news item: “Embryos for Donation: Where are the Ethical Boundaries?” by Carole of Fertility Lab Insider

Years ago, when I first started researching and googling because we were having troubles conceiving, Carole’s blog is one of the very first ones I came across. She has directed several fertility labs since 1995, and her blog is a wealth of information on all things fertility related, and I have always found her posts on everything from ART to the ramifications to the ALI world of pending political bills to be incredibly informative and insightful.

This week the post that grabbed my attention was one that she wrote about a lab that is now offering embryos via an egg donor/sperm donor cycle. She described it as follows:

Couples pay a set price –roughly equivalent to the cost of a fresh IVF cycle– to participate in the program and each couple gets two embryos from the pool of fresh embryos created using donated eggs and donated sperm in their shared cycle. None of the recipient couples have a genetic link to the created embryos. Any remaining embryos are frozen pending assignment to other couples outside the original shared cycle, defaulting to a type of custody or perhaps ownership (?) on the part of the embryo donation clinic until they are matched with a recipient couple. If a couple fails to become pregnant from the pre-paid cycle, they get another embryo creation cycle at no charge with a new egg and sperm donor. A brief description of the embryo donation program can be found on the California Conceptions website, but it is a little short on details.

Now I never did IVF, but from talking with many of you, I know that the question of what to do with the remaining embryos after family building is complete is a tough one. This takes it to a whole new level wherein the clinic would have effective “ownership” over these embryos before excess embryos are assigned to a new couple…and by extension, that clinic would have ownership over life.

Carole goes on to say:

Apparently, the means by which embryo donation is carried out is evolving beyond the simple traditional model which requires that we give some thought to what limits, if any, we want to put on the process of embryo donation. Should embryo donation be limited to donations from patient gamete-created embryos only? Is it ethically okay to design an (arguably) more cost-effective system to produce more “donor embryos” to meet the demand? I don’t have the answers. For me, the ethical way to handle embryo issues is  always to be fully transparent with all individuals involved and- as much as is possible–to look out for the best interests of the embryo’s future as a donor-conceived child.

Before commenting on this post, I highly recommend reading the entirety of Carole’s post because she raises a lot of really valid points and questions. Then come back here and let us know…

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What do you think about a business owning embryos?

What did you do / will you do with your leftover embryos? Was this a consideration for you when deciding whether or not to pursue IVF?

Do you think this is a realistic, ethical way to help with the possible shortage of donor embryos?

Is the cost benefit of this idea to IF patients a major or minor factor in your feelings about the issue?

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Comments

  1. I’ll start at the bottom. Cost benefit is a major factor. With insurance labeling IVF as an elective procedure in most area of the U.S. these costs come out of saving and personal loans in order for many to afford the procedure. By the time a couple is to the point of needing donor embryos, they’re likely in debt already from previous unsuccessful attempts to have a child.

    My question would be who decides which couple will get the top grade embryos?

    For me the benefit of this program would be a matter of quality. The problem with donated their leftover embryos is they’re the lowest quality embryos left. The higher quality ones where already used by the couple already. Are they still capable of growing into a healthy child, sure they are. But the statistics are surely lower or doctors wouldn’t bother grading them in the first place. This program would be a way to help these couples secure embryos of higher quality and a higher chance for success.

    If we had ended up with leftover embryos, we planned to donate them.

    What I also have issue with is a couple paying the price of a fresh IVF cycle to participate. I’m assuming the two donors are being paid for the donation and those costs must be covered. Still, 4 couples each paying for a fresh IVF cycle where it really is just a single cycle with 4 recipients seems high to me. Sure the couples don’t have the stimulation drug costs on top of this, but still.

    As far as businesses owning embryos…not sure I want to make a quick decision on how I feel about it.

    • GREAT points on all counts. But I still don’t like it 😉

      • Yeah, I’m so torn on this. I think the cost benefit is a major incentive, because you’re right – if people are to this point, they have already spent 10s of thousands. However – who DOES get the “best” embryos, and how does that work? And if a business entity ends up owning the “not so great” embryos, how does that work? Too many unknowns for me – I think a lot more regulation is needed for this so that the pro-life movement can’t use it to say SEE – IVF IS BAD!

  2. Short thoughts after reading the article:

    I think that this clinic in particular is doing the “owning the embryos” thing ethically, by assigning people in this program to bonus embryos before there are any so no storage happens without a recipient planned. I think there’s a lot of risk in this though, so it makes me ethically nervous that there are no positions out there taken by groups of doctors or ethicists.

    The cost bugs me too. If you’re sharing a donor, shouldn’t the cost be lower than a fresh IVF cycle (or does donor egg/donor sperm cost much more and so “only” the cost of IVF means a lot less money)?

    And I’m bothered by how you decide who gets the one (should there be only one) top grade embryo. Is that something that’s laid out for all participants ahead of time?

    I also feel like the ethics of donor eggs aren’t really all that neat. Maybe my view is skewed because I have a friend who started out donating and now works for a plasma bank, but I worry about donating our body parts for profit, and that often the risks aren’t clearly spelled out in ways donors really understand.

  3. This gives me a pain in my chest that I can’t even describe. On the surface, I don’t like this. These are not donor embryos at all – they were created for 4 couples who paid a lot to get them
    (the cost of a fresh cycle is WAY too high * 4 when you consider the cost of a donor cycle is a fresh cycle + $10,000 (roughly) for the egg donor). This sounds like baby brokering to me and I equate it to paying someone to go out and get pregnant so that they can give their child up for adoption to someone else. I would like to know what these “donors” are being paid out of the money being paid by each of the four couples.

    What about these babies who are out there, in the same general vicinity, with 3 100% genetic siblings around the same age?

    Recipe for disaster all the way around.

    And IVFmale makes so many great points, the greatest being who decides who gets the best embryos? All 8 aren’t going to be of the same quality – that’s impossible. I also like his point about normal donor embryos not being the best quality – that is 100% true. The 5 embryos we have left right now are the ones that the embryologist thought were of lesser quality than the ones we’ve transferred.

    This is hard – because my gut says it’s wrong, wrong, WRONG but my head sees the value in it for couples who really want to have a baby and are willing to give this a shot. The idea of this makes me sick. But… I also see the good in it. Ugh.

    I do agree that the personhood movement will use this to try to squash IVF across the board, and why wouldn’t they? That alone tells me this is not a good idea. For that reason alone, I would like to see this HIGHLY regulated by some entity like SART.

    • That was one of the 1st things that struck me – these kids have 100% genetic siblings around! And what if one falls sick later in life – can they “call on” the others to help? SHOULD they be able to? So many confusing repercussions regarding this.

  4. Is it something that can be regulated in the same way adoption is? Or is it already like that? My heart tells me if this can help someone achieve their dream then ….. But I agree with Courtney in that it would have to be highly regulated and it should definitely not be another money spinning exercise by people who already charge too much money.

  5. I was considering embryo donation as a possibility for our frosties (we have 3 on ice) but apparently embryos created from a donor cycle (in NZ) are not allowed to be donated/adopted. Despite half of them being ‘donated’ already, I’m unsure exactly what the ethical issue is, maybe I’m missing something glaringly obvious as I can’t see how difficult it is to keep track of what goes where.
    I have no idea what we will do them if we are lucky enough to have ‘completed our family’ with just one of the frosties, it seems so wrong to me to just discard them if I am not going to use them (I know the reality is that it might take them all to get that 2nd baby, if at all) but I have a real issue with just throwing them out, after what we have been through and what other people go through. Yes it was something I was aware of before going through IVF (what to do with surplus embies) but I was not aware until a few weeks before starting our cycle that there was such a block on donating on embryos from donor cycle

    • Wow – I have no idea why that would be blocked. 😦 Let us know what you end up figuring out!!

      • It may take a while yet. Our FS pretty much told me “you could look into it, spend thousands on lawyers fees, and most likely end up with exactly the same answer I’ve given you” (paraphrased).
        I just want to find out why there’s a block too, even if nothing comes of it. Even if we gain written consent from the donor and find our own recipients etc . . . just don’t understand that blanket decision from ECART

Trackbacks

  1. […] Josey found an article for us about embryo donation and some of the ethical issues it presents. This is something I knew very little about when I read the article, and I find the myriad legal complexities of this issue alone to be fascinating. Go check out “Embryos for Donation: Where are the Ethical Boundaries?“ […]

  2. […] LAST week PAIL posted on this topic. As someone who has embryos left over from her fresh cycle, this kind of hit home. HARD! The […]

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