Recently in Fetal Development Category

Originally posted here.

The debate over embryonic stem-cell research is at the forefront of many people's minds with President Obama's recent decision to overturn former President Bush's restrictions on its federal funding. There are some basic questions that must be asked in the course of this debate about the creation of extra embryos, and what other options exist for parents outside of destroying these embryos either by stem-cell research or by what amounts to throwing them away in the trash.

Researchers at the University of Pennsylvania conducted a study in which they sent questionnaires to 341 fertility clinics in the United States which asked questions regarding their methods and policies on embryo disposal. Here is an excerpt including a summary of their findings:

217 of 341 clinics (64 percent) responded. Nearly all (97 percent) were willing to create and cryopreserve extra embryos. Fewer, but still a majority (59 percent), were explicitly willing to avoid creating extras. When embryos did remain in excess, clinics offered various options: continual cryopreservation for a charge (96 percent) or for no charge (4 percent), donation for reproductive use by other couples (76 percent), disposal prior to (60 percent) or following (54 percent) cryopreservation, and donation for research (60percent) or embryologist training (19 percent). Qualifications varied widely among those personnel responsible for securing couples' consent for disposal and for conducting disposal itself. Some clinics performed a religious or quasi-religious disposal ceremony. Some clinics required a couple's participation in disposal; some allowed but did not require it; some others discouraged or disallowed it. (Emphasis added.)

It is worth noting that most people who argue for embryonic stem-cell research will present as a fact that since "leftover" embryos are just going to be thrown away anyway, why should we "waste" them when they could be helping to advance science and save lives? However, they neglect to mention the option made available by over 75% of fertility clinics for the adoption of these embryos by other couples who are unable to bear children, with organizations entirely devoted to this process. Furthermore, the majority of fertility clinics are willing to avoid creating more embryos than the parents would have implanted, if requested to do so by the parents, so there is not necessarily a need for any unused embryos to even exist. What are the actual feelings of the parents who have used IVF to become pregnant toward their leftover embryos? These parents are faced with the difficult choice of what to do with the extra embryos created by the fertility clinics, often due to the lack of information they were given before the IVF process began.

According to research done by Anne Lyerly, parents care deeply about what happens to their embryos after they are created, and the decisions thrust upon them are heartwrenching. "Perhaps half a million embryos lie frozen in U.S. clinics, and many are likely to continue to do so because fertility patients feel they don't have satisfactory options for dealing with embryos left over from their treatment, research out today suggests," says Lyerly. The research found that "Among patients who wanted no more children, 53 percent did not want to donate their embryos to other couples, mostly because they did not want someone else bringing up their children." (Emphasis added.)

One fertility doctor has this to say about why many parents don't wish to donate their embryos:

"It's partly reflected in the attitude of the clinics," he said, explaining that he does not even suggest that people give embryos to other couples anymore, whereas 10 years ago many patients did donate.

The excruciating decision parents have to face after undergoing IVF is often the result of the failure of clinics to broach the subject of dealing with their leftover embryos beforehand, and inform them of the options that will be available to them. According to this survey, many parents feel that they SHOULD donate their embryos to research as a way of not letting them die meaninglessly, but one mother who donated her extra embryos to research had this to say: "Ms. Betancourt said she wished there had been more discussion about the extra embryos early in the process. If she had known more, she said, she might have considered creating fewer embryos in the first place."

Lyerly's conclusion after her research (as reported by the New York Times) was this:

The message from the survey is that patients need more information, earlier in the in vitro process, to let them know that frozen embryos may result and that deciding what to do with them in the future "may be difficult in ways you don't anticipate," said Dr. Anne Drapkin Lyerly, the first author of the study and a bioethicist and associate professor of obstetrics and gynecology at Duke University...

Many couples are so desperate to have a child that when eggs are fertilized in the clinic, they want to create as many embryos as possible, to maximize their chances, Dr. Lyerly said. At that time, the notion that there could be too many embryos may seem unimaginable.

Even though it is important to see that many parents of these embryos consider them special and human, the ethics involved should be beyond individual decision. Robert George, a professor at Princeton University, has this to say about how leftover embryos should be treated:

The principle... is one that says all human beings, irrespective of age or size or stage of development or condition of dependency, possess the same human dignity, because human dignity is inherent... [They] should be treated respectfully, the way we treat the remains of human beings at later stages of development...buried or burned... This is a decision that we as a community have to make. It can't be left to individual choice to decide... It's certainly not a religious decision anymore than infanticide is a religious decision... You can find ancient cultures whose religions authorized infanticide. But that didn't make it right. And that doesn't mean that we should accept it.

In Italy, parents are not forced to make an excruciating ethical decision, because there is a law that forbids fertility clinics from creating more than 3 embryos, and all the embryos created must be implanted in the mother's uterus. A bill was recently introduced in the state of Georgia with the goal of creating these same limitations on the number of embryos that can be created by fertility clinics and implanted in the mother. Though that particular goal was not realized, the bill still "importantly defines embryos outside the uterus as human beings, so court disputes must be decided in the best interest of the embryo, not either parent fighting over the embryo."

Consider this quote from "Beginning Life," by Geraldine Lux Flanagan: "In the hours of conception every aspect of the genetic inheritance for a new individual will be determined once and for all: to be a boy or girl, with brown, or with blue eyes, fair or dark, tall or short; all the rich detail of physical attributes from head to toes..." These youngest among us have no voices to speak for them. Will we then speak on their behalf, or be silent?