Thursday, January 7, 2010

Is it Morally Acceptable to Discard Unwanted Frozen Human Embryos?

Around the world, a debate is raging over the ethical and moral implications of scientific breakthroughs in the field of assisted reproductive technologies. At the center of the controversy is an organism so small that it can fit on the end of a pin: the frozen human embryo. [1] Suspended indefinitely in a place where time has stopped—frozen in vials in fertility clinics—hundreds of thousands of human embryos await implantation in a mother’s womb.[2] With storage space running low, many fertility clinics are left wondering what should be done with unclaimed and unwanted embryos. Discarding seems to be the easiest option, but some ethicists and scientists argue that destroying embryos is not morally acceptable because it takes the life of a human being.

The frozen human embryos in question are created using in vitro fertilization (IVF). IVF is a process that allows infertile couples to conceive. In a study on reproductive technologies, Jacques Cohen and Robert Lee Hotz write, “These new technologies usually are aimed at women who cannot carry their own child and at those numerous couples—an estimated 2.4 million married couples in the United States (U.S. Congress 1988:3)—who are infertile and cannot conceive unaided.”[3]

In the IVF process, eggs are harvested from the female which are then fertilized in a Petri dish. After five to six days of growth, having formed six cells, the embryos are in the blastocyst stage, and are ready to be implanted in the mother’s womb. Because the success rate for IVF is low, many embryos are created at once and some are cryogenically preserved, or frozen, for later use.[4] According to Andrea Bonnicksen, “During a woman’s initial IVF cycle, three or four of the embryos created are transferred to her uterus, while the rest are frozen for storage, to be thawed and transferred at a later date.”[5] If the first batch of implanted embryos is not successful, the frozen embryos are used.

Cryopreservation of human embryos is possible because the freezing temperature literally slows down time and stops the development of the embryo until it is thawed for use. Dr. Jerome Lejeune, a geneticist renowned for his discovery of the cause of Down’s syndrome,[6] explains: “But in the fundamental sense what we are doing by lowering down the temperature is stopping not totally but very deeply the movements of the atoms and molecule so…we have more or less arrested the flux of the time.”[7] Because the growth of human embryos is halted, they can be left frozen for an indefinite period of time.

The issue arises when the embryos go unclaimed, and clinics are left with the dilemma of determining their fate. The clinics mail out letters, asking the parents to determine an outcome for their embryos. In a study about the rationales behind opting to either donate or discard embryos, Sheryl de Lacey writes that the decisions are “extremely difficult and morally challenging.”[8]

The two options available for unwanted frozen human embryos are either donation (to another couple or to research) or discarding. According to researcher Sheryl de Lacey:

Once a woman and her partner have determined that further treatment is no longer possible or desirable, the decision about the fate of the frozen embryos typically involves selecting between options that commonly include discarding embryos, donating embryos to another couple (either anonymously or to a known recipient), or donating to research. [9]
A study of current trends in Australia shows that a significant number of couples do choose to discard their unwanted embryos: “In essence, 64.7% of the patients applied for an extension or used the embryos themselves in the 6 months between the reminder and the expiry date. Only 5.9% patients overall opted to donate embryos to others and the decision was not influenced by pregnancy. This compared with 18.8% of patients who chose to discard their embryos.”[10]

But is it morally acceptable to discard human embryos? The answer depends on one’s view of life. To a person who believes that life begins at conception, the embryo is a human life. Lejeune states unequivocally that the embryo is a human being: “But as a geneticist you ask me whether this human being is a human, and I would tell you that because he is a being and being human, he is a human being.”[11] Reproductive rights supporter Cheryl Meyer follows the implications of the belief that human life begins at conception: “If the embryo represents human life, this could become an insurmountable problem to medical research on, or even performance of, the IVF procedure. Theoretically, physicians could no longer conduct research using embryos or discard embryos, because to do so could be considered murder.”[12]

However, in a 1979 report by the Department of Health, Education, and Welfare that supported IVF and embryo transfer, the Ethics Advisory Board concluded that “the human embryo is entitled to profound respect; but this respect does not necessarily encompass the full legal and moral rights attributed to persons.”[13] Scott B. Rae and Paul M. Cox from the Center for Bioethics and Human Dignity disagree:

Embryos are persons, deserving of full human rights. They are not potential persons, a concept that itself is problematic. Either one is a person, or one is not a person. What one normally means by this imprecise use of that term is that the embryo (and fetus also) is a person with the potential to become a full-grown adult. It is better to say that the embryo is a “person with potential.”[14]

Those who consider destruction of human embryos to be morally acceptable often use the term pre-embryo rather than embryo. However, Lejeune considers the term a “meaningless neologism,” stating that “before the embryo there are only the egg and the sperm, and, inasmuch as no one of them has achieved fertilization, no new being exists. There is, therefore, no pre-embryo, since by definition the embryo is the youngest form of being.” [15]

The fact that the frozen embryo has the potential to lead a normal life is another consideration when determining whether it is acceptable to discard frozen human embryos. According to a study in Human Reproduction, there is no noticeable increase in defects in children born from frozen embryos compared to children conceived naturally:

A study of 91 children born after transfer of cryopreserved embryos and 83 children born after natural conception (Sutcliff et. al., 1995), showed no increase in the incidence of malformations, either minor or major. Nor was there any difference in later psycho-motor development between the two groups, as assessed using Griffiths’ quotient (Griffiths, 1976) (Table XII).[16]

If Lejeune is correct that destroying frozen embryos takes the life of a living human being, and if it is true that the embryo has the potential to lead a normal life, what should be done in the case of unwanted frozen embryos? Donating the embryos to another couple is an alternative to discarding that preserves the life of the embryo, but statistics show that the option is not preferred.[17] A shortcoming to the adoption solution is that donating an embryo is a complex emotional decision, one that many couples are not prepared to make. Rae and Cox state, “Even though donation does not involve discarding the leftover embryos, and is more ethically acceptable, it is very difficult to accept emotionally for many couples.”[18]

Ethicists Rae and Cox propose another possible solution to the unwanted frozen embryo dilemma. They write that the number of embryos that can be created at one time should be limited, for if the doctor limited the creation of embryos to the number that could be implanted at one time, cryopreservation would become unnecessary and difficult decisions about the fate of excess embryos would not have to be made. Rae and Cox write,

The most prudent course for couples to follow and for their physicians to encourage in these procedures is to avoid having leftover embryos as best they can….A couple can inform the clinic of their views concerning when personhood begins, and tell the clinic they do not want any leftover embryos after they are finished doing business there.…The number of eggs to be fertilized depends on the number of embryos the couple wants implanted. [19]

Limiting the number of embryos created to the amount that could be implanted at one time would dispel the need to cryogenically preserve embryos, but the solution would require effort and time to implement.

Clearly, the debate over the fate of unwanted frozen human embryos is not one that will find an easy solution. The issue is complex, with many moral and ethical implications. Donating to willing couples and limiting the number of created embryos are both viable alternatives to discarding which recognize the human life and potential in the embryo. The implications of a decision on the fate of the embryos are far-ranging and will affect thousands of frozen human embryos, so it is important that all options be considered carefully. An understanding of the sacredness of human life will be necessary as scientific research moves forward and new discoveries with moral implications are made in the field of reproductive technologies.

Bibliography

Bonnicksen, Andrea. “Embryo Freezing: Ethical Issues in the Clinical Setting.” The Hastings Center Report, 1988.

Brinsden, Peter R., ed. A Textbook of In Vitro Fertilization and Assisted Reproduction: The Bourn Hall Guide to Clinical and Laboratory Practice. New York: The Parthenon Publishing Group Inc., 1999.

Cohen, Jacques and Robert Lee Hotz. “Toward Policies Regarding Assisted Reproductive Technologies.” In Emerging Issues in Biomedical Policy 1, ed. Robert H. Blank and Andrea Bonnicksen, 225-237.
New York: Columbia University Press, 1992. http://www.netlibrary.com.ezproxy.phc.edu/Reader/ (accessed September 25, 2009).

Darlington, Neroli and Phillip Matson. “The Fate of Cryopreserved Human Embryos Approaching their Legal Limit of Storage within a West Australian In-Vitro Fertilization Clinic.” Human Reproduction 14, no. 9 (1999): 2343-2344, http://cli.gs/6LmWgY (accessed September 25, 2009).

de Lacey, Sheryl. “Decisions for the fate of frozen embryos: Fresh insights into patients' thinking and their rationales for donating or discarding embryos.” Human Reproduction 22, no. 6 (June 2007): 1751-1758, http://cli.gs/6H3m2b/ (accessed September 25, 2009).

Department of Health, Education, and Welfare Ethics Advisory Board. Report and Conclusions: HEW Support of Research Involving Human In Vitro Fertilization and Embryo Transfer. 1979. http://www.bioethics.gov/reports/past_commissions/HEW_IVF_report.pdf (accessed October 27, 2009).

Lejeune, Jerome. The Concentration Can: When Does Human Life Begin? An Eminent Geneticist Testifies. San Francisco: Ignatius Press, 1992.

Ludwig, M., S.Al-Hasani, R.Felberbaum and K.Diedrich. “New aspects of cryopreservation of oocytes and embryos in assisted reproduction and future perspectives.” Human Reproduction 14 (1999): 162-185, http://cli.gs/ZgnrvZ (accessed September 25, 2009).

Meyer, Cheryl L. The Wandering Uterus: Politics and the Reproductive Rights of Women. New York: New York University Press, 1997.

Rae, Scott B. and Paul M. Cox. Bioethics: A Christian Approach in a Pluralistic Age. Grand Rapids, MI: William B. Eerdmans Publishing Company, 1999.



[1] Peter R. Brinsden, ed., A Textbook of In Vitro Fertilization and Assisted Reproduction: The Bourn Hall Guide to Clinical and Laboratory Practice (New York: The Parthenon Publishing Group Inc., 1999), 105.

[2] David Hoffman, Gail Zellman, Christine Fair, Jacob Mayer, Joyce Zeitz, William Gibbons, and Thomas Turner, Jr., “Cryopreserved embryos in the United States and their availability for research,” abstract, in Fertility and Sterility 79 Issue 5, (May 2003), http://www.fertstert.org/article/S0015-0282%2803%2900172-9/abstract (accessed October 18, 2009).

[3] Jacques Cohen and Robert Lee Hotz, “Toward Policies Regarding Assisted Reproductive Technologies,” in Emerging Issues in Biomedical Policy 1, ed. Robert H. Blank and Andrea Bonnicksen (New York: Columbia University Press, 1992), 225.

[4] Ibid, 232.

[5] Andrea L. Bonnicksen, “Embryo Freezing: Ethical Issues in the Clinical Setting.” The Hastings Center Report (1988): 26.

[6] Jerome Lejeune, The Concentration Can: When Does Human Life Begin? An Eminent Geneticist Testifies (San Francisco: Ignatius Press, 1992), 22.

[7] Ibid., 36.

[8] Sheryl de Lacey, “Decisions for the Fate of Frozen Embryos: Fresh Insights into Patients’ Thinking and their Rationales for Donating or Discarding Embryos,” Human Reproduction 22, no. 6 (2007), 1751, http://cli.gs/6H3m2b/ (accessed October 4, 2009).

[9] Ibid.

[10] Neroli Darlington and Phillip Matson, “The Fate of Cryopreserved Embryos Approaching their Legal Limit of Storage within a West Australian In-vitro Fertilization Clinic,” Human Reproduction 14 no.9 (1999): 2343.

[11] Jerome Lejeune, The Concentration Can: When Does Human Life Begin? An Eminent Geneticist Testifies (San Francisco: Ignatius Press, 1992), 72.

[12] Cheryl L. Meyer, The Wandering Uterus: Politics and the Reproductive Rights of Women (New York: New York University Press, 1997), 64.

[13] Department of Health, Education, and Welfare, Ethics Advisory Board, Report and Conclusions: HEW Support of Research Involving Human In Vitro Fertilization and Embryo Transfer, 1979, http://www.bioethics.gov/ reports/past_commissions/HEW_IVF_report.pdf (accessed October 27, 2009), 101.

[14] Scott B. Rae and Paul M. Cox, Bioethics: A Christian Approach in a Pluralistic Age, (Grand Rapids, MI: William B. Eerdmans Publishing Company, 1999), 183.

[15] Jerome Lejeune, The Concentration Can: When Does Human Life Begin? An Eminent Geneticist Testifies (San Francisco: Ignatius Press, 1992), 11.

[16] Ludwig, M., S.Al-Hasani, R.Felberbaum and K.Diedrich. “New aspects of cryopreservation of oocytes and embryos in assisted reproduction and future perspectives.” Human Reproduction 14 (1999): 162-185, http://cli.gs/ZgnrvZ (accessed September 25, 2009).

[17] Neroli Darlington and Phillip Matson, “The Fate of Cryopreserved Embryos Approaching their Legal Limit of Storage within a West Australian In-vitro Fertilization Clinic,” Human Reproduction 14 no.9 (1999): 2343.

[18] Scott B. Rae and Paul M. Cox, Bioethics: A Christian Approach in a Pluralistic Age, (Grand Rapids, MI: William B. Eerdmans Publishing Company, 1999), 185.

[19] Ibid.

6 comments:

embieadoptmom said...

I will have to agree that discard is throwing away a human life.

I am currently 14 weeks pregnant with our sweet adopted embryo. We believe life begins at conception & in the sanctity of human life.

If they aren't babis or human lives then what am I pregnant with?

Embryo adoption/donation is a MIRACLE for couples like us who faced infertility! Such an answer to YEARS worth of prayers!

Thank you for bringing light to this subject!

Jen

Jess said...

Jen, thank you so much for your comment! It is very encouraging to have someone who has "been there, done that" corroborate what I wrote. It's one thing for me to research the facts and statistics, but it makes everything more real to hear from someone who has personally experienced adopting an embie.

Congratulations on the baby on the way...how exciting!!

IVF Clinic India said...

Great Post.....

I found your site on stumbleupon and read a few of your other posts. Keep up the good work. I just added your RSS feed to my Google News Reader. Looking forward to reading more from you down the road!

Thanks for sharing....

Anonymous said...

I have 6 embryo's frozen and have just received paperwork to make my decision. I have absolutely no idea. I wish I hadn't known about them so I wouldn't have to make a decision at all :(
I have a 9 mnth old daughter conceived through IVF. I don't really want another child but my husband does so it's hard. It costs money to keep them in storage and times are tough at the moment with only one wage. It's $300 per year which to some is nothing to hold onto potential life, but regardless I'm going to have to make the decision because I'm not trying for 6 kids in the 5yr storage period! I have been advised by many to wait a little longer, since it's early days and I'm still getting over my first pregnancy. I'm not 100% sure and reading so many comments of murder, maybe I will pay another storage fee for 6mnths to make sure I'm doing the right thing...I dunno...it's hard. What makes it worse is I have close friends struggling to get just one embryo for transfer and I have 6! I feel awful discarding them but I'm going to have to one day...

Anonymous said...

Hello

Just wanted to show my appreciation for your time and hard work

LAK said...

I have seven in the freezer, and since they are the result of IVF procedures done in my early 40's (am 46 now), it could be that none of them are viable. However, because I have a deep intuition that discarding them is akin to murder, I am going to give them the chance this year. If they do not go on to develop, at least it was not my decision to make.

Thank you for your post Jess. You have eloquently laid out my concerns.