By PPL Board Member, Patricia June, MD
In discussing the ethics of embryo adoption, we cannot forget where these embryos originated. When God does not enable a couple to conceive naturally, they may attempt in-vitro fertilization which involves many ethical crossroads: will the sperm and ova involved come from a married husband and wife? How many eggs will be exposed to sperm resulting in how many potential embryos? What is the maximum number of embryos who will be returned to their mother’s uterus? If more embryos result than can safely be implanted, what will happen to the “excess” embryos?
Couples can leave them in frozen limbo, have them “disposed of” (killed) or allow them to be experimented upon and then killed, OR they can donate them to a couple unable to conceive, through embryo adoption. Here, the adoptive mother receives the embryo, (after proper preparation to ensure the best environment for implantation), and carries and gives birth to her and her husband’s adopted child. The donors know that their children will have the possibility of continued life.
The adopting parents are blessed both by attempting to “rescue the perishing” and also can ensure that their children will not be exposed to tobacco, alcohol, marijuana and other drugs in utero, etc.
History
Within 6 years of the birth of the first “test tube baby” conceived through in vitro fertilization (IVF) in 1978, a method of freezing IVF embryos was developed. It soon became common to induce the mother to hyperovulate, producing a large number of eggs which were exposed to sperm, resulting in a large number of embryos. Why? Retrieving eggs is expensive, carries some risk for the prospective mother, many embryos do not survive, embryos could be genetically tested and only those passing the eugenics test could be picked for attempts at implantation. Since artificial reproduction is an unregulated field, many fertility clinics had no moral constraints.
Given the risks of higher multiple births, eventually the number of embryos inserted into the mother’s uterus was limited, generally to not more than three, (and now often to one or two), and any leftover embryos were frozen. Sometimes the hyperovulation process made the mother sick enough that all the embryos were frozen, awaiting a more auspicious time for attempted implantation. Soon the estimated number of frozen embryos rose to around 500,000. Of these about 87% remain to potentially be returned to their biological parents, but others were destroyed or used for human experimentation and then destroyed.
Although the legal system considers embryos “property” rather than persons, Christians recognize them as a person bearing the image of God. The first embryo adoption was facilitated by Nightlife Christian Adoption in 1998. Nightlife coined the term “Snowflake” in reference to embryos because they are all frozen, unique, and created by God. Since 2002 over $24 million U.S. federal funds Have been used promote embryo adoption through grants to agencies and clinics that create embryo adoption programs. To date, Nightlife has had over 700 babies born.
in 2004 the Christian Medical and Dental Associations (CMDA) assisted the Southeastern Center for Fertility and Reproductive Surgery in Knoxville, Tennessee in establishing the National Embryo Donation Center. By 2020, the NEDC has provided both lie and televised presentations to nearly all of the 486 fertility clinics in the United States. Embryos have been donated from all 50 states and patients have traveled to Knoxville from 48 states for their embryo transfers and over 920 babies have been born. Today at more than 120 transfers annually, the NEDC has nearly reached the maximum number of patients it can see each year and is actively searching for an affiliate like-minded clinic, preferably in the Northeast, Midwest or West Coast, to expand the growing ministry of the NEDC.
According to NEDC, there is never a charge to donate embryos, and parents can change their minds (for a fee) until a match is made. Both NEDC and Nightlife treat the embryos as human children, and though embryo adoption is a legal property transfer, in all other aspects it is treated as an adoption with a required home study and the option for biological and adopting parents to decide whether the adoption will be anonymous or open and how much future contact there will be. Nightlife gives the option of shipping the embryos to the parents’ infertility clinic, whereas NEDC stores donated embryos and does the transfers in its Knoxville clinic.
There are many websites for embryo adoption, and parents considering donating embryos need to carefully check out the various organizations. Nightlife (www.nightlife.org) does not list its requirements for potential adoptive parents, but is a Christian organization. Some organizations will let single women, same-sex couples, etc adopt (see NRFA at https://www.nrfa.org/embryo-adoption-academy/#myanchor1), NRFA is critical of the limitations that Christian organizations apply. The following is copied from the NEDC website at www.embryodonation.org.
“Many choose to adopt through the NEDC because of our superior pregnancy rates (54% in the most recent reporting year). Many donate embryos through the NEDC because of the peace of mind provided by our home study requirement, which means their embryos will go to a stable, healthy family. And all are reassured by our nearly two-decade-long track record and commitment to keep strengthening the NEDC long-term, ensuring the ability of embryo donors and recipients to receive and share information in the future. We work hard to assure our donors that their embryos will be placed in healthy, stable homes with loving parents.
· Couples must be a genetic male and a genetic female married for a minimum of 3 years.
· The combined age of the applicant couple must not exceed 100 years.
· The adopting mother must be healthy and able to carry a child to term with a maximum age of 45; BMI under 40; no smoking during the application process, embryo transfer preparation and procedure process, or during pregnancy. Surrogates are not an option for carrying the pregnancy.
· At least one partner of the recipient couple must be a legal citizen of the United States, Mexico or Canada or have a permanent US work visa
· Couples must complete and pass a comprehensive family assessment (home study) prepared by a state-licensed adoption agency in the couple’s state of residency.
· You will have two visits to the NEDC office in Knoxville, TN.
· Open relationships can allow as much or as little personal information as you and your donors wish to share.”
Embryo adoption is expensive: agency fees (plus home study/legal fees) for the initial attempt are comparable to each attempt at IVF, around $10,000-15,000, with second attempts less than half that. Private embryo adoptions might cost only $3500 but carry more risks.
Ethical recommendations
CMDA has “called for parents undergoing reproductive technologies to allow the in vitro process to produce only the number of embryos they are committed to implant now or later, regardless of whether successful pregnancy is achieved early in the process. Our embryos are no less our responsibility than our born children.”
“With that vision in mind, we would like to see the huge excess of embryo cryopreservation in this country halted, and there are now excellent options for it utilizing oocyte (egg) vitrification (flash freezing).” Egg freezing started as a way to protect the certain loss of fertility in female cancer patients. (It should not be used merely to delay motherhood). Eggs are fragile; the successful thaw rate of eggs is less than that of embryos, yet knowing that the freezing and thawing process costs some embryos their lives, egg freezing for future IVF cycles can be used to reduce the number of embryos created per cycle. The loss of an egg is not the loss of a human being. Roughly, 10 frozen eggs will result in four to six embryos, which can be returned to the uterus two at a time, resulting in an average of two- to-three living infants.
God cares for the “healthy” and for the disabled. Pre-implantation diagnosis which results in destruction of “less than perfect” embryos is not part of God’s call for us to care for the least of these.
As long as there are frozen embryos, embryo adoption is a life-affirming action. Yet at PPL, we, too, look forward to the day when the freezing of eggs rather than of embryos, will decrease the risks involved in the freezing and thawing of our smallest brothers and sisters.
“Our vision is that all frozen embryos would be used in attempts to create an ongoing pregnancy,” said Dr. Keenan, the NEDC physician.