Nationwide fertility clinics tackle growing number of abandoned embryos
Patrizio said storage fees at his clinic cost $ 600 per year, but could cost twice as much, according to the clinic.
“The problem is that even if an embryo is considered abandoned, even if there is a contract in place, it is very difficult to get rid of it. What if one day someone shows up and says, “Where’s my embryo?” And you end up on the front page for destroying someone’s embryo? The damage would be done, ”he said.
For this reason, Patrizio said, his clinic does not destroy abandoned embryos.
Richard Vaughn, founding partner of the International Fertility Law Group, a national fertility law firm with offices in New York and Los Angeles, said he was unaware of any fertility clinics willing to get rid of abandoned embryos.
“They don’t want to be responsible for a wrongful death,” he said.
Embryos generally do not require a lot of space.
“Frozen embryos take up very little space,” said Dr. Sherman Silber, director of the St. Louis Infertility Center. “You could put an entire city in a lab.”
But if the embryos are small, the liquid nitrogen reservoirs in which they are housed are not. Patrizio noted that a number of clinics are running out of room for reservoirs and outsource storage of abandoned embryos to companies like Reprotech, a national storage company he calls “a mini embryo storage facility.” “.
“A lot of clinics don’t want to have embryos abandoned at their facility for liability reasons,” Patrizio said.
Patrizio and Sweet said the issue of abandoned embryos is sometimes discussed at world fertility conferences, but generally remains in the industry what Sweet calls “the elephant in the room”, which is neither discussed nor addressed. publicly.
The problem, Allen said, is that clinics fertilize too many eggs.
The number of eggs a woman can produce in a monthly cycle leading to egg retrieval varies depending on her age, ovarian reserve, medical history, and response to fertility medications.
During the 1990s, many clinics found it necessary to inseminate as many eggs as possible from a patient because many embryos failed the freezing and thawing process. Now, says Allen, the techniques have improved.
“With the technology we have, creating a large amount of surplus embryos is completely unnecessary,” Allen said, noting that embryologists now know that only a few eggs at a time need to be inseminated.
“[But] you still see a lot of doctors with the ‘more the merrier’ mentality. So you see [some women] having 40, 50 or 60 eggs taken in a cycle and the embryologist is ordered by his doctor to inseminate them all – and the question is not asked whether the patient even wants that number to be inseminated.
“No one is going to have 30 children,” she said.
Allen said regulation is needed in the fertility industry and hopes the United States will follow the examples set by Germany and Italy where only a few embryos can be legally created and transferred at a time, thus avoiding embryo surpluses.
Sara Raber, 43, said she knew frozen embryos were part of the process when she started IVF treatments in 2008.
After several turns, Raber and her husband had two sons in 2010 and 2012 in New York City.
The two boys were conceived by transferring fresh embryos to Raber’s uterus at the Center for Human Reproduction (CHR), a fertility clinic in New York City. Other embryos were frozen during his treatments. Raber said she had the option of using frozen embryos when she started trying for her second child, but chose to use new eggs instead.
“I knew I wanted to keep the embryos frozen for a rainy day,” Raber explained. “It was my insurance policy.”
Raber said she tried using a frozen embryo to have a third child in 2014, but suffered a painful miscarriage. It was then that she struggled to decide what to do with her five remaining embryos.
“Even though I knew I was done childbearing, it was very difficult to make the final decision,” Raber said. “For months I sat on paperwork.”
The clinic gave Raber four choices: She could continue paying the storage fees for her frozen embryos, give them to another woman, allow the clinic to destroy them, or give them to the lab for research.
Eventually, Raber donated his embryos to his fertility clinic’s lab for research.
“I didn’t want to give them to a stranger,” Raber explained. “I had the impression that if I gave the embryos to a stranger, it would be our child there that we weren’t raising.”
Raber said she understands why many patients quietly abandon their embryos.
“They had their babies. They are now focusing on child care. And storage costs are a financial pressure they don’t want to endure. “
Some embryos, even if they are not technically abandoned, are stuck in legal limbo, which happens when the couple who created the embryos cannot agree on what to do with them.
This was the case with actress Sofia Vergara. The “Modern Family” star created two embryos with her former partner, Nick Loeb. When the couple broke up, Loeb wanted custody while Vergara wanted to make sure the embryos were never implanted. Today, the embryos remain frozen, as Vergara and Loeb continue to fight in court.
According to Vaughn of the International Fertility Law Group, there have been at least 13 cases similar to Vergara that have reached appellate courts. He predicts that there will be more lawsuits in the future.
“This will continue to be a growing problem until we have a clearer way of dealing with embryo law,” Vaughn said, noting that there are no national laws in place that deal with embryos. abandoned.
Tad Pacholczyk, director of education at the National Catholic Bioethics Center, agrees that a national debate on frozen embryos will spill over into future generations.
Pacholczyk said he is aware of cases in which couples, unable to agree on what to do with the excess embryos, continue to pay the storage bills – and intend to do so for the rest. of their life.
When the couple dies, a new generation will find itself struggling with the embryos.
Pacholczyk advises couples to create trust funds for excess embryos, so storage costs can be paid indefinitely.
“The creation of a frozen embryo trust fund shows that a couple takes responsibility for what they created,” said Pacholczyk. “To me, the complexity of the situation of what to do with those excess embryos is a powerful reminder that when you cross moral boundaries, there is a price to pay.
The medical community does not know how long frozen embryos will remain viable.
Silber of the St. Louis Infertility Center said that if the embryos were properly frozen, they could remain viable for decades.
“We have reason to believe that embryos frozen using modern technology can last over 100 years,” said Silber.
Even when patients indicate they want to donate their embryos to science, Sweet said, there are few facilities willing to take them.
We have reason to believe that embryos frozen using modern technology can last more than 100 years.
Dr Sherman Silber
“We have 18% of our patients who tell us they want to donate their embryos to science, but I can’t find anyone to take them away,” he said, noting that the University of Michigan is part of it. of the rare places in the country to have accepted abandoned embryos in recent years. “Now I have to go back to these patients and find out what they want to do, but we often can’t find these people.”
Concerned about the growing population of abandoned embryos, Sweet established Embryo Donation International in 2011 in Fort Myers. The program collected surplus embryos from 67 fertility clinics, all from women and couples who have explicitly granted permission to donate their embryos to infertile patients.
Sweet said that Embryo Donation International has provided a way for patients to donate embryos to women and couples who want to have babies. But the program cannot use embryos abandoned by patients who do not sign the documents.
These embryos, Sweet says, get stuck.
In an effort to curb the creation of more embryos that could end up in limbo, Sweet made the decision ten years ago to make her fertility clinic a “rejection-free” facility, which means that all of her patients must sign documents stating that they will not reject their embryos.
Sweet said he made the decision for ethical, not religious reasons.
“The embryos were abandoned by the patient, and I felt that if I abandoned them, they were abandoned a second time.”
Sweet knows there is a lot to her profession when it comes to abandoned embryos. The process, he said, will not be easy.
Still, he said, it’s time for the industry of making babies to finally tackle the embryos that were created, and then abandoned, in the process.
“I think a lot of us realize we’ve got a bit of a mess and I’m not sure the doctors know how to fix it,” Sweet said. “But we have to try.”