Many infertility patients with unused frozen embryos are dissatisfied with the common options offered to them, such as donating to another couple or discarding the embryos, according to a study to be published Thursday in Fertility and Sterility, the New York Times reports. It is estimated that more than 400,000 embryos are frozen at clinics across the U.S., and many infertility patients grapple with the decision of what to do with embryos after they no longer want additional children, the Times reports.
The study, which was conducted by researchers at Duke University Medical Center, involved a survey of more than 1,000 infertility patients at nine clinics (Grady, New York Times, 12/4). The survey found that donating embryos for research was the most popular option (Rubin, USA Today, 12/4). Among study participants who said they did not want any more children, 66% said they would be likely to donate their embryos for research, but only four of the nine clinics in the survey offered the option. Fifty-three percent of participants who wanted no additional children said they did not want to donate their unused embryos to other couples, mainly because they did not want their biological offspring to be raised by other people or have to address the possibility that their own children could encounter an unknown sibling in the future. In addition, 43% did not want their embryos discarded, and 20% said that their embryos likely would remain frozen indefinitely. Embryos can remain viable for 10 years or more if properly stored, although not all of them survive after thawing, the Times reports. According to the Times, a small number of study participants “wished for solutions that typically are not offered,” such as holding a ceremony during the thawing and disposal of the embryos or placing the embryos in the woman’s body at a time during her cycle when she was unlikely to become pregnant, so that they would “die naturally” (New York Times, 12/4).
Lead author Anne Drapkin Lyerly — a bioethicist and associate professor of obstetrics and gynecology at Duke University — said a significant factor impeding embryo donation for research is the Bush administration’s 2001 restrictions on federal funding for research on new embryonic stem cell lines (USA Today, 12/4). Brigid Hogan, chair of the department of cell biology at Duke, said there is insufficient funding to fully research existing embryonic stem cell lines, leaving minimal use for the hundreds of thousands of embryos available. Hogan said, “Even if somebody said, ‘I’ve got 100 embryos I’m donating tomorrow,’ I think there are many places that would just say, ‘We don’t have the funding'” (Collins, Raleigh News and Observer, 12/4). Sean Tipton — a spokesperson for the American Society of Reproductive Medicine, which publishes Fertility and Sterility — said researchers are reluctant to accept embryos donated from other medical centers because of concerns about violating informed consent procedures. Lyerly added that the process of shipping frozen embryos also presents a challenge (USA Today, 12/4).
Lyerly said, “The national debate presumes that if you care about and respect a human embryo, you would want that embryo to have a chance at life.” She added, “What we found was that people cared very much about what happened to their embryos, but one of their significant concerns was that their embryos not become children in families other than their own” (Collins, Denver Post, 12/3). Mark Sauer, director of the Center for Women’s Reproductive Care at Columbia University Medical Center, said choosing what to do with the leftover embryos is a “huge issue” for couples, adding that some patients ask to be given their leftover embryos, while others pay storage fees for years and years. The Times reports that some patients stop paying for storage and “disappear, leaving the clinic to decide whether to maintain the embryos for free or to get rid of them.” Sauer said patients who do that “would rather have you pull the trigger on the embryos. It’s like, ‘I don’t want another baby, but I don’t have it in me; I have too much guilt to tell you what to do, to have them discarded.'”
According to Lyerly, many patients create as many embryos as possible to increase their chances of having a child. She added that more information needs to be given to patients early in the in vitro fertilization process to inform them of their options for unused embryos and letting them know that deciding what to do “may be difficult in ways you don’t anticipate.” She said that discussion about the embryos should be “revisited and not happen just at the time of embryo freezing, because people’s goals and their way of thinking about embryos change as time passes and they go through infertility treatment” (New York Times, 12/4).