As my donor procedures were by intra-uterine insemination and not IVF I’ve never experienced having more embryos from a cycle than was sensible to transfer and having to freeze or vitrify them for potential future use. Of course if a fresh cycle does not result in a viable pregnancy then these embryos become invested with renewed hope for a child, or for siblings. Some women, like our daughter-in-law, seem to conceive more readily with embryos that have been frozen, possibly because these are often transferred on a non-drug stimulated cycle. But there can come a time for some lucky individuals and couples when a family is complete, but embryos remain in cryopreservation. The dilemma is then what should become of them.
The usual alternative options are donation for family creation or research. Or allowing the embryo to perish. Embryos are not inevitably future children. Even those defrosted with great care for uterine transfer, do not always survive the thawing process. Perfect looking blastocysts can contain chromosomal imperfections that will lead an early pregnancy to end in miscarriage. But, even for those without a religious belief, embryos seem to have a significance that goes beyond a bunch of cells. Because of this, I have read of some people who have decided to ‘bury’ embryos they could not use with a small ceremony to mark their ending, or have them defrosted and put into the woman’s vagina where they have no hope of surviving but can end their life in a warm, friendly environment. As odd as this may seem to some, I can imagine taking one of these options myself – (my sister, an old hippy if ever there was one, would be proud of me).
In this week’s Bio-News http://www.bionews.org.uk/page_113982.asp Professor Eric Blyth and Dr Lucy Frith write about Embryo Relinquishment for Family Building, particularly in relation to the ideological debate that has been stirred up by the language used by different communities. The sub-title of their article, What’s In a Name, refers to the word ‘donation’ which is used by the United States fertility industry to refer to embryos from anonymous donors and the term ’embryo adoption’ that has been taken up by largely faith based agencies who seek to match embryo donors and recipients. As Blyth and Frith say,
“The latter incorporates certain aspects of contemporary infant adoption placement practices, such as enabling relinquishing couples to choose recipient families for their embryos, making available information on genetic origins for infants conceived as a result, and promoting information-exchange and ongoing contact between relinquishing and recipient families.”
Families in the US who do not wish their embryos to perish or to be donated to research have a choice between completely anonymous donation or an open programme based on anti-abortion faith politics. Neither are great options for those who believe in openness and would like parents and children to continue to have contact over the years but who do not share the faith based assumptions of the ‘adoption’ agencies. Maybe this is less of an issue in the States where religious affiliation is more part of everyday life than in the UK, but maybe the wrangling between the two approaches is also missing the main point. Embryo donation or ‘adoption’ of embryos from IVF cycles of couples, means that there will be full genetic parents and full genetic siblings of a child who will be being raised by people who are not genetically connected to him/her. Even if we ignore the clamourings of outraged donor conceived people (which we shouldn’t), this kind of genetic disconnection is way beyond the situation in which those who have been conceived by simple sperm or egg donation find themselves in. Surely what the US faith based agencies are doing in bringing together donors and recipients and encouraging close contact is in the best interests of the children. I would personally say that they are probably leading the way for donation as a whole.
Whether the term ‘adoption’ legally refers to an existing child and not the potential for a child as embodied in an embryo does not seem an argument worth having. What is important is that embryos from couples of faith or no faith are treated with the integrity and respect that their progenitors assign to them. And then that donors and recipients are given the time and support to come to mutually satisfying agreements about their future and the future of any child born. Embryo donation – as it is always referred to in the UK – has become rare in this country since the ending of anonymity for donors made everyone realise the enormity of what it means for all parties. As a result many couples and individuals with completed families are faced with the agonising dilemma of embryos remaining in extended storeage. At the same time people are going abroad for embryo donation where embryos are largely ‘made to order’ and children will never get to know anything about either donor. UK rules should be changed to allow embryo donors and would-be recipients to meet and with the help of an intermediary service focused on children’s well-being work out an arrangement for the future. This would lead the way to changes for all types of donation, where medics would use the skills they have to assist with conception where that is needed, and psycho-social professionals in secular, not-for-profit services would support families in making good decisions, as happens in adoption. And in the current financial climate, pigs might fly!