You can arrange to have your baby's stem cells preserved at birth, but it's costly and you need your hospital's consent, writes FIONA REDDAN
STEM CELL research is not without controversy, but already it is starting to have a major impact on the medical profession. More recently, for example, it was discovered that stem cells may be able to correct muscle damage caused by heart failure.
While it is as yet not known how important stem cells may become in treating chronic and serious illnesses, some parents are betting that it will be, by preserving stem cells for their children. One of the easiest ways of collecting stem cells is to do so at the time of birth – but can you do this in Ireland and how does it work?
WHAT ARE STEM CELLS?
Stem cells are regarded as the building blocks, or raw materials, of the blood and immune system – cells from which all other cells with specialised functions are generated. There are several sources of stem cells – including embryonic stem cells, which have been the subject of some controversy; amniotic fluid stem cells; bone marrow; and umbilical cord blood.
Given the non-invasive nature of collecting stem cells from cord blood, it has become increasingly popular to collect and store these stem cells when a baby is born. These can then be used, if necessary, to help treat the child if they develop an illness at a later date.
IS STEM CELL PRESERVATION POPULAR IN IRELAND?
At present, there is only one regulated provider of such services in Ireland: Medicare. According to the company’s managing director, Michael Doherty, Medicare has to date had about 2,000 clients since it first started to offer the service in 2002.
However, the rate of growth has declined since regulation was introduced in 2006, although one might have expected that this would make it more acceptable to potential clients.
Regulation has also made it more expensive. About 200 people now engage in stem cell cord preservation each year, says Doherty, down from about 300 before regulation came in.
According to Doherty, over half of Medicare’s clients who wish to preserve cords on behalf of their children are healthcare professionals, such as doctors or chemists.
Internationally, it has become more popular. In 27 states in the US, for example, it is now the law that parents must be educated about stem cells.
WHY DO PEOPLE DO IT?
Parents preserve stem cell for their children for various reasons, but the main purpose is to store it in case it is needed in the future.
“We describe it as a form of health insurance – the accepted statistic of any child needing stem cell in their life-time is one in 400,” notes Doherty. “People come in very well informed, and our philosophy is informed choice.”
WHAT ARE STEM CELLS USED FOR?
To date, stem cells have been used in about 70 therapies worldwide. There are two types of treatment: allogenic, whereby a patient receives stem cells from a matching donor, and autologous, whereby the patient uses their own stem cells.
Stem cells are now used as standard in treating many illnesses, such as leukaemia and bone marrow cancers, as well as clinical trials, which do not, as yet, have conclusive results. These include type 1 diabetes, Crohn’s disease and lupus.
In 2010, the number of stem cell transplants exceeded those from bone marrow for the first time.
As science develops, the number of uses for stem cells may increase dramatically – on the other hand, progress may be stalled as scientific research focuses on other areas.
HOW MUCH DOES IT COST?
Cord preservation is not cheap in Ireland, and doing so for 20 years for one child, or for identical twins, will set you back €2,450, or €4,410 for non-identical twins, with Medicare.
Aviva is the only insurer in Ireland to make a contribution (€600 and €900 respectively) towards the cost.
Moreover, you can expect additional costs as, under Irish legislation, the mother needs to have her blood tested within 30 days leading up to the birth, and a minimum of six months after. These tests cost an additional €330.
However, as it’s a medical procedure, you may be able to claim costs back against your annual tax bill. So, if your total bill, after insurance reimbursement, comes to €2,180, you could reduce this by a further 20 per cent, or €436, by filing a Med 1 form.
WHAT IS INVOLVED IN THE PROCEDURE?
If you are keen to go ahead with the procedure, you will first need to engage with Medicare, and check that your hospital is willing to go ahead with it. If they are willing, a hospital staff member, who will be present at the birth, will be trained by Medicare under EU regulations to collect the stem cells.
Once the baby is born, it is checked by medical professionals and handed to the mother, while this trained professional takes the umbilical cord and collects the blood from it. The procedure should take no longer than 10 minutes.
The blood is then shipped to a laboratory, where the stem cells are extracted and can be stored and used for up to 20 years at a facility in the UK.
IS IT ACCEPTED IN HOSPITALS ACROSS IRELAND?
Given that a certain level of co-operation will be needed from the hospital in which the mother is going to give birth, it is essential that if you are interested in stem cell cord preservation, that you discuss it first with your midwife or obstetrician.
While Medicare has an established relationship with private hospital Mount Carmel, some of the public hospitals are more resistant. Indeed, according to Doherty, some of Medicare’s clients were refused the procedure in their local public hospital.
“We do advise that before parents proceed that they get the permission of their hospital and obstetrician,” he says.
DOES IT ALWAYS WORK?
On occasion, it may not be possible to collect sufficient blood, which means that it is not possible to extract enough stem cells to make storage worthwhile.
This can arise in cases where a baby is of very low birth weight or is premature, for example. According to Medicare, its failure rate is less than 10 per cent.
WHAT HAPPENS TO THE CORD CELLS?
Stem cells can be stored privately and used to treat only the child from whom they originally came.
They could also be used to treat a sibling of the child, given that stem cells have a one in four chance of being an exact match for siblings.
However, in other countries such as the US, for example, it is also possible to store stem cells in banks which can be accessed by members of the public. These banks store stem cells which can be used to help treat people who are unrelated to the donor.
While it may be possible to donate stem cells to just such a bank, at present, none exists in Ireland.
“Public banking must be encouraged; it’s something we will be pushing for,” says Doherty.
For 20 years for one child, or for identical twins. cord preservation will set you back €2,450 or €4,410 for non-identical twins with Medicare
