Morgan Carter
04/22/2020
Embryo adoption is growing. For instance, in 2016, the latest year for which empirical data is available, findings by both CDC (2018) and Lester (2019) indicate that more than 260,000 in vitro fertilization (IVF) were attempted in the United States. Of these attempts, over 150,000 resulted in direct transfers of embryos – either from fresh donors or cryopreserved surplus. Reliable data about the number of frozen or cryopreserved embryos is lacking, but studies estimate the total at between 600,000 and 1,000,000 in the United States alone, with an additional 20,000 embryos being added every year (Clark, 2014; Lester, 2019). In fact, between 2000 and 2016, more than 2 million transfers of embryos were recorded by the CDC in the United States. Of these, only about 16,000 were donor embryos with the remaining (over 99%) coming from the growing depositories of unused frozen embryos. The number of donor transfers per year nevertheless rose rapidly over the same period. It increased from less than 334 in 2004 to over 1,940 in 2014 – and findings show that it is continuing to increase (Lester, 2019). Embryo adoption has given donated embryos a chance to become babies and proven to be a viable alternative for treating infertility among assisted reproduction techniques (ARTs), thus providing other couples with the opportunity to experience pregnancy as well as give birth and raise a child. However, the procedure is getting entangled in a never-ending ethical and legal debate. Embryos, whether freshly donated or cryopreserved in a “frozen limbo,” are obviously living – as evinced by their development and potential ultimate delivery as viable offspring. But then again, in their present state, do embryos, which comprises only of a few cells represent human tissue or an individual human being – a person worthy not just of dignity, but also respect and legal protections? This article argues in the affirmative, and the following is why.
Infertility is a persistent and growing problem worldwide. In the United States, 2.1 million married couples (or about 5 million people) are estimated to be affected by infertility (Clark, 2014). Infertility, defined herein as failure to conceive following a year-long period of unprotected sex, is a consequence of several factors – 40% of which are due to male factors, another 40% due to female factors, and the remaining 20% are a combination of both or unknown origin (Clark, 2014). The toll of infertility is complex and multifarious, and couples are
affected psychologically, physiologically, and even financially. The ethical and legal burden of it is also fundamental. Available data show that between 85% and 95% of infertile couples tend to receive conventional treatment, and between 10% and 15% are more likely to become candidates for various forms of ARTs to help them get pregnant and have their own biological children. IVF is the most widely used procedure, and according to Clark (2014), it accounts for as much as 99% of ART.
Since it was introduced to the world way back in 1978 with the successful implantation and subsequent birth of Louise Brown, in Cambridge, United Kingdom, IVF has grown to become an established mainstream scientific treatment for several forms of human infertility (Keenan, 2011). As a medical practice, IVF entails the creation of a human preimplantation embryo by the union of male sperm and female ova in the lab. The principal objective of this laboratory procedure is to accord affected patients with the opportunity to have children using either own eggs and sperms or from donors. It is designed to result in pregnancy when other treatment options have either failed or are inappropriate – and since its inception has been effective in helping infertile couples have children (Keenan, 2011). The procedure is, however, still inefficient and costly. One key aspect of the inefficiency is that IVF has resulted in numerous cryopreserved embryos with no definitive plan for disposition. It has been estimated that since the late’70s, there are 500,000 plus embryos frozen and stored with about 20,000 being added every year (Clark, 2014).
Freezing the embryos has facilitated the limitation of the total number of embryos transferrable to a woman’s uterus – a phenomenon that has also decreased the average number of multiple gestations. Most importantly, the freezing of embryos has allowed couples to preserve their frozen embryos for use in the future, especially if the initial cycles have proven unsuccessful. Besides being effective, the freezing of embryos also lowers the cost of subsequent IVF procedures. The issue, however, has been what to do with the surplus frozen embryos, which has been increasing in number. A variety of options have been proposed. The embryos could be unfrozen and then destroyed. They could also be cryopreserved indefinitely, used for scientific research, or offered for adoption/donation. Whereas all these alternatives present significant problems, the adoption option has arguably stirred the most controversy, medically, legally, and more so, ethically (Clark, 2014).
Medically, for instance, the lifespan and survivability of a cryopreserved embryo are unknown. The potential effects of the freezing process on the development and quality of the embryo if brought to term is also less understood. Studies, such as Clark, (2014) have established that babies conceived through IVF tend to be born with major congenital disorders and are twice as likely to be underweight compared to babies conceived naturally. Tarkan (2008) reveals that of the IVF twins born in 2004, 56% weighed less than 5.5 pounds, while 65% were born prematurely. Besides elevating the odds of preterm births and infant mortality, IVF has also been associated with long-term health complications such as pre-eclampsia, C-section, and gestational diabetes. With a 10-25% implantation rate, the survival rate for implanted embryos is another issue. Successful birth rate varies from 11% for women aged 40 and above and 35% for those under the age of 35 (Clark, 2014). These figures show that several IVF embryos do not survive, thereby requiring multiple transfers per cycle and numerous cycles.
Legally, the connotational meaning of the terms “adoption” and “donation” remains elusive and highly divisive (Kindregan Jr. & McBrien, 2004; Clark, 2014; Patterson, 2015). There is also no clearly set federal laws regarding the legal caveats of embryo adoption. Indeed, according to Kindregan Jr. and McBrien (2004), the term “embryo adoption” is both ambiguous and misleading. This is because it connotes that the procedure for donating an embryo is based and governed by adoption laws. Also misleading is the implication that the donee and donor couples voluntarily partake in the frequent practice of criminal background checks and home investigations to ascertain parental fitness as it usually occurs in child adoption processes. “Embryo donation,” on the other hand, has been used to connote a non-commercial transfer of embryo ownership, for which no explicit authorization is required. The donation, is nevertheless, a property concept, and some have expressed reservations against substituting property law categories for traditional parentage as a way of statutorily protecting the parties involved in the transaction (Kindregan Jr. & McBrien, 2004). Regardless, the state, as well as the Uniform Adoption Act (UAA), nullifies the biological parents’ consent to adopt an embryo.
Ethically, embryo adoption continues to stir up significant moral controversy. Currently, the bioethical debate has centered on the notion of radical environmentalism, which elevates nature to the highest possible level of determinism. For proponents holding this perspective, cryopreserved embryos are put at equal footing with other frozen floral and faunal species with bias or particularly preferred status. Efforts are, however, directed towards ecological concerns. Other secondary ethical issues raised by the procedure regards the matters of appropriateness (or lack thereof) of knowledge stewardship, the commodification of medical practice, social justice, right of privacy, and even discrimination – showing partiality in selecting, which embryo to donate and transplant (Keenan, 2011). Another popular view is the theistic perspective. For theists, human life is sacred and deserving of both dignity and respect, from syngamy, in the few hours following fertilization. This view is Keenan’s (2011) argument and is the basis upon which the assertion that a one-celled embryo is indeed a person is centered. Thus, and despite the numerous arguments to the contrary, embryo adoption is necessary and ethical. Several reasons attest to this conclusion.
First, embryo-donation is an effective family-building option for persons affected with infertility. Such persons include women suffering from premature ovarian failure or is irresponsive to conventional ovarian stimulation. The technique has also proven effective for men suffering impairment in gamete production, thus providing them with an opportunity to conceive, experience pregnancy, bring forth, and raise children (Söderström-Anttila et al., 2001). Moreover, embryo donation has been indicated for couples carrying hereditary conditions that instigate significant morbidity in the child (Söderström-Anttila et al., 2001). Second, and besides fulfilling a person or couple’s desire to have a child, embryo adoption is also present significant financial benefits (Kaminsky, 2014). For example, according to Lester (2019), the transfer of donated embryos is significantly cheap compared to virtually any alternative to natural pregnancy. The cost for adopting a child can run into several thousand dollars, while a single IVF round can go at between $12,000 and $17,000. In contrast, the donation of embryos averages approximately $8,000, making it viable and affordable to most individuals. Keenan (2011) echoes similar sentiments, noting that the cost for embryo adoption is about $7,800. This amount compares to nearly $12,000 for local traditional adoption and around twice as much ($15,000) for an IVF cycle.
Third, embryo donation has grown since 1978 to become of one of the most accepted methods in ARTs in several parts across the globe, including the US, Australia, and in several most EU countries like Spain, Finland, the UK, Belgium, and Russia (Söderström-Anttila et al., 2001). In addition, embryo adoption is fast becoming a preferred option for most people not just because of the potential to grade the embryo for their viability but because it allows the parents-to-be to choose the gender as well as the appearance of their baby. It also allows the embryo to be genetically tested for diseases and chromosomal abnormalities, which is critical for eliminating congenital germline disorders as well as saving both the parents and the child from the disadvantages that come with such disorders in later life.
Perhaps the most potent argument in favor of embryo adoption is Patterson’s (2015) deliberation on the same. Addressing the morality of saving a frozen embryo, the researcher argues that moving the embryo from the freezer into the nurturing environment of a woman’s womb does not violate or contravene the transmission of life. It similarly does not intrude upon the good of matrimony nor the relationship between the potential mother and the baby. This is because the adoption entails no sexual act. Besides, the baby is neither marital nor a substitute for marital association (Patterson, 2015). The act of embryo adoption, therefore, does not involve fertilization. This procedure has already been attained in the lab. As such, the good of life transmission and the good of marriage exuded by the act does not feature. In fact, to further highlight the appropriateness of embryo adoption, Patterson (2015) suggests that the procedure is comparable to a mother nursing a foundling conceived out of marriage, abandoned, but rescued by a suitable individual or partner. Thus, and despite the ongoing legal and ethical debate on the issue, it can be argued, and rightly so, that embryo adoption is both essential and ethical.
This article has examined, albeit briefly, the arguments for and against the practice of embryo adoption. Sentiments and perspectives on the notion are diverse and conflicting. It is found that depending on an individual’s supposition about when human life potentially begins, three outcomes are possible. First, embryos are persons. Second, in their state, embryos are properties (governed by property rights). Third, that embryos are budding human life capable of growing and attaining satisfactory maturity and functional human ability to qualify. Subsequently, the article has established that the case in favor of embryo adoption seems to present the superior case – cryopreserved embryos are nascent biological life, human in both origin and destination.
References
Centers for Disease Control and Prevention (CDC). (2018). 2016 Assisted Reproductive Technology National Summary Report. US Dept of Health and Human Services, Atlanta (GA). https://www.cdc.gov/art/pdf/2016-report/ART-2016-National-Summary-Report.pdf
Clark, P. A. (2014). Ethical Implications of Embryo Adoption. In C. Atwood & S. V. Meethal (Eds.), Pluripotent stem cell biology: Advances in mechanisms, methods and models. IntechOpen. https://doi.org/10.5772/58592
Kaminsky, M. (2014, July 9). Legal aspects of frozen embryo adoption. Retrieved May 11, 2020, from https://www.legalzoom.com/articles/legal-aspects-of-frozen-embryo-adoption
Keenan, J. (2011). National Embryo Donation Academy Reference Manual. B. D. Motto (Ed.). National Embryo Donation Academy (NEDA). https://www.embryodonation.org/wp-content/uploads/2015/01/webManual.pdf
Kindregan Jr., C. P., & McBrien, M. (2004). Embryo Donation: Unresolved Legal Issues in the Transfer of Surplus Cryopreserved Embryos. Villanova Law Review, 49(1), 170-205. https://digitalcommons.law.villanova.edu/cgi/viewcontent.cgi?article=1254&context=vlr
Lester, C. (2019, February 17). Embryo ‘Adoption’ Is Growing, but It’s Getting Tangled in the Abortion Debate. The New York Times. https://www.nytimes.com/2019/02/17/health/embryo-adoption-donated-snowflake.html
Patterson, C. (2015). Embryo adoption: Some further considerations. The Linacre Quarterly, 82(1), 34-48. https://doi.org/10.1179/2050854914y.0000000029
Söderström-Anttila, V., Foudila, T., Ripatti, U., & Siegberg, R. (2001). Embryo donation: Outcome and attitudes among embryo donors and recipients. Human Reproduction, 16(6), 1120-1128. https://doi.org/10.1093/humrep/16.6.1120
Tarkan, L. (2008, November 9). Lowering odds of multiple births. The New York Times. https://www.nytimes.com/2008/02/19/health/19iht-19multiples.10170147.html