Letter To The American College of Obstetricians and Gynecologists (ACOG)

C. Ward Kischer
Reproduced with Permission

In 2004 I became aware of a book published hy the ACOG, authored by the ACOG Committee on Ethics, which contained a chapter entitled: "Preembryo Research". Finding objections to the content of this chapter, I wrote the following letter with my comments about the "preembryo " to Dr. Stanley Zinberg, identified as the Deputy Vice President of the ACOG.
Dr. Zinberg wrote a reply to me as follows: dated February 3, 2005
"Thank you for your letter of January 27, 2005, outlining your concerns with the terminology used in the "Preembryo Research " chapter of Ethics in Obstetrics and Gynecology, Second Edition. I will share your letter with the ACOG Committee on Ethics, which authors this book, at its meeting next month.
Staff will share any response from the committee soon thereafter."
Copies to: Arlene J. Morales, MD.
JeJ/rey L. Ecker, MD.
Mary F. Mitchell
As of this writing, 3 July, 2005, I have not received any communication from the ACOG. - C. Ward Kischer, Ph.D.

Stanley Zinberg, M.D., FACOG
American College of Obstetricians
And Gynecologists
409 12 St. SW
Washington, D.C. 20024-2188

P.O. Box 96920
Washington, D.C. 20090-6920

Dear Doctor Zinberg:

27 January, 2005

Thank you for your letter of 15 December. I welcome this opportunity to address the chapter "Preembryo Research" in the publication of the book "Ethics in Obstetrics and Gynecology" by the ACOG.

The term "preembryo" is a fraudulent term and is not certified by any human embryologist.

My qualifications for this truth are as follows: I am a retired emeritus professor of Cell Biology and Anatomy, specialty in Human Embryology. I taught this subject, as well as other anatomical disciplines, for 30 years, the last 20 of which were spent at The University of Arizona, College of Medicine. I have written extensively about the term and concept "preembryo". If you are interested, you can plug in my name in a Yahoo search and find many examples of my articles.

My declaration that "preembryo" is not certifiable is not uniquely mine.

There is no bona fide contemporary textbook of Human Embryology which uses this term. Keith Moore and T.V.N. Persaud, in their 5th edition of "The Developing Human. Clinically oriented embryology" used this term and indexed it. At my behest, they deleted the term both in the text and index in the 5th printing of this edition, and have not used it since. Also, at my urging, they did the same with the term "individuation".

Adding to this declaration is the fact that, again, because of my communications with them, the Nomenclature Committee of the American Association of Anatomists categorically refused to recognize any certification of the terms "preembryo" and "individuation". This Committee is the one which certifies the lexicon for Terminologia Embryologica This is the official organ for the language of Human Embryology. These terms are also not used in the Carnegie Stages of Human Development.

Ronan O'Rahilly, the current Dean Emeritus of Human Embryology, in his textbook "Human Embryology & Teratology" comments that the term "preembryo" is fraudulent and not used by any human embryologist.

I have read the chapter "Preembryo Research". To criticize the entire chapter would compel me to be seriously redundant. So, I will limit my further remarks to just one or two points.

First, you do not cite the original coinage of that term, that of Clifford Grobstein's article in Scientific American in 1979. In that article he freely admits that he is inventing the term in order to "reduce the status" of the human embryo. He then proceeds to abuse the facts of Human Embryology in order to make the term believable. Clifford Grobstein was [now deceased] a frog embryologist, given to speculations that, unfortunately, found their way into the public discourse, but never into the discipline of Human Embryology, save for the one instance of Moore and Persaud's text, which they corrected with apologies.

You cite justification of the "preembryo" term as the lack of "individuation" until approximately the 14th day p.f. You ignore the fact that monozygotic twinning accounts for only 0.22% of all live births. Of those identical twins, approximately one-third are "determined" early, probably in the first or second cleavage. This can be determined by observation of the clinical aspects of the placentae.

What accounts for the singleness of 99.78% of the rest of the live births? The answer is unknown.

Second, the chapter states that "1 or more blastomeres can be removed from the aggregate and the remainder can still produce a complete adult". The only place I have seen "evidence" for this is an on-line report from the Shady Grove Fertility Clinic, hardly a peer-reviewed source.

The use of the term "totipotent" in the chapter is careless, and does not address the true status of each of the blastomeres during cleavage upto and including the inner cell mass, which to this day is unknown. The use and definitions of other terms are also precarious.

Third, the speculation about the "high rate of loss of zygotes" is frought with serious conclusions. The chapter combines this speculation with the presumed availability of "spare preembryos" with "overcoming human problems". This smacks of the 1930s declaration of the "untermenschen" by the Nazis.

Fourth, and lastly, the chapter cites two Human Embryology texts in the references, those of Moore and Persaud, and of Sadler, as if, by implication, they support certification of the term "preembryo". They do not. At best this is disingenuous; at worst this is fraudulent.

I am well aware of the history of influence of Clifford Grobstein and the Reverend Richard McCormick on the Proceedings of The American Fertility Society and on The ACOG. I find it most regretable.

I am sure you will not appreciate this abbreviated critique; but, I would hope that somehow, someday, that you folks would be willing to carry on some constructive dialogue with Human Embryology. After all, it is implied that what we have been teaching to medical students all this while has been in error. That is a very serious implication.

With all good wishes,

C. Ward Kischer, Ph.D.
Emeritus professor of Cell Biology and Anatomy
University of Arizona
College of Medicine

Mailing address:

6249 Camino Miraval
Tucson, Arizona 85718
e mail: wardkischer@yahoo.com