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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 janet paterson, an akinetic rigid subtype parkie 53 now / 44 dx cd / 43 onset cd / 41 dx pd / 37 onset pd TEL: 613 256 8340 SMAIL: PO Box 171 Almonte Ontario K0A 1A0 Canada EMAIL: [log in to unmask] URL: http://www.geocities.com/janet313/