Clinics Full of Frozen Embryos Offer a New Route to Adoption

February 25, 2001

WASHINGTON, Feb. 24 — On the afternoon of Feb. 14, an express courier truck
arrived at an Atlanta fertility clinic to make an unusual pickup. Waiting
for the driver, frozen inside a thermos of liquid nitrogen, was the promise
of human life: 12 fertilized embryos, the genetic offspring of Susanne and
Bob Gray.

For the Grays, now parents of four, the shipment represented an escape from
a moral quandary. Their embryos, left over from fertility treatment that
resulted in the birth of twins, had sat in cold storage for years while the
Grays, Christians who describe themselves as deeply religious, agonized
over what to do with them.

Their solution: to put the embryos up for adoption.

A California adoption agency introduced the Grays, of Alpharetta, Ga., to
an infertile couple from Virginia. The two families met in December.
Lawyers drafted an "embryo adoption" contract, and the Valentine's Day
shipment is now at a fertility clinic in Fairfax, Va., where, the
prospective mother says, doctors will soon implant three embryos into her
womb.

While experts say embryo adoption, also called embryo donation, is rare,
the Grays' predicament is not. Twenty years after the birth of America's
first test-tube baby, reproductive medicine has produced tens of thousands
of children. But it has also produced tens of thousands of human embryos,
microscopic clusters of cells, frozen in tanks in laboratories around the
nation.

These embryos — consisting of more than 100 cells at the largest, one or
two cells at the smallest — are not only potential babies. They are also
the source of embryonic stem cells, which scientists say hold great promise
for curing human disease because they can grow into many types of cells.
But this research is controversial, because it requires that embryos be
destroyed. Now, as President Bush considers whether to permit federal
financing for stem cell studies, the fate of the nation's leftover embryos
weighs heavily on the minds of fertility doctors and their patients.

"It is a very emotional situation to be in," Susanne Gray said. Because of
their religious views, the Grays were opposed to destroying the embryos or
using them for research. "I knew that God had a life promise in these
children," she said, "and I have two of them running around my house."

That view is not confined to people who believe that life begins at
conception.

"Other people may see embryos as nothing, but the people who created them
don't," said Dr. George J. Annas, a health law professor at the Boston
University School of Public Health. "The default solution for couples is to
just leave them there, whereas that is not a default solution for the
clinic. They hate that."

Dr. Alan Copperman, director of reproductive endocrinology at Mount Sinai
Medical Center in Manhattan, knows the default solution well. When his
program merged several years ago with one at New York University, Dr.
Copperman began trying to track down hundreds of patients in anticipation
of closing the Mount Sinai laboratory — some whose embryos were 15 years old.

He has sent registered letters and conducted Internet searches. He charges
quarterly storage fees of $500 — the practice, which is not uncommon, gives
patients "an incentive to make a decision," Dr. Copperman explained — and
has sent unpaid bills to a collections agency. Still, he said, he lacks
instructions for 120 sets of embryos.

"I don't like the whole concept of bullying a patient into making a
decision," Dr. Copperman said. "That being said, we're faced with a problem
in this country and we need ways to deal with it."

That problem may soon grow more complicated. President Bush's aides are now
reviewing a rule, issued by the Clinton administration last August, that
would give government money to scientists studying stem cells, as long as
taxpayer money is not used to extract the cells from embryos.

The rule, which has been harshly criticized by many abortion opponents,
requires that the cells be derived from embryos obtained from fertility
clinics, with the express consent of couples who no longer want children.
If the rule remains in effect, fertility clinics could wind up in the thick
of the stem cell debate.

Already, some scientists are delicately trying to negotiate with fertility
doctors to obtain excess embryos. Among them is Dr. Doug Melton, who
conducts privately financed stem cell studies at Harvard University.
"Because it is a new procedure, no one is quite certain what should be done
to make certain that it is all done properly," Dr. Melton said.

To Pamela Madsen, whose two boys, now 8 and 12, began life as embryos
created in a laboratory dish, stem cell research offers a welcome escape
hatch from the problem the Grays faced.

"If I give these embryos to another couple, then my children will have a
full sibling out there, a blood sibling," said Mrs. Madsen, an advocate for
the infertile who with her husband has eight embryos in storage. "My
embryos may not be somebody's child, but maybe my embryos could help
somebody's child walk."

In part to advise its members on how, or whether, to become involved in
stem cell research, the American Society for Reproductive Medicine, which
represents fertility specialists, is planning to survey its members to
learn how many frozen embryos there are. In the meantime, Sean Tipton, a
society spokesman, said the group had advised members "to be very cautious
in this area."

The society has advised clinics that they may destroy embryos if they have
diligently tried to contact the patients for five years. Two years ago, an
Arizona fertility specialist who was retiring took out a newspaper
advertisement warning that unclaimed embryos would be destroyed.

But most fertility specialists don't take the society's advice. Dr. Richard
T. Scott Jr. of Reproductive Medicine Associates of New Jersey said he
tells patients their embryos will be destroyed after 20 years.

Mr. Tipton said: "Destroying embryos is a pretty final act. Doctors don't
want to find themselves in court trying to defend an action like that."

Amid all this hand-wringing, a number of fertility programs are quietly
offering couples the option of putting their excess embryos up for adoption
— either openly, as the Grays have done, or anonymously.

For couples who cannot conceive using their own eggs or sperm, embryo
adoption is an inexpensive alternative. Egg donors are compensated as much
as $15,000. But clinics, fearful of running afoul of laws that forbid the
selling of babies, typically require embryo donors to give the embryos as a
gift, so the only fee is the cost of the in vitro fertilization procedure,
typically around $3,000.

And there are other advantages, said Susan L. Crockin, a Boston lawyer who
specializes in reproductive issues. Expectant parents, she said, "can
experience pregnancy and control prenatal care, and also get much more
information about their child's genetic parents."

But, she said, there are drawbacks. Only five states have laws governing
embryo donation. And demand for frozen embryos far exceeds supply, said
Patricia Mendell, a psychotherapist who counsels infertile couples, because
many potential embryo donors fear the possible consequences of having
another family raise their offspring. "The whole fantasy in adoption is to
go find your rightful parents, and so people are fearful," she said.

Dr. Scott said he had helped arrange a handful of embryo adoptions over the
past five years. He is cautious; he always screens the genetic parents for
AIDS and other diseases, and he provides psychological counseling to both
sides.

But while he uses embryos in his fertility research, he said, he would
rather see an embryo donated than destroyed. "The best thing that can
happen to an embryo," he said, "is to help make somebody pregnant."

The Grays had 23 embryos in storage, an unusually large number. Their
fertility clinic offered the option of donating the extras anonymously, but
the Grays did not like the idea of not knowing how their biological
offspring would be raised.

Bob Gray, theorizing that not all of the 23 would be viable, pressed his
wife to have more children. "That was the only realistic option that I
saw," he said, until Mrs. Gray learned of the Snowflakes Embryo Adoption
program, run by Nightlight Christian Adoptions in Fullerton, Calif.

The three-year-old program bills itself as the only one run by an adoption
agency. While fertility clinics typically match embryo donors and
recipients from within their own pool of patients, the Snowflakes program
matches families across the country — an approach that offers an advantage
to embryo donors who would not relish the prospect of their children
running into biological siblings being raised in another family.

So far, Snowflakes has paired 26 sets of genetic parents with 21 adopting
families, said its director, JoAnn Davidson. Of 14 women who have had
embryos implanted, she said, six have become pregnant, and eight babies,
including two sets of twins, have been born. (Nationally, 19 percent of
women who attempt pregnancy with frozen embryos give birth, according to
the reproductive medicine society.)

The Grays spent months considering the program and then gave Ms. Davidson
explicit criteria for any adopting couple: they had to be Christian,
married for at least seven years, with bachelor's degrees. And they had to
be willing to maintain a relationship with the Grays.

Ms. Davidson found Cara and Gregg, of Hamilton, Va. Cara, who agreed to be
interviewed only if her last name was not used, said she and her husband
had tried in vitro fertilization three times before doctors concluded that
she could not conceive with her own eggs. She heard about the Snowflakes
program on a Christian radio show. "It was the answer to my prayers," she
said.

Last December, Cara and Gregg flew to Atlanta to see the Grays. A fast
friendship developed. "We were all very frank," Mrs. Gray said, "about our
fears and our hopes."

Still, both sides hired lawyers; Virginia has a law addressing embryo
donations, but Georgia does not. Cara and Gregg agreed not to terminate any
pregnancies. The Grays agreed to turn over 12 of their 23 embryos and send
more if Cara and Gregg need them. If they do not, the Grays will be faced
with the same decision again.

Neither side is quite sure what the future will hold. "I am just very
hopeful and excited, in a strange way, about this couple raising their
children," Bob Gray said. "It will be an exciting extended family."


By SHERYL GAY STOLBERG
Copyright 2001 The New York Times Company
http://www.nytimes.com/2001/02/25/science/25EMBR.html?pagewanted=all

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