What to do with excess embryos? One doctor has an idea

WASHINGTON (RNS)— The woman across the table told Dr. Jeanne Loring she was on the horns of a dilemma—feed and clothe her existing family or continue to pay to keep frozen her embryos from an earlier fertility treatment.

The woman, a hairdresser who was married to a mechanic, had had one child and then triplets—all born after successful in vitro fertilization treatments.

“I can’t afford to keep the remaining embryos frozen,” the woman told Loring over lunch. “I can’t afford to feed the family I have.”

The question of what to do with excess—or unused—embryos can be vexing for parents who have completed their families. Those frozen embryos—currently estimated at about half a million in the U.S.—typically are discarded, given to researchers for stem cell research or “adopted” by other couples.

But for some families, none of those options is attractive. Some, like the woman Loring encountered, simply can’t afford the $300-$600 annual fee to keep the embryos stored at -320 degrees Fahrenheit. Others have moral qualms about handing over potential human life to science or entrusting their genetic offspring to total strangers.

Loring, director of human embryonic stem cell research at the Scripps Research Institute in La Jolla, Calif., didn’t need more embryos for her research, and ethics rules precluded her from encouraging a donation to science. She felt badly about destroying the embryos by discarding them. All Loring could recommend was donating the embryos for possible implantation in another woman’s womb.

Surely, she thought, there must be a better way.

Although she doesn’t know what the woman ultimately decided, the incident stayed with Loring. She’s already established a storage bank for people wishing to donate embryos for scientific research, and now, Loring would like to help establish a different kind of bank for frozen embryos.

That bank might retain the embryos indefinitely or perhaps have an adoption component, though she wonders how effective that option really is. “There are not enough uteruses to accommodate even the embryos that are frozen,” she said.

The main purpose of her embryo bank would be to relieve the responsibility—financial, moral and otherwise—from parents who feel they face no good options. And if religious groups feel so strongly about the fate of unused embryos, she said, perhaps they can help foot the bill.

“There needs to be a group that says we’re going to do something about this,” she said. “The issue they are not facing is (these groups) are against using embryos for research, but … they are not offering another solution.”

Supporting or providing adoption opportunities “is the role of religion,” said Loring, who said she is not personally particularly religious. “I don’t think it is the role of a scientist.”

The fate of unused embryos has taken on new resonance after President Obama lifted an eight-year ban on federal funding of embryonic stem cell research. Obama has said embryos cannot be created solely for research, but most experts expect researchers to secure embryos from leftover IVF treatments.

In a typical IVF treatment, hormones help a woman stimulate her production of eggs, which are then fertilized with sperm to create an embryo. Doctors select the healthiest embryos for implantation. The rest typically are kept on ice.

Numbers vary, but some couples are left with as many as 12 to 14 remaining embryos. Many observers, including the Roman Catholic Church and some evangelical groups, believe the fertility industry is too profit-driven and should not be creating so many extra embryos in the first place.

Without so many excess embryos, the thinking goes, the question of what to do with them would answer itself.

A 2002 study of 430 fertility clinics by the RAND Corporation, a nonprofit research organization, found nearly 400,000 embryos had been frozen and stored since the late 1970s, when the first successful “test tube baby” was conceived. Today, that number is estimated at 500,000 and growing.

RAND found the majority of frozen embryos—more than 88 percent—are kept for family building; 2.8 percent are donated for research, leaving nearly equal portions to be donated to others (2.3 percent) or discarded (2.2 percent).

Some groups, like Colorado-based Focus on the Family, consider embryonic stem cell research tantamount to taking nascent human life and advocate instead for embryo adoption.

Carrie Gordon Earll, a bioethics analyst with Focus on the Family, said many couples who had completed their families through IVF had not fully “connected the dots” that the procedure could leave them with both leftover embryos and a moral dilemma.

“It dawned on us that what you have with frozen embryos is the opportunity for early adoption,” Earll said. “We are rescuing an adoptable child.”

This form of “adoption,” though, has its critics. Abortion-rights groups generally object to the term “adoption” since they believe that a fertilized egg is not a human being. And the Catholic Church—while both pro-adoption and anti-abortion—says IVF violates the principle that all life must be considered fully human from the moment of conception.

Tad Pacholczyk, director of education at the National Catholic Bioethics Center in Philadelphia, said Christian ethicists have been predicting disaster for years as they watched the growth of the “multibillion-dollar” fertility industry. He describes the 500,000 stored embryos—the equivalent of the population of Tucson, Ariz.—as “caught in a frozen orphanage.”

Pacholczyk said the question should not be what to do with the existing leftover embryos, but rather, “How can we stop the production of more frozen embryos” to begin with. Germany and Italy, he noted, prohibit the creation of more than three embryos during IVF, and all must be implanted.

Pacholczyk pointed to the Vatican’s December 2008 document on bioethics, “Dignitas Personae,” that urged caution on the idea of “prenatal adoption” of frozen embryos. While adopting embryos seems “praiseworthy with regard to the intention of respecting and defending human life,” the document said the matter presents medical, psychological and legal problems.

Like the Catholic Church, Focus on the Family also objects to the creation of excess embryos, calling it an irresponsible use of technology. Still, as long as there are surplus embryos, the group will advocate for their donation and adoption rather than research or destruction.

Earll, for one, was skeptical about Loring’s proposed embryo bank because she believes embryos ought to remain the responsibility of the families who created them.

“Parents need to be engaged in deciding about the welfare of their children,” she said, “whether they’re born or pre-born.”

Pacholczyk agreed that maintaining the frozen embryos is the “minimal duty” for a biological parent. He recommended keeping the excess embryos on ice until they were no longer viable, followed by a “decent burial.”

Yet ultimately, he said, “there isn’t any simple solution.”