Reproductive Technology | Introduction
When Louise Brown was born in 1978 in England, she became the world’s first baby to be born as a result of a procedure called in vitro fertilization (IVF). Since that time, IVF has grown into a multimillion dollar industry. More than 114,000 babies have been born as a result of this technology in the United States, bringing joy to thousands of couples. Of those who seek medical attention for infertility, 5 percent utilize in vitro fertilization.
The IVF process begins in a laboratory. A technician removes and then fertilizes several oocytes—immature egg cells— with sperm in a petri dish to create fertilized eggs. Some of these are selected for transfer to the mother’s uterus a few days later.
The IVF procedure has some inherent problems. First, not every implantation results in the birth of a baby. Successful birthrates vary by clinic but average about 29.4 percent per egg retrieval, according to the American Society for Reproductive Medicine (ASRM). Each egg retrieval involves the removal of at least three and as many as a fifteen eggs from the woman for fertilization. Usually, only two to four embryos are implanted at one time. Since not every implantation results in pregnancy, multiple implantations may be necessary to achieve childbirth. Second, the process can be physically painful. The woman must inject herself with hormones every day for seven to ten days to stimulate egg production, and she may have to have progesterone shots or suppositories to facilitate implantation and pregnancy. An additional obstacle is that the procedure is expensive, costing an average of $12,400 in the United States for each egg retrieval, according to ASRM. Very few insurance plans cover this expense—and only a few states mandate that insurance companies provide IVF coverage.
One of the most serious consequences of the IVF procedure is the creation of surplus frozen embryos. According to Nicholas Wade, science editor for the New York Times, “Because of the expense and inconvenience of extracting an egg for in vitro fertilization, couples prefer to extract a large number of eggs at once so that others will be on hand if the first implantation fails.” Columnist Jeremy Manier of the Chicago Tribune explains further: “Leftover embryos are a common result of in-vitro fertilization . . . most clinics will create a dozen or more embryos during a given round of IVF treatment, but implant only the two or three embryos that grow best or seem most likely to survive in the womb.”
The result of this practice is that almost four hundred thousand frozen human embryos are currently preserved in fertility clinics in the United States, according to a survey published in 2003 by the Society for Assisted Reproductive Technology. Approximately 87 percent of these embryos are being kept for possible future use by the parents, the survey found.
Once a couple has decided they will not implant their remaining embryos, they have several options: The embryos can be donated for research, donated for adoption, or destroyed. The decision about what to do with surplus frozen embryos raises many ethical issues. The central debate, however, is whether humanity has the right to manipulate or destroy life.
Embryo use in research
Those who donate their frozen embryos for research do so because they believe that others can be helped by it. According to health columnist Kevin Lamb, “The clear scientific consensus is that [embryos] also offer the best potential for saving people from Alzheimer’s disease and other debilitating brain disorders, diabetes and spinal-cord injuries, among many afflictions.” Embryos are valuable in research because they contain stem cells—undifferentiated cells that can develop into any parts of the body. Those cells can be used to rejuvenate or replace dying or diseased tissue and thus may eventually be useful in combating illnesses like Parkinson’s disease that attack nerve or brain tissue. In the future, doctors may be able to extract tissue from a patient, create a cloned embryo, and use that embryo’s stem cell tissue to create needed organs the recipient’s body will not reject. This could be a lifesaving procedure for the thousands of patients on donor waiting lists.
Despite its potential to save lives, opponents of embryo research think using a frozen embryo for research purposes is wrong. They believe embryos are potential lives and that it is therefore inhuman to experiment on them. The Center for Bioethics and Human Dignity likens embryo research to the medical experiments performed on prisoners at Auschwitz, a German concentration camp during World War II. Opponents also point out that researchers can use adult stem cells in their studies rather than needlessly destroying embryos.
Embryo adoption
Many people opposed to embryo stem cell research believe that donating frozen embryos for adoption by another couple is the best solution to the problem of excess frozen embryos. A potential life is not lost and an infertile couple receives the possibility of having a child. As Father Joseph Howard states in the journal Human Life Review, “There is an ethical obligation to do what one can to save a life.” In 2002 the federal government supported embryo adoption by creating a $1 million program to promote it.
Embryo adoption has been labeled a godsend by the infertile couples who who have chosen it. A woman who receives a donated embryo has the chance to experience childbirth, and the couple may begin caring for the child almost from conception. In addition, the cost for the adopting couple is much less prohibitive than with traditional in vitro methods because they do not have the expense of fertility shots or of harvesting the eggs—they must only pay for implantation. Some couples have even claimed a federal adoption tax credit.
However, some people argue against the adoption of embryos. They believe that allowing adoption only legitimizes the practice of creating more embryos than needed. Instead, they think that no extra embryos should be produced. Some critics believe that creating extra embryos and not using them is the same as abandoning children.
Many religious leaders are also critical of embryo adoption. William Smith, a monsignor and professor of moral theology at St. Joseph’s Seminary in New York City, believes that adopting an embryo “amounts to a form of high-tech surrogate motherhood, which distorts natural sexual and family relations,” as reported by Brian Caulfield in Human Life Review. Smith states that, while those who wish to adopt embryos have good intentions, the act violates the “underlying principles of the procreative act and the nature of marriage.” Other religious leaders, such as Bishop Elio Sgreccia of the Pontifical Academy for Life, are hesitant to counsel women to choose embryo adoption because they believe that the freezing and thawing process may cause many embryos to suffer genetic damage.
The legal status of embryos is another important issue in embryo adoption. The main debate is whether frozen embryos should be considered property or people with rights. Right-tolife organizations argue that embryos should be afforded the same rights as any person. As columnist Jeremy Manier reports, some of these organizations believe that people who wish to adopt an embryo should submit to the same background checks and home visits required for traditional adoptions. However, embryo adoption is not necessarily the same as adopting a child because the adopting mother carries and gives birth to the child. As legal expert Lori Andrews points out, “One reason the adoption model would be wrong for embryo donation is that the adoption process is supposed to screen would-be parents to confirm they are committed to raising a child. Embryo donation is different because most state laws presume that a woman who carries a child to birth has earned the right to be a parent.”
If background checks for adopting parents became a requirement, not only might the legal status of the embryo change, but the costs for the adopting parents would increase significantly.
Regardless of the moral and legal arguments, for many parents the decision to place an embryo up for adoption is a personal, emotional one. In fact, most couples feel uncomfortable donating their surplus frozen embryos and dislike the idea of giving their potential offspring to a stranger. According to a 2001 study of patients at Northwestern Memorial Hospital in Chicago, only 13 percent of couples preferred donating their extra embryos for adoption. Almost one-third preferred having them destroyed.
Embryo destruction
Ultimately, some couples decide the best course of action is to dispose of their surplus embryos. Embryos are usually destroyed by being thawed and allowed to resume their cell division until they can no longer continue to grow outside of a uterus because there is no nourishment, at which point they die. In some instances, they are plunged in a hot solution— termed “rapid thaw.” In both instances, the embryos are then discarded as biological waste. Some women have the embryos implanted during a time of the month when pregnancy is unlikely so that they can die “naturally.” Some couples are unfazed by the disposal of their embryos. Others bury them, or they watch when the embryos are disposed of by the fertility clinic. Many women, like Martha Panak of Richmond, Virginia, feel an emotion that lies between the detachment one feels toward an object and the love one has for a child. She has four frozen embryos and commented in a Redbook article that “they’re more than just a bunch of cells . . . I don’t view them in the same way as my children . . . [but] we have an emotional attachment to them.”
Religious laws concerning embryo destruction vary. Jewish law prohibits the destruction of a fetus, but does not prohibit disposing of an embryo outside the womb. The Catholic Church, however, believes that life begins at conception—defined by the church as the point at which the egg is fertilized by the sperm. Therefore, the church likens the destruction of an embryo to abortion. Evangelical Christian groups agree. As JoAnn Davidson of the Christian Adoption and Family Services states, embryos “are life from the moment of conception. . . . There’s only that one unique moment when the sperm and egg come together, and everything else is just stages of development.”
Embryos in storage
As outlined above, both religious and personal beliefs factor into a couple’s decision about what to do with their surplus frozen embryos. Undeniably, the choice is a difficult one, and so hundreds of thousands of embryos are left in storage in fertility clinics. Robert J. Stillman, medical director of Shady Grove Reproductive Science Center in Washington, D.C., explains in a Redbook interview the difficult choice couples with frozen embryos face: “They just can’t bear to give their ‘child’ to research, and they don’t want it disposed of, and they certainly don’t want it running around in somebody else’s house. . . . So they make a non-decision.”
In some cases, couples abandon their embryos by no longer paying for their storage fees. In 1996 British authorities destroyed almost three thousand abandoned frozen embryos, which led to a law in the United Kingdom limiting storage time for embryos to five years. As of May 2003, there were fifty-two thousand frozen embryos in the United Kingdom. The United States allows unlimited storage time, which helps explain why there are four hundred thousand frozen embryos in storage. To handle the burden, facilities that serve solely as storage for frozen embryos have opened.
The debates over when life begins and over whether it is ever acceptable to manipulate or even destroy potential life reflect the many issues that are at stake in the field of reproductive technology. The authors in At Issue: Reproductive Technology address the ethical questions that arise with the continuing scientific discovery in the field of reproduction.
