade.

The post-war era’s thriving economy contributed to an American Dream that was as scripted as a “Leave it to Beaver” episode. About one in four women took jobs outside the home to fill in the labor gap left by men fighting overseas, but as the men returned, women were expected to return to their roles as housewives. Women often got married right after high school — if they went to college, they’d joke it would be to get their “MRS,” or Missus. Husbands brought in most of the dough, and would remain so for the next few decades: According to Pew research data, only 4 percent of husbands had wives whose income topped theirs in 1970, compared to 22 percent in 2001.

On Hyman’s return, he and Estelle built a household that was not much unlike many of their neighbors’.

Hyman was the primary breadwinner, running a furniture store in the Boston area, although Estelle worked at the shop to help out. She was responsible for all domestic chores.

“My father did nothing!” recalled their daughter Syrel Dawson, laughing. “Because my mother took care of the house. She did all the cooking and dishes.” And, with Syrel, four children to look after.

From what Syrel remembers, her parents had a happy marriage until her mother died in 1982 (her father died in 1997). Not all women were lucky. Before the sexual revolution and wide availability of safe birth control, being a single woman in the 1940s and 50s provided a tremendous amount of anxiety — marriage often being the only way out. Pregnancy was something that constantly lingered in the back of every woman’s mind.

“To be unmarried and pregnant in the 1950s was to be in the deepest kind of trouble,” writes journalist Brett Harvey her 2002 book “The Fifties: A Woman’s Oral History.” “First of all, there was the shame; a kind of shame that’s unfamiliar to girls now: a profound and overwhelming feeling that you were bad and dirty in the deepest part of you, that you’d done something irredeemable. Then there was the terrible quandary of what to do.”

Most women knew little about abortion. Because it was illegal in most cases, woman resorted to word of mouth to find sympathetic doctors or much shadier — and dangerous — clinics. Dr. Alfred Kinsey’s infamous “Kinsey Report” in 1953 found that 20 percent of sexually active single women in the survey underwent abortions.

While abortion remains a controversial subject, the stigma of marriage out of wedlock has largely disappeared. In the 1980s, the average age of first child became younger than average age of first marriage, and in 2012, nearly half of first children have been born out of wedlock. In the 1940s and well into the 1950s, much of that shame is attributable to religion and the taboo of promiscuity. But most of all, there was nothing more pitiful than a single mother, supporting herself. Marriage was very much a part of wealth, identity and social class.

“Single motherhood was not a viable choice if you were white and middle class: The stigma was simply too crippling to live with. If you were black, your family and community might treat you with more compassion, but your life was irrevocably changed. The only option left, the one most white women took if they could, was marriage. But even marriage couldn’t shield you from censure if your baby was born at 35 weeks,” Harvey writes.

Mick and Syrel

Nineteen-year-old Mick Dawson came over from England to work at a summer camp in Massachusetts through a foreign exchange program in 1971. A coworker said he was going to go to his uncle’s house, and Mick went along.

“He didn’t mention that he had a beautiful young cousin,” Mick said. A week later, he returned to the house to pick up a record he left behind while he was on his way to do laundry in Plymouth. The cousin, Syrel, took pity on the boy, carrying a laundry bag on his only night off, and offered to clean his clothes for him. She suggested he watch the game with her father, but Mick said “I’d rather talk to you.”

The summer ended, and Mick had to return to England to finish school. But they continued to correspond through letters, which Syrel still keeps in a box. He came back the following summer for her, and she later took a trip to Brussels, where his family had been living.

“We were sitting in a little Belgian cafe,” Mick recalled, “and I said, ‘let’s get married’ and she went, ‘but-but-but you’re still an undergraduate,’ and I said, ‘just say yes.” Although they knew each other for almost two years, they had only officially been dating for four months. “We’ll figure it out,” Mick said.

Both 21 years old, Mick and Syrel had a small and beautiful backyard wedding in 1973. While their parents were supportive, Syrel said many of her relatives didn’t show up because Mick wasn’t Jewish – he was an atheist raised in a Christian home. They wrote their own ceremony — also unusual for their time — but they wouldn’t have found a rabbi to marry them, so they went before a justice of the peace the day before the ceremony.

Mick, who works at a biotech firm, and Syrel, a soon-to-retire teacher, are now both 60 years old and will be celebrating their 40th wedding anniversary this June. “I know how Mick and I are truly blessed,” Syrel said.

Blessed indeed. If the 1940s and the 1950s were about the rise in marriage, the 60s and 70s were about the rise of divorce. The divorce rate doubled from 1960 to 1980, when there were about 22.6 divorces per 1,000 married women that year. By 1980, many states allowed what is called no-fault divorce — the court no longer needed at least one spouse to have committed a crime or adultery as a grounds for divorce. Larry Bodine, a lawyer and editor-in-chief of Lawyers.com, says the spike is attributable for a number of factors: Divorce was easier, joint child custody became an option, and the stigma was largely gone.

“In the 1960s it would be the neighborhood scandal. By the 1980s, it was no big deal,” Bodine said. Pop culture contributed to that attitude: “Prominent people, to some degree, are role models. Celebs are getting divorced, and it just makes it a more acceptable thing.”

Additionally, interfaith marriages were very unusual. As Naomi Riley writes in her book “‘Til Faith Do Us Part,” the General Social Survey found that 15 percent of households were of mixed faiths in 1988. That eventually rose to 25 percent in 2006 and about 42 percent today.

Interfaith marriage, however, was never illegal in the eyes of American law — couples could always find a justice of the peace to seal the deal. For much of American history, interracial marriage was not only socially unacceptable but was illegal. Up to 1967, it was still illegal for people of two races to get married in 15 states because of anti-miscegenation laws. After the Supreme Court deemed it unconstitutional, interracial marriage became more and more common. According to a 2008 Pew study, rates of intermarriages among newlyweds more than doubled between 1980 (6.7 percent) and 2008 (14.6 percent).

There were a lot of things Mick and Syrel did differently than their parents, but like them, they jumped into marriage without living together. Neither had a stable, full-time job. For them, getting married felt right — the rest could be figured out later. As the “Knot Yet” study would describe it, their marriage followed a “cornerstone” model.

“We didn’t have two pennies to rub together when we got married. Each night, we’d write everything in a cash book,” Syrel said. “We’d turn our pockets out each night, and that was our lives as a couple.”

But unlike the Shermans, they shared both money-making and domestic responsibilities. At first, Mick stayed home with their only daughter, Lindsey, while he was working on his Ph.D. When he got a job, Syrel stayed home with Lindsey for a year. Always on a budget, they rarely went out to eat or for entertainment in their first year as newlyweds. Instead, they’d often read books out loud to each other.

“We had to get to know each other. We would get to know each other by reading to each other,” Syrel said.

Lindsey & Jessica

If the Shermans and the Dawsons had letters to anthologize their courtship, Lindsey and Jessica have online messages. Lindsey had just moved to Washington to continue her career in health policy. She signed up for the online dating site OKCupid. “Once I got there, I realized I didn’t know any people,” she said. “Honestly, I didn’t really think about it that seriously.”

Jessica, a 34-year-old attorney, received an OKCupid email alert. “I saw someone come up, and said, ‘Oh, she’s cute.’” At first, she was hesitant to get too committed because Lindsey was there on an internship. But then Lindsey found a full-time job, and soon it became clear that she was in D.C. to stay.

“It’s really abnormal for both of us to jump into something quickly and be so sure of something, but it just clicked,” Jessica said. She’d never imagined she’d meet someone to spend the rest of her life with.

“Growing up I assumed I would meet someone in college and get married. That didn’t happen, and then I went to law school and still didn’t find anyone,” she said. “Once I felt completely okay with being a single person, I met Lindsey.”

Considering the median age of first marriage is older than it’s every been before, getting married in one’s thirties is a regular thing these days. They tied the knot March 30 during a weekend-long ceremony by a cabin the Potomac woods, close to the hiking trail where they got engaged. But one could say they sealed the deal way earlier in a way more and more couples are, when they bought a house together in the suburbs outside the capital.

According to a recent survey by Coldwell Banker Real Estate, 24 percent of married millennials between the ages of 18 and 34 bought their home before they married, compared to 14 percent of couples who were over the age of 45.

Psychotherapist and Coldwell Banker consultant Dr. Robi Ludwig said for some couples, especially in the Northeast and Midwest, buying a home together is the new engagement.

“Couples right now are very fiscally aware,” Ludwig told CBSNews.com. “If we’re looking at the history of marriage, 50 years ago many women didn’t know a lot about finances and put this responsibility, for better or worse, in their husband’s hands,” Ludwig said. “Now, we’re getting married later, we have careers. If you want to be smart for yourself, you have to be financially responsible and aware.”

The less legally binding form of cohabitation, leasing a space, is even more popular. A recent study by the CDC found that 48 percent of unmarried women lived with their significant other. The number is a sharp increase from the 23 percent reported in 2002 and the 35 percent reported in 1995. Only 23 percent of the women surveyed said they got married to their boyfriends before living together. It’s a trend Larry Bodine of Lawyer.com says he thinks is contributing to a steadily decline in divorce rates since 1990.

Jessica and Lindsey both think it’s necessary for a couple to live together before getting married. But they recognized what a huge risk buying a house was. “My mom was born in 1939,” Jessica said. “Back then you would never move in with someone before getting married, but when it came to her daughter, she said I should do it.”

They wouldn’t be able to get married to begin with, however, if it weren’t for the LGBT movement. On January first this year, Maryland began allowing gay and lesbian couples to get married. As of May 14, twelve states had legalized same-sex marriage.

The two said they would have gotten married this March regardless — they would have gone to a courthouse in D.C. But being allowed to get married in the state they lived in, at a place that held so much meaning to them, was important to them. It meant Maryland took their marriage — and love for one another — seriously. The two also plan on adopting children someday.

“I was elated, overjoyed, relieved and overwhelmed at the same time,” Jessica said. “One of our neighbors saw us out in the yard the next day, and she pulled over her car, and got out to give us a hug.”

–

It’s difficult to say what a typical married millennial couple is, because there really isn’t one. Averages and numbers can point to trends, but married households in the 21st century vary so much from region to region, family to family. Marriage is no longer a prerequisite for success or motherhood, either, so why do people bother to get married at all?

Lindsey — like her parents, and her grandparents — say their answer is simple: “I was overwhelmingly in love with her.”

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While Prof Ozkan, the doctor who performed the first successful womb transplant, clearly has an interesting method (implanting wombs from dead donors), it is still tragic that a young woman with so much hope lost her child. The Daily Mail provides a detailed look into the process and where it may have gone wrong:

A woman who was the first to have a successful womb transplant from a dead donor has had her pregnancy terminated after the embryo showed no heartbeat, doctors in Turkey have said.

Derya Sert, 22, who was born without a womb, had been receiving in vitro fertilisation (IVF) treatment after the transplant in August 2011.

Her pregnancy was announced in April.

But in a statement released today by Akdeniz University Hospital in Turkey’s Mediterranean city of Antalya, it read: ‘Derya Sert’s pregnancy was terminated after her end of eight weeks examination showed no embryo heartbeat.

‘The general health status of the patient is fine.

‘IVF will be continued when she is ready, in appropriate conditions.’

Thousands of British women born without a womb were given hope if the breakthrough treatment succeeded.

But some British experts, including Lord Winston, claim that a pregnancy could cause potentially fatal complications.

The baby would have to be born by caesarean, which carries the risks of surgery.

Prof Ozkan performed the pioneering transplant on 22-year-old Derya Sert in August 2011.

Prof Ozkan, from Akdeniz University in Antalya, Turkey, also revealed three more women were to undergo transplants at his clinic, providing Mrs Sert has a healthy baby.

Mrs Sert, who is married to husband Mustafa, said at the time of the transplant: ‘If I had a magic wand, I would want to be pregnant now. I just want to hold my baby in my arms, to be a mother.’

One in every 5,000 women globally is born without a womb, while thousands more have the organ removed due to cancer or other diseases, leaving them unable to get pregnant.

TV presenter Yvette Fielding revealed in 2009 that she had undergone a hysterectomy to stop her agonising periods.

Fielding already has two children. However, many women are childless when they have the drastic surgery.

Those in favour of womb transplants argue it is the only way to meet the desperate desire of many of these women to ‘carry’ their own baby.

This need cannot be met if they use another woman as a surrogate, a controversial process that is strictly regulated in the UK and illegal in some countries, including France and Germany.

Many British couples end up travelling to India, where clinics hire out women as surrogates.

However, this is fraught with legal issues. For example, couples whose surrogate children are born abroad have to go to court in the UK to ‘prove’ they are the legal parents.

Adoption does not give a woman the chance to have a child who is genetically her own and, again, there is a strict vetting procedure.

Surgeon Richard Smith, a consultant at Imperial College London, has spent more than 15 years researching the possibility of pregnancy among women who have had womb transplants.

Last year he revealed his team had achieved the first successful pregnancy in a rabbit with a transplanted uterus, although the animal went on to miscarry.

He planned to carry out the procedure on five more rabbits before it is trialled in sheep.

Only then will Mr Smith approach UK ethics committees for approval to try it on humans.

Women who have lost their wombs to cancer need to have been free of the disease for at least five years before they can be considered for a transplant.

But womb transplants have been criticised by experts because they are not carried out to ‘save a life’.

Risks include rejection of the new womb and potential side effects during pregnancy from the powerful anti-rejection drugs.

After the first womb transplant, carried out in Saudi Arabia in 2000, the donated organ ‘failed’ after three months because the blood vessels used to connect it were too narrow and became blocked by clots.

However, Prof Ozkan does not doubt womb transplants are worth the risks for thousands of women otherwise unable to have a ‘normal’ pregnancy.

He has previously said: ‘Many people think that womb transplants aren’t necessary because they’re not lifesaving operations and that women have the option of adoption or surrogacy.

‘But we’ve had applications from women all over the world wanting womb transplants. This is absolutely necessary for these women: you just have to ask them to realise this.’

A total of 100 women were screened last year by Prof Ozkan in addition to Mrs Sert, who received her healthy organ from a car-crash victim.

Ten of these have been selected as possible recipients.

Prof Ozkan could have a race on his hands to become the first doctor to achieve a successful pregnancy from a womb transplant.

Swedish experts carried out two procedures last year, both involving the world’s first mother-to-daughter uterus transplants.

Prof Ozkan’s Turkish team used wombs from dead donors.

The scientists and doctors at the University of Gothenburg had received approval to complete ten procedures in total.

Doctors are divided over whether to use living or dead donors. Some experts are uncomfortable with taking the womb from a living woman when it is not for life-saving reasons.

With live transplants, there are risks to two living patients. However, an organ from a living donor can be a better match.

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It’s been 17 years since Dolly the sheep was cloned from a mammary cell. And now scientists applied the same technique to make the first embryonic stem cell lines from human skin cells.

Ever since Ian Wilmut, an unassuming embryologist working at the Roslin Institute just outside of Edinburgh stunned the world by cloning the first mammal, Dolly, scientists have been asking – could humans be cloned in the same way? Putting aside the ethical challenges the question raised, the query turned out to involve more wishful thinking than scientific success. Despite the fact that dozens of other species have been cloned using the technique, called nuclear transfer, human cells have remained stubbornly resistant to the process.

Until now. Shoukhrat Mitalipov, a professor at Oregon Health & Science University and his colleagues report in the journal Cell that they have successfully reprogrammed human skin cells back to their embryonic state. The purpose of the study, however, was not to generate human clones but to produce lines of embryonic stem cells. These can develop into muscle, nerve, or other cells that make up the body’s tissues. The process, he says, took only a few months, a surprisingly short period to reach such an important milestone.

Nuclear transfer involves inserting a fully developed cell – in Mitalipov’s study, the cells came from the skin of fetuses – into the nucleus of an egg, and then manipulating the egg to start dividing, a process that normally only occurs after it has been fertilized by a sperm. After several days, the ball of cells that results contains a blanket of embryonic stem cells endowed with the genetic material of the donor skin cell, which have the ability to generate every cell type from that donor. In Dolly’s case, those cells were allowed to continue developing into an embryo that was then transferred to a ewe to produce a cloned sheep. But Mitalipov says his process with the human cells isn’t designed to generate a human clone, but rather just to create the embryonic stem cells. These could then be manipulated to create heart, nerve or other cells that can repair or treat disease.

“I think this is a really important advance,” says Dieter Egli, an investigator at the New York Stem Cell Foundation. “I have a very high confidence that versions of this technique will work very well; it’s something that the field has been waiting for.” Egli is among the handful of scientists who have been working to perfect the technique with human cells and in 2011, succeeded in producing human stem cells, but with double the number of chromosomes. In 2004, Woo Suk Hwang, a veterinary scientist at Seoul National University, claimed to have succeeded in achieving the feat, but later admitted to faking the data. Instead of generating embryonic stem cell lines via nuclear transfer, Hwang’s group produced the stem cells from days-old embryos, a technique that had already been established by James Thomson at University of Wisconsin in 1998.

That scandal, as well as ethical concerns about the dangers of encouraging work that could lead to human cloning, dried up interest in getting the process to work with human cells. Then came a breakthrough in 2007, when Shinya Yamanaka of Kyoto University succeeded in reprogramming adult skin cells back to their embryonic state simply by dousing them in a concoction of four genetic factors and some growth media. That technique for generating embryonic-like stem cells (called induced pluripotent stem cells, or iPS cells) bypassed the need for transferring the cells into eggs, as Wilmut had done, and also averted the ethical issues attached to extracting stem cells from embryos as Thomson had done. Plus, the iPS cells had the advantage that patients could generate their own stem cells and potentially grow new cells they might need to treat or avert diseases like diabetes, Alzheimer’s or heart problems.

Except that researchers still couldn’t prove that the heart, nerve, muscle and other cells they made from the iPS cells were exactly like the ones generated from the embryonic stem cells. The gold standard embryonic stem cells still came from embryos themselves, including ones that were made through nuclear transfer.

Now that the technique appears to work with human cells, the process could be another source of generating stem cells that may ultimately treat patients, says Mitalipov. His group is especially interested in promoting the technique for treating mitochondrial diseases – these organelles posses a different set of DNA than that contained in the nucleus of cells, and are responsible for generating the energy needed for cells to function. But because they lie outside of the nucleus, transferring cells from a patient with mitochondrial diseases into a donor egg that has a healthy set of mitochondrial DNA would generate populations of cells that are free of disease.

In order to make the process work, Mitalipov says he modified more than a dozen steps in the process that proved successful with sheep and other species. His group had the advantage of working first with monkey eggs; the knowledge about what stimulated the eggs to start dividing helped him to make the appropriate changes in the human eggs that contributed to his success.

Beginning with high quality eggs that were donated by healthy volunteers was critical, he says. Most previous attempts involved discarded eggs from IVF clinics that may have been of lesser quality and affected their ability to survive the transfer process. From the monkey studies, the team also realized that the process of introducing the donor cell into the egg also required a gentle touch; timing the transfer at the point when the egg was most likely to accept the new genetic material and start dividing was important. Infusing a bit of caffeine into the process also helped. “Even though nothing we did seems that brand new – there wasn’t anything that people didn’t try in other species or we haven’t tried with monkey cells – but the right combination, timing and concentration made the difference,” says Mitalipov.

He estimates that about 50% of the success can be attributed to the quality of the eggs while the remaining 50% is related to the optimization of the process. So far, the technique appears to be pretty efficient; from eight eggs, the group generated four embryonic stem cell lines. In the future, Mitalipov anticipates it will be possible to produce a stem cell line from each donated egg. “We knew the history of failure, that several legitimate labs had tried but couldn’t make it work,” he says. “I thought we would need about 500 to 1000 eggs to optimize the process and anticipated it would be a long study that would take several years. But in the first experiment we got a blastocyst and within a couple of months we already had an [embryonic] stem cell line. We couldn’t believe it.”

Egli and other stem cell scientists are eager to replicate the process, to test how reliable and robust it is, and hurdles still remain before the technique is standardized. It’s not clear yet, for example, whether the process will work as efficiently with adult, or older cells, and healthy egg donors may not be as available in some parts of the country as they were in Oregon, where the state allows scientists to compensate donors for their eggs, just as IVF clinics do. But the achievement could establish another important source of stem cells that patients can generate to ultimately treat themselves.

Trained at UCLA’s Brain Research Institute, Philip H. Schwartz, PhD, is a full-time stem cell biologist and holds a Senior Scientist position at the Children’s Hospital of Orange County (CHOC) Research Institute. Dr. Schwartz is Founder and  Director of CHOC’s National Human Neural Stem Cell Resource (NHNSCR) and is Principal Investigator on stem cell-related research grants from the National Institutes of Health and the California Institute for Regenerative Medicine. 

Dr. Schwartz’s response follows:

The Mitalipov group is outstanding and they have previously done this with non-human primates.

The advantage of creating an embryonic stem cell line (a pluripotent stem cell line created during the destruction of an embryo) using the DNA of any particular individual is that, theoretically, cells or tissue derived from that line would be an immune match to the individual and would therefore not be rejected when they were transplanted into that individual. Transplant rejection is the biggest problem for transplantation medicine.

That being said, there are several problems with this approach, both scientific and ethical:

1) the egg that is used, even though it has been “enucleated” (i.e. had its nuclear DNA removed) still has other DNA that does not get removed – the mitochondrial DNA. So an exact immune match is impossible using this method as only the nuclear DNA will match, not the mitochondrial DNA.

2) for patient-specific therapy to work, and that is what we are talking about here, you would probably have to have one egg donor for each patient. Since donating eggs is NOT a walk in the park, there is an ethical problem with getting that many donors. Do you pay them? Would only the women that really needed the money step forward for this?

3) the other ethical problem is that real viable human embryos are created to be destroyed using this approach.

4) there is another approach, induced pluripotent stem cells, that can make the equivalent of embryonic stem cells from any given patient without going through the embryo stage. This has both an ethical advantage and a scientific advantage because no embryo is destroyed and the cells produced have both the nuclear and mitochondrial DNA of the patient. There may still, however, be residual immune rejection problems depending on how you make them.

It seems that like most groundbreaking scientific experiments, there are always positive and negative aspects to their results. Only time will tell where cloning human stem cells takes us.

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This sentencing, while welcome news to many, in no way remedies the damage that was wrought by Tonya Collins. That harm was irreparable, the damage caused largely indiscernible and no prison sentence will ever make her victims whole again.

This case has struck a personal chord with me since early 2009 when the first victims approached me about irregularities at SurroGenesis. I was blessed to get to know many of the victims in the course of our representation. Several have become dear friends. I know the pain they felt. It was palpable. Not at the loss of their money, but rather the realization that they will likely never get the chance to become parents. All because of the depraved behavior of Tonya Collins.

I recognize that under our criminal justice system, yesterday’s sentence was a watershed moment in our industry as it represented the stiffest sentence ever handed down in a surrogacy scandal. But before we pat ourselves on the back and consider that justice has been served, we need to step back and remember that many of the victims will never get to see their baby take its first step, hear their toddler utter the words “mommy” or “daddy”, get a chance to walk their young adult down the aisle or have the unadulterated joy of being grandparents. The money that was embezzled was tangential, even superficial to the real story. Instead, it was merely a means to an end. It represented the chance to have a child. And sadly that is the untold story that will haunt these clients and friends forever.

No matter how much time Tonya Collins serves in prison, many of our clients and now my friends, have forever lost their chance at becoming parents. Tonya Collins did not just steal money. She stole the dreams of decent, caring and trusting people who had already been victimized by being unable to have a child without the help of an egg donor or surrogate. She preyed upon the most vulnerable, the most in need and the most hopeful.

So yes, our imperfect criminal justice system functioned as designed yesterday. Perhaps the sentencing will be a clarion call to the industry and will serve to deter similar malevolent conduct in the future. That would be a worthy legacy to this heinous scandal, I guess.

Yet I cannot feel good about the outcome. I cannot help but feel bad for Tonya Colllins’ young children who will be losing their mother for years. But at least Tonya Collins got to hold her children. One day, relatively soon, Tonya Collins will be reunited with her family. The cruel irony, just twenty-four hours after Mother’s Day, is that while Collins will be able to continue to enjoy this holiday with her children, many of her victims will never get that chance. And no amount of jail time or statements of remorse can change that.

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ABC Local News

The owner of a Modesto surrogate agency accused of a $2 million fraud scheme was sentenced in federal court Monday morning. Tonya Collins, 37, was sentenced to prison on four counts of wire fraud in connection with a scheme to defraud more than 50 clients located throughout the country.

The prosecution argued Collins financially and emotionally preyed on couples’ attempts to have children and those who wanted to help.

Collins refused to answer any questions as she walked out of the federal courthouse in downtown Fresno — her family by her side. The 37-year-old was sentenced to 5 years, 3 months in federal prison for her involvement in a $2 million surrogacy scam. “It’s just not fair that one person can rob that from so many. That just breaks my heart,” said Beth Mardones of Chicago.

Mardones was one of those who fell victim. More than $20,000 she and her husband placed in an account through Collins’ surrogate agency, SurroGenesis USA, disappeared. “Devastated. I thought this just couldn’t be right because we had signed a contract. We did everything the right way,” said Mardones. “I just felt that all of our hopes of having our own biological child were shattered.”

According to court documents, Collins carried out the scheme from her Modesto-based surrogate agency between 2006 and 2009. Collins created a fake financial firm to hold clients’ funds but instead used the trust to pay for personal expenses — including vacations, cars and a home.

“She used false names, false identities to make it appear that they were really independent, separate employees working for this company when in fact it was her and others at her direction,” said Assistant U.S. Attorney, Kirk Sherriff.

Before sentencing, Collins did express remorse, telling the judge she was sorry for the pain she caused her victims. “I’m glad she was given some jail time to think about what was done,” said Mardones.

Mardones and her husband were fortunate to be able to have a child through another surrogate. But the same could not be said for other victims. “They only suffered monetary lost but for some victims, it was more than that. They lost in some cases their last chance to have a child,” said Sherriff.

Collins will have to pay restitution fees to the victims she defrauded. She will begin serving her 5-year sentence June 27th.

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Abortion provider Kermit Gosnell was convicted Monday of three counts of first-degree murder for severing the spinal cords of infants born during abortions at his West Philadelphia clinic.

Gosnell also was convicted of involuntary manslaughter in the 2009 death of 41-year-old Virginia woman Karnamaya Mongar, who died from an overdose of drugs while undergoing an abortion at the clinic. Prosecutors described the clinic as a “house of horrors” because of the unsanitary conditions and unsafe practices that defined it.

The trial now moves into a sentencing phase to decide whether Gosnell should receive the death penalty or face life in prison on the capital murders counts.

The verdicts were announced just before 3 p.m., a few hours after the jurors informed the judge in the case that they were hung on two charges.

It remained unclear which of the more than 260 charges against Gosnell had caused the stalemate. When jurors were brought into the courtroom about 11:15 a.m., Judge Jeffrey P. Minehart gave them what is commonly called a Spencer charge, telling them to reexamine the evidence and continue trying to reach a verdict.

“The fact that you are stuck on two counts — it shows you are considering the evidence seriously. It’s an indication of your sincerity and your objectivity,” Minehart said. “It’s a difficult case. We appreciate that.”

Minehart said the gridlock also could represent “confusion” about the details of the charges in the case and the evidence presented. He said he was sending the jurors back to further consider that evidence in hopes of reaching a consensus. But, he added, “no juror should surrender an honest conviction” merely to reach a verdict.

Monday’s verdicts came during the jurors’ 10th day of deliberations, which have stretched into a third week.

Gosnell, 72, faced four first-degree murder charges in connection with babies identified in court as A, C, D and E. He was acquitted in the death of Baby E.

He originally faced seven first-degree murder charges, but Minehart dismissed three of those charges.

Gosnell also originally faced a third-degree murder charge in the death of Mongar, but that was reduced to involuntary manslaughter.

He was found guilty of many lesser charges.

Prosecutors filed a slew of charges against him, including 227 counts of failing to observe Pennsylvania’s 24-hour waiting period before performing an abortion, two dozen counts of performing abortions beyond the state’s 24-week legal limit, and various other charges, including conspiracy and running a corrupt organization.

Investigators portrayed the Women’s Medical Society on Lancaster Avenue, which Gosnell ran for decades, as a little-regulated place where untrained, uneducated employees pumped patients full of anesthesia and labor-inducing drugs, and where women often ended up injured or sick. Prosecutors said they intended to seek the death penalty in the event of a conviction on any of the first-degree murder charges.

Jurors spent significant chunks of last week rehearing testimony of key witnesses, suggesting that could be wrestling over a peculiar legal quandary at the heart of the case: To find Gosnell guilty of murder, they first had to agree that the babies were alive outside the mother’s womb.

That remained a central dispute throughout the high-profile trial, which began in March.

Gosnell’s attorney, Jack McMahon, argued that no live births took place at the clinic because Gosnell terminated the pregnancies in utero using a drug called digoxin. A medical examiner could not say conclusively whether any of the infants had been alive after delivery, in part because their remains had long been frozen in a clinic freezer.

Jurors were left to rely primarily on the eyewitness accounts of untrained former employees who testified that women often gave birth in the clinic after being pumped full of drugs to induce labor. The former employees also described seeing infants move or make noises after birth, just before Gosnell severed their spinal cords with scissors. Some of those same employees performed abortions and have pleaded guilty to crimes, including third-degree murder, while agreeing to testify against their former boss.

Co-defendant Eileen O’Neill, an unlicensed doctor who saw patients at Gosnell’s clinic but did not participate in abortions, faces multiple charges of conspiracy and theft by deception for allegedly posing as a licensed doctor.

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