EAED 201: The History of Embryo Donation and Adoption
THE FIRST TEST TUBE baby, Louise Brown, was born in 1978. Now, one percent of U.S. babies are born through the use of assisted reproductive technologies. IVF is growingly popular among couples without fertility issues. The Centers for Disease Control (CDC) reported in 2010 that 6.7 million American women aged 15-44 were infertile, but 7.4 million had used “infertility services.” Many of those who successfully undergo IVF end up with extra embryos, frozen for future use if the first transfer is unsuccessful or the couple decides to have more children. In 2006, news stories estimated between 400,000 and 500,000 frozen embryos were in storage across the U.S.; some proponents of embryo donation claim that there are at least 600,000 now.
As the use of IVF grows, so, too, will the number of embryos in storage. Physicians and patients reduce costs and patient discomfort by minimizing the number of procedures performed and optimizing the results of each. Put simply, the physicians try to harvest as many eggs as possible, then create as many embryos as possible. At the same time, fertility specialists are moving toward a consensus that the optimal number of embryos to transfer is just one. Early recognition of these trends led to the emergence of embryo adoption. The year Louise Brown turned 20, another couple welcomed America’s first “snowflake baby,” the term advocates of embryo adoption use to describe the children born from this practice.
EMBRYO DONATION HAS BEEN
marginalized, but it may–and should–become more popular. President George W. Bush began an initiative to promote embryo adoption through the Department of Health and Human Services (HHS). President Obama continued the program. To date, Obama has signed off on the use of $13.4 million to promote embryo adoption—bringing the total U.S. federal funds used for this purpose to over $24 million. The program is administered by HHS, but the department doesn’t carry out the program’s mission to “educate Americans about the existence of frozen embryos … available for donation/adoption” directly: The office makes grants to agencies and clinics that create embryo adoption programs. Its grantees have facilitated embryo adoptions resulting in 630 infants.
The early proponents and recipients of “frozen embryo adoption awareness” grants were conservative Christian activists and adoption agencies. They tended to be strongly pro-Christian, anti-single parent, and anti-gay. But the newest grantees are less polarizing and more transparent. The National Embryo Donation Center (NEDC), although endorsed by the Christian Medical and Dental Association (CMDA), uses inclusive language. A medical practice, Boston IVF, received a $1 million grant to make embryo donation a possibility for more of its patients, while RESOLVE, an adoption agency, makes a point of saying that they support unequivocally a couple’s right to choose what to do with their embryos.
As new, more moderate advocates have begun promoting embryo adoption, the process has reached both parents with embryos already in storage and would-be parents contemplating creating embryos. Not all will choose to give their embryos away to be adopted, but an increasing number are open to the possibility—and even those who don’t give their embryos up for adoption may think about donating them to research.
EMBRYO DONATION IS DEPICTED
as ineffective and ideological. It need not be either. According to the NEDC, the success rate for adopted embryo transfers—involving a healthy embryo and an adoptive mother with no medical obstacles to pregnancy—may be nearly 50 percent, higher than many clinics’ overall IVF success rates. The embryo adoption movement is no longer primarily religious. Persuading would-be parents to adopt embryos instead of creating new embryos averts the creation of “extra” embryos and gives extant frozen embryos a chance to become children, an objective good if you believe that life begins at conception. But embryo adoption has other major advantages for single parents and couples who need IVF to conceive.
Many Americans prefer pregnancy to adoption, for the experience of carrying a child and giving birth, having the opportunity to bond immediately—and for more pragmatic reasons. Pregnancy, and even surrogacy through IVF, allows parents to conduct genetic prescreening and exercise control over a child’s in utero environment and birth. Adoption seems riskier: The prevalence of fetal alcohol syndrome, for example, is “between nine and sixty times higher” among adoptees and foster children. Parents’ concern may now legitimately extend beyond fetal exposure to drugs, alcohol, or other substances, as research gives us reason to worry about how maternal behavior affects childhood development.
IVF is expensive, often cripplingly so. Only 10 percent of insurance plans cover IVF, and the average cost of a cycle of IVF in the US is $12,400. Those open to adopting will still encounter financial obstacles. Most parents prefer to adopt an infant—and most such adoptions are private and cost between $30,000 and $34,000, depending on whether parents use an attorney or agency. While adopting from foster care may cost less than $3,000, the process may be lengthy as few infants are available.
By contrast, embryo adoption is affordable. The total cost of embryo adoption and transfer may be just $2,500 to $4,000. Affordability means that parents may be able to attempt an embryo transfer earlier, with a higher likelihood of success, rather than delaying until they are able to finance more expensive fertility treatments. It also means parents may be able to afford more than one attempt at implantation, rather than pinning hopes on a single procedure. The potential complications associated with embryo donation are the same as those attached to other fertility procedures. The potential threat to genetic diversity (and probability of “accidental incest”) is higher with sperm donation than embryo donation, which is not geographically concentrated.
Embryo adoption offers a viable alternative to invasive fertility procedures or adoption proceedings—and a compromise for members of the subset of parents who cannot conceive naturally but prefer pregnancy to adoption. Those who would not otherwise get to become parents have that opportunity; children who would otherwise have remained frozen are given the chance to develop and lead full lives.
Continue reading the original article in it’s entirety here:
The Frozen Children: The Rise – and Complications – of Embryo Adoption in the U.S.