Stem Cells


Everybody asks, "Should I have my umbilical cord blood stem cells frozen and stored?" Usually, by the time patient is asking me this question, she has been bombarded with advertisements from the stem cells storage companies. But, even if the patient doesn't ask me, I will ask the patient at about 20 weeks. In my practice, it  is a prenatal care checklist item for 20 weeks, along with the 20 week genetic and anatomy sonogram. So, I will make sure that the patient has the information that she needs to make a good decision.

First of all, everybody should be aware that umbilical cord stem cell storage has not been endorsed by any professional group other than the stem cell companies themselves. My ACOG states that this procedure is unnecessary. Anything that is unnecessary is not going to be a covered benefit under the health insurance. So, anyone who does it is going to have to find a way to pay for it.

It costs anywhere from $1350 to $9000 or so to get the process started. The price varies from company to company. There is also variance on what exact services you have contracted for. There are some companies that will take the whole placenta and use it to get more of the stem cells. Other companies will take a short segment of the umbilical cord itself. All of these things are added cost.

Once the stem cells are frozen and kept under liquid nitrogen, the companies that do this work will charge you once a year to keep the cells frozen. The yearly charge is something on the order of 150 to 250 dollars a  year. I suppose that if you don't pay, they would throw out the stem cells. Or maybe donate them to science, or a public stem cell bank.

What is the benefit of doing this?

The stem cells that are retrieved from the umbilical cord, fetal blood, and placenta, are processed and examined by the cord blood storage companies. Then they are deep frozen under liquid nitrogen. This does not kill the cells. It preserves them for future use. If, in the future, this baby has some kind of medical problem that can be cured with an infusion of stem cells, then the stem cells are there for the baby to use. These problems are usually some kind of leukemia or cancer. In that case, the future oncologist has the option of removing this victims bone marrow cells, curing the cancer, then thawing out the stem cells, and then restoring the immune system with those stem cells. This is all only theoretical, because the successful cases done like this are rare.

The stem cell companies claim that about one out of 200 stored units are eventually put to use. I have not seen an independent validation of this claim. If this is so, then I think that everybody should do the stem cell storage. I think it is more likely that there is a small number of stem cell units that are used. The rest will stay frozen indefinitely.

There is a ton of ongoing research right now to see if stem cells can be used to treat a bunch of other conditions. There is some some studies being done for heart disease, and some even on autism. So the applications for stem cells seem to be widening. It may be that the future for stem cells is very wide indeed.

On the other hand, biotechnology marches on. It seems now, that many times, the biologists can get stem cells retrieved even from grown ups. If this is so, then there is no reason to store the fetal cells, as everyone has stem cells. We can use the adult stem cells to do the job of the fetal stem cells. If that is true, then no one needs to freeze the fetal stem cells, we have our adult cells and that will be good enough.

So, in the final decision making, a family needs to decide the odds of using these stem cells, versus the odds of not using them or not needing them because the body makes it's own. I also tell my patients that if they need the stem cells years later, and they didn't store them, they may be very sorry.

And then the decision is affected by how much you value the 2000 dollars or so you invest in it.

I tell a family, "if you have a lot of money, then you can spend a lot on the stem cell fees". On the other hand, "If you don't have a lot of money, and 2000 dollars will break the bank, then don't do it. Either way, I will help you both figure out the right thing to do is, and I will help you do it. You need to make your decision some time before the placenta comes out."  I will then note in the chart that we had the discussion, and I will note whatever they seem to be deciding at the moment. We will revisit this discussion throughout the rest of the pregnancy and I will offer to help decision making.

The majority of the people in Bergen County will decide that they do not want to pay for it.

If they do, there are a couple of good choices available.

Viacord is the biggest company. They are based in Ohio. They will not let you visit your unit of blood. They generally will not negotiate with you. They will provide my office with 500 dollar coupons that people can use to lower the price from 2300 to 1700 dollars.

Neostem is the best local company. They are based in the next town, Allendale New Jersey. I personally have met some of the people, and I like them. They will let you visit your unit of blood. They have good prices. They will talk to you on the phone. They also have a coupon available in my office.

CBR is another big company.

There are a hundred others.

The local blood bank still does it as well. I don't know why more people don't use them. Maybe they are being out marketed by the commercial providers? I don't think the blood bank markets the service at all. They used to have an open donation program that was free to donors. I sent a lot of donors their way. The donor program is now closed due to lack of money. As you can imagine, the donor program was quite expensive to administer. If it ever opens again, I will send a lot of patients to the blood bank for stem cell donations. It was a very very popular program with my patients when it was still open.

Ultimately, the decision to store the stem cells is difficult for most people. It is an assessment of risks, potential benefits, and costs.

Sometimes, the grandparents have a very strong opinion, and take action. It's great watching them when they do this. It becomes a parent taking care of a child, but the parent is the new grandparent, and the child is the pregnant women and her husband. The grandparents say, "where doing this, that's all their is to say about it". They will allow no dissent. And then the stem cells are stored.

I don't know how the stem cell companies find the pregnant women to market to, but they seem to use some kind of internet magic. There was a story of a 17 year old girl who got pregnant, and did some looking around the internet on Google. Pretty soon, there were items in her mail box to help her with the pregnancy, and try to sell her things. This, despite nobody but her knowing about the pregnancy. Her Father read the mail, and found out she was pregnant. I don't know the outcome of that story. There is a strong lesson there, though. The lesson is, almost nothing one does is the modern world is completely private. I think, for the sake of safety, always assume there is a camera watching you, and there is someone who knows what you do on the internet. There are technical ways to block that snooping, but I am pretty sure they are not completely successful at blocking your trail.

I think the next post will be about Hyperemesis Gravidarum, as that is what our beloved princess Kate is hospitalized with right now.

Thank you sincerely,

John W Marcus MD FACOG
89 North Maple Ave
Ridgewood NJ 07450

phone 201-447-0077
fax 201-447-3560
blog at doctorjohnmarcus.blogspot.com