Millions of federal dollars go to promote "embryo adoption" but not
research, I learned from this article, Ray


Scott and Geri Bowman's in-vitro cycles resulted in twins Joey and Angie, 4,
and Addie, 2. They donated their frozen embryos to other couples.
Science helped them get pregnant. But science might be less helpful
afterward, when it's time to decide what to do with these nascent life
forms - "babies waiting to be born," as one mother put it - the size of a
speck of dust and preserved at minus 320 degrees Fahrenheit, sometimes for
years.
"To an awful lot of people, it's a very difficult decision," said Dr. James
Goldfarb, director of the in-vitro fertilization program at the Cleveland
Clinic.
A study by the RAND Corp. in 2002 estimated that there were 400,000 human
embryos stored in fertility clinics in the United States, a number that has
undoubtedly increased since then; the Cleveland Clinic alone has 4,200,
nearly 1,000 of which are more than 10 years old.
"We want to keep them here, under our control, until our patients decide
what to do with them," Goldfarb said. He concedes, however, that for some,
doing nothing is a decision in itself.
The embryos are the products of in-vitro fertilization, a procedure
pioneered in the late 1970s that is now a relatively commonplace treatment
for couples experiencing fertility problems. According to the American
Society for Reproductive Medicine, 48,756 children were born in the U.S. in
2003 as a result of in-vitro fertilization.
The procedure involves the retrieval of eggs from a woman's ovaries after
several weeks of hormone treatments.
In a lab, the eggs are mixed with sperm, then implanted into the woman's
uterus several days later.
Doctors typically transplant two or three embryos into the woman; the
remainder - on average, seven or eight - can be frozen for future use.
Couples can use these frozen embryos if their initial attempt fails or if
they want more children, though success rates with frozen embryos aren't as
high as with "fresh," according to Goldfarb.
Couples are encouraged to make a decision about any unused embryos before
they initially undergo in-vitro fertilization.
But Tallmadge, Ohio, mom Geri Bowman said that for couples dealing with
infertility, decisions about the future always take a back seat to current
struggles. "At that point in time, it's all about 'I want to get pregnant. I
want to have a baby.' "
Years later, however, a parent's perspective often changes, as it did with
the Bowmans. Their decision to donate the embryos to another couple proved
more complicated than they expected.
After their fertility doctor declined to get involved in the donation
process, they contacted two embryo adoption agencies, settling on a facility
in Tennessee, which now has possession of the embryos.
Meanwhile, the issue hung over them for months. "In the back of your mind,
there's no closure," said Scott Bowman. "I don't think people understand how
big of an issue it is. There are so many embryos out there that people don't
know what to do with."
Some patients ask their doctors to fertilize just two or three eggs,
negating the need to make a decision about any excess. Two years ago in
Italy, a law went into effect prohibiting the creation of more than three
embryos at a time, and requiring that they all be implanted simultaneously.
But most couples in the United States want doctors to create as many
fertilized eggs as possible, which has led to the increasing number of
embryos in storage, said Goldfarb.
Money plays a role as well. Each in-vitro cycle, as the process is known,
costs an average of $12,400, according to the reproductive medicine group,
and insurance seldom pitches in. Using a frozen embryo costs about $1,500.
Couples who are finished having children - or finished trying - and have
remaining embryos have several options, at least hypothetically.
.They can opt to have their embryos destroyed.
.They can donate them to an infertile couple.
.They can designate them for research.
Research involving human embryos, including embryonic stem-cell research, is
severely limited in the United States because of a ban on federal funding
for such experimentation. Couples can agree to keep the embryos frozen until
research opportunities develop.
A strong opponent of embryonic stem-cell research, President Bush has
advocated so-called embryo adoptions, or the donation of embryos to
infertile couples. When he vetoed legislation in July that would have eased
funding restrictions on research, Bush surrounded himself with 18 families
who had children from adopted frozen embryos.
A handful of embryo adoption centers have opened in the past several years,
boosted by millions of federal dollars to promote the practice.
Sean Tipton, a spokesman for the American Society for Reproductive Medicine,
says such programs are motivated by an effort to elevate the legal status of
an embryo to a human by using words like "adoption." Legally, embryo
donation is a property transfer, not an adoption.
A small percentage of patients dispose of the embryos, usually after they
receive a storage bill from their clinics, which charge between $200 and
$400 a year.
The Cleveland Clinic, for example, thawed and disposed of 111 embryos during
the first four months of the year; it froze an additional 309 during the
same time.
Future couples might be spared the need to decide the fate of leftover
embryos. The technology that created the problem might yet solve it.
Some doctors are now offering an alternative to patients who object to
freezing excess embryos: Freeze eggs instead, and fertilize them only as
needed, prior to implantation.
Pregnancy success rates aren't as high using frozen eggs as they are for
frozen embryos, but eventually could rise.
Because an egg is only half of what's needed to create a human life,
disposing of excess eggs does not pose the same ethical issues that embryos
do, said Goldfarb.

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