Embryo Donation

Introduction:

Embryonic donation--or embryonic adoption--is a high-tech method of circumventing some of the difficulties encountered by infertile couples in achieving pregnancy. It is most commonly used when both partners are infertile, one or both partners present a high risk of transmitting a genetic disorder to the child, or as an alternative to in-vitro fertilization (IVF) after multiple IVF procedures have failed (Mundy 2005). Generally, the procedure involves implanting a viable, living embryo directly into the womb, using a previously created embryo. However, the procedure can also be accomplished by combining separately extracted sperm and ovum for external combination and fertilization prior to implantation.

All stem-cell-related technology has been the focus of much media attention ever since the realization of the beneficial potential of human stem cells, primarily because of the moral issues related to the use of human embryos for medical research (Shreeve p.44). Embryo donation, on the other hand, raises altogether different ethical issues, but is, on the whole, far less objectionable even to many of those most opposed to stem-cell technologies and research, precisely because its goal is to generate human life from the embryos themselves. The fundamental moral objection to other uses of stem cells is that, unlike embryo donation, they result in the inevitable destruction of viable human embryos (Mundy p.17).

Procedures and Selection Criteria:

In-vitro fertilization is a well-known method of achieving pregnancy for couples that have failed to do so naturally, but it can require multiple procedures to accomplish the desired result. Therefore, IVF is often a relatively lengthy and expensive process that far exceeds the comparative cost of achieving pregnancy through implantation of donated embryos. On the other hand, IVF still offers the hope of parenthood that includes the advantage of using the genes of both parents, extracted separately and combined externally. However, for some couples, giving birth to a child sharing their genes is impossible, even through IVF; for them, embryo donation is a viable alternative that is less expensive and less likely than IVF to require repeat procedures.

Embryo donation is normally recommended for couples where either partner or both partners are infertile. Males who have extremely low sperm counts or no sperm at all are incapable of impregnating their spouses even through IVF techniques. Similarly, females may be incapable of producing ova by virtue of premature menopause, malfunctioning ovaries, ovaries damaged by infection, diseases, cancer, or treatments such as radiation or chemotherapy (IVF-infertility.com 2008).

Couples with known predisposition to genetic diseases, such as muscular dystrophy, cystic fibrosis, and Huntington?s disease face the dilemma of transmitting a devastating illness to their children or terminating their pregnancy, which may violate their personal or religious beliefs. While IVF procedures are available that provide pre-implantation genetic diagnosis, this presents additional complications and complexity to a procedure that is already difficult, and at considerably increased financial expense (IVF-infertility.com 2008).

The third category of potential candidates for embryo implantation are couples where the woman fails to respond positively to fertility drugs or whose own ova are of too poor quality to achieve pregnancy, or where repeated extraction attempts have been unsuccessful (IVF-infertility.com 2008). The donors of embryos for implantation are carefully screened for both genetic and inheritable disease. Both sperm donors and egg donors are subject to mandatory screening HIV, Hepatitis B and C, Cytomegalovirus, and syphilis, in addition to other specific traits like Sickle Cell Anemia, Tay-Sachs Disease, as required by both the American Society for Reproductive Medicine (ASRM) and the Human Fertilization and Embryology Authority (HFEA).

The main source of donor embryos is the excess embryos produced during the IVF process, because IVF procedures very often produce more embryos than necessary for a single pregnancy. As a result, approximately half a million potentially viable embryos are currently maintained in a frozen state in the United States (Mundy 2005). Frequently, couples who achieve pregnancy through IVF techniques donate their excess embryos for use by couples in similar predicament for whom IVF procedures prove unsuccessful. Alternatively, sperm and egg may be procured from separate individuals rather than from couples, for separate donation and subsequent mixing and fertilization prior to implantation. In either case, donors are screened just as carefully.

Political, Bioethical, and Moral Considerations:

In principle, all forms of human reproductive technology face political opposition from the Religious Right and other highly conservative groups. However, more moderate conservatives support embryo donation because it represents the antithesis of abortion and of fetal stem-cell research, because it culminates in living human beings rather than in the destruction of potentially viable embryonic tissue. Even President George Bush, always a vocal opponent of stem-cell research, supports embryonic donation. In 2005, he posed with pictures of 21 babies produced from 86,993 frozen embryos donated by successful IVF couples to other infertile couples in conjunction with his opposition to federal funding for embryonic stem-cell research (Mundy 2005).

A defensible and acceptable policy would be to support federally funded embryonic stem-cell research if the embryo is not destroyed, the embryo donation cell or cells are not used to produce a new embryo or clone, and the procedure does not prevent the embryo from being implanted. Some might argue that there is still a risk to the embryo, albeit it is notably less than is the risk from thawing or freezing. In this case, while there is some risk is to the embryo, the potential gain to society in general and to the people battling horrible diseases is clear. (Bartlett, 2001). Life forces the weighing of risk against possible gain in many things. In general, stem cell research can be viewed as a valuable weapon in the ongoing fight against disease.

While the term "embryo adoption" is sometimes used synonymously with embryo donation, it is important to make clear to donor couples that this term is highly inaccurate from a legal perspective (Kindregan & McBrien p.11). Unlike the case of bona fide adoptions, donors retain no legal rights whatsoever with respect to the donated embryo. The recipient couples are entitled to full parental rights that are indistinguishable from the rights of natural parents (Kindregan & McBrien p.12).

There are several other obvious advantages of "adopting" an embryo compared to traditional adoption of a full-term fetus or a child. Specifically, egg donation in the course of IVF procedures is very expensive, costing as much as $20,000 in fees for extraction, drugs, fertilization, transfer, and payment to the donor. By contrast, the typical cost of embryo donation and implantation is ordinarily no more than one-fifth of that and very often, even significantly less, because recipient parents pay only for actual medical costs; whereas egg (and sperm) donors are entitled to receive payment, federal law prohibits payment for viable embryos (Mundy p.57).

Perhaps even more importantly from the perspective of recipient couples, the source of donated embryos are usually other infertile couples who have already been subjected to the most rigorous screening. Whereas egg (and sperm) donors are also screened, they generally participate for profit and, therefore, have incentive to conceal information that could disqualify them. Furthermore, because traditional adoption and surrogate pregnancies require a third party to carry the fetus to term, the recipient parents are not necessarily in control of the uterine environment (Mundy 2005) and the health of their baby is subject to choices made by the surrogate mother throughout gestation. Finally, in that regard, surrogate mothers may sometimes suffer changes of heart and emotional attachment to the infant, which can complicate the transaction and introduce significant emotional turmoil for all involved once they deliver the baby.

Embryo donation still represents potential ethical issues, including "trait shopping" based on superficial characteristics. Presently, embryo donation is less controversial than embryonic research, but in the future, it may raise complicated issues in bioethics and in many areas of state and federal law (Kindregan & McBrien p.70).

Embryo Donation

Bibliography

IVF-Infertility.com Website. (2008) Retrieved February 17, 2008, from IVF-Infertility Website, at http://www.ivf-infertility.com

Kindregan, Charles, P., McBrien, Maureen. "Embryo Donation: Unresolved Legal Issues in the Transfer of Surplus Cryopreserved Embryos." Villanova Law Review. 86993. 169 (2004).

Mundy, Liza "The Booming and Bizarre Business of Embryo Adoption." Washington Post May. 2005. Retrieved February 17, 2008, from Slate.com website, at: www.slate.com/id/2119845/

Mundy, Liza. Everything Conceivable: How Assisted Reproduction is Changing Men, Women, and the World. New York: Knopf, 2007.

Shreeve. Jamie. "The Other Stem-Cell Debate." The New York Times Magazine 10 Apr. 2005; pp.42-7.

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