What do you do when you undergo in-vitro fertilization, conceive a child and find yourself left with extra embryos? One Oregon couple kept theirs in the freezer for 19 years after having a set of twins via IVF, in case they wanted to expand their family more someday. But, year after year, they didn’t move forward and instead paid their annual storage bill of several hundred dollars. Finally, they decided to give their four remaining embryos to Kelly Burke, 45, a single woman from Virginia. Two were thawed and transferred to Burke’s uterus, and she’s now a mom to smiley 9-month-old Liam James.
This story is remarkable on many levels. First, the embryo that became Liam is believed to be one of the oldest ever that was thawed after being frozen for so long. His siblings who were conceived at the same time are now college age. Second, the way Liam came into this world is part of a growing trend of embryo donation that represents a promising solution to our national problem of hundreds of thousands of leftover IVF embryos languishing in storage.
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As the use of IVF to treat infertility rises rapidly—more than 154,000 cycles were performed in 2011, compared with roughly 146,000 in 2010, according to the Society for Assisted Reproductive Technology—couples are often faced with the agonizing decision of what to do with their leftover embryos. Do they donate them, give them to research, discard them or leave them in storage indefinitely?
In theory, embryo donation seems like the ideal solution: You have embryos you don’t want. Other people desperately want them. But of course, it’s hard to for many couples to get past knowing that someone else would be raising their biological children (or their siblings unknowingly mating with them—a risk known as “accidental incest”).
One survey of more than 1,000 patients from nine U.S. fertility clinics who had extra embryos found that nearly 60% said they were “very unlikely” to donate them to another couple trying to have a baby; only 7% were “very likely” to consider this option. “It was the idea that their child was walking around, and they couldn’t ensure it was having a great life,” says lead author Dr. Anne Drapkin Lyerly, an ob-gyn and associate director of the Center for Bioethics at the University of North Carolina at Chapel Hill. “If they couldn’t raise that child, many felt that the responsible choice was to make sure they didn’t become children in someone else’s life. One woman told me, ‘I’d rather have them destroyed than born.’ ”
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But more and more people are deciding to have them born into other families. In 2011, there were 1,019 transfer cycles from donated embryos, which is up from 933 cycles in 2010. More than one third of those led to the birth of at least one child, according to the Centers for Disease Control.
Couples who want to donate embryos have two options: They can go through a fertility clinic or an agency, and the experiences are quite different. For example, at the Center for Human Reproduction in New York City, which oversees about 20 such arrangements a year, donor couples allow the clinic to post information about their embryos’ genetic characteristics on a website. Interested recipients undergo physical and psychological screening. If it’s a match, the embryos change hands anonymously, and the recipients pay about $5,000 for the medical costs. However, at many agencies, donor couples are allowed to choose the recipients, who must undergo long waits, extensive vetting and home visits. The donations are called embryo “adoptions” and can cost thousands more.
Embryo adoption is a controversial term, and the American Society for Reproductive Medicine recently issued an opinion arguing that the term should be reserved for actual living children. Yet the question remains whether allowing donors to have control over who gets their embryos would help them feel better about giving them up. “Our patients view it as adoption,” insists Stephanie Moyers, marketing manager for the National Embryo Donation Center in Knoxville, Tennessee, which stores some 300 sets (ranging from 1 to 20 embryos) from clinics. In fact, she says more than half of donors prefer an “open” process—which can range from asking to be notified of a pregnancy and a child’s milestones to regular contact and visits. “In one case, the donor and recipients families go to Disneyworld together every year,” she says. “The twins are five now.”
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As the practice grows, there are kinks to be worked out about which approaches work best for donors, recipients and the resulting children. And there are broader social consequences to be considered—namely the more than 100,000 children in foster care whose average age is seven to eight who might end up even more likely to be overlooked for adoption.
Yet, as our national stockpile continues to multiply, IVF patients are going to think more and more about embryo donation as an alternative to indecision. That includes Liam’s mom, who has two embryos left, donated by another woman, the fate of which she must now decide.