June 12, 2005
Most Couples Oppose Donation Of Excess IVF Embryos

A very interesting New York Times article by Pamela Belluck reports on the widespread reluctance of couples to donate their excess embryos created by in vitro fertilization to other couples to start pregnancies.

"When couples are coming into in vitro, and they are asked what they would want to do with leftover embryos, they might say, 'Oh yeah, donating to another couple - if we could help prevent another couple from going through the agony and the pain of what we've been through, we would be willing to do that,' " said Dr. Susan C. Klock, associate professor of obstetrics, gynecology and psychiatry at Northwestern University's medical school.

But 3 to 10 years later, 9 out of 11 couples who had said they would donate to another couple were no longer willing to do so, Dr. Klock said.

Others have seen similar results. "Of the dozen or 15 cases I've handled where people have considered donating embryos to another couple, over half of those cases never went forward," said Susan L. Crockin, a Boston lawyer.

One couple, Ms. Crockin said, who had had two children through in vitro fertilization, wanted to donate their extra embryos to friends in their neighborhood. "They came in to me to do what they thought at the outset was a simple legal task of 'make it happen,' " Ms. Crockin said. "Instead, after really exploring what this might mean to their existing children, what it might mean for the resulting child, how would they deal with the children they were raising and this child who was going to be raised down the street, they couldn't reach a comfort level. The wife called me in tears: 'We want to do this, we want to be generous, I feel selfish, but I can't do this.' "

The article reports that couples who used either donated eggs or donated sperm to create their embryos are more willing to donate their excess embryos. But then the egg donors express ambivalence or opposition to the idea of their eggs being used to provide babies to other people who they didn't develop a relationship with ahead of time. So people obviously feel a bond to offspring or potential offspring made from their own DNA.

President George W. Bush has been funnelling money to embryo adoption programs such as the Nightlight Christian Adoptions Snowflakes program due to his belief that all embryos are really humans.

The Snowflakes were on hand to show that, in Bush's words, "there is no such thing as a spare embryo." The alternative is "adoption."

The reluctance of couples to donate their embryos to other couples strongly argues against Bush's position. Those couples in the NY Times article who can't bring themselves to see other people raise their genetic children are the tip of a growing iceberg. So far the Snowflakes program has arranged for 81 embryo adoptions. But at least 400,000 embryos sit frozen in IVF clinics in the United States.

A 2003 study by the RAND Law and Health Initiative estimated that there are about 400,000 frozen embryos in IVF clinics across the nation, 11,000 of which have been set aside for research purposes.

The number is probably much larger than that and likely to grow larger still. A British web site reports a very rapid growth in the number of frozen embryos in Britain.

Since 1990 about 250,000 embryos have been frozen following IVF treatment in Britain. In March 1999 there were 51,346 embryos stored. This had jumped to 97,719 in March 2001 and 116,252 by March 2003, more than doubling in four years.[5] Around eight embryos are created in each IVF treatment cycle but only a maximum of two can be implanted, meaning that there are always spare embryos to be frozen, donated, experimented upon or destroyed. Couples are allowed to keep them for up to ten years for an annual storage fee of approximately 250.

Note that since some couples are likely deciding to stop storage of frozen embryos once they've managed to get pregnancies to term the increase in the number of stored embryos is happening in spite of embryos destroyed every year.

Many human embryonic stem cell (hESC) researchers would like to use the left-over embryos created during in vitro fertilization (IVF) attempts to extract cells to create hESC lines to use in research and for the development of medical treatments. Their argument is that these embryos are eventually going to be destroyed anyway. So why not use them for research?

If the people who think embryos are humans want to prevent embryo destruction then their only possible way to achieve that goal is to try to win support for a ban on the creation of embryos through IVF. Though I think the odds are strongly against the enactment of such a ban. The existing federal ban on the use of US federal government research money to use embryos for creation of human embryonic stem cell lines is not preventing embryo destruction.

Future advances in reproductive science and technology will lead to cures for many causes of infertility. That alone would lead one to expect a reduction in the use of IVF in the future. However, advances in DNA sequencing and DNA testing technology combined with much greater understanding of the meaning of all the human DNA sequence variations will increase the incentive for using IVF over regular sex for initiation of pregnancies. IVF combined with pre-implantation genetic diagnosis (PIGD) will be attractive to tens or hundreds of millions of couples as a way to select which genes to pass along to progeny. Therefore in the coming decades I expect IVF's popularity to grow and therefore the number of extra frozen embryos to grow as well.

Share |      Randall Parker, 2005 June 12 01:41 PM  Bioethics Debate


Comments
toot said at June 12, 2005 2:32 PM:

I, on the other hand, would anticipate "regular sex" remaining as popular in the future as it has been in the past.

Also, I am surprised that the article does not tell us how the couples feel about using the surplus embryos to derive material for laboratory experimentation, i.e., research. Surely the pollsters did not neglect to ask that obviously related question.

I think that you are right that as the in vitro fertilization technology improves the need for such a great surplus of embryos will subside, and of course the obvious regulation to push for by those who are concerned about the destruction of embryos would be to limit the factor by which excess embryos are produced for this purpose, rather than to outlaw the procedure.

Engineer-Poet said at June 12, 2005 6:34 PM:

It's truly ironic that Bush & Co. want to prevent the donation of frozen embryos (which will otherwise just be destroyed) for medical research, but they have said nothing about parents making medical bequests of the bodies of dead newborns and children.

To this administration, born people are less human than embryos.

Lei said at June 12, 2005 6:56 PM:

Excellent points about the destruction of embryos vs. their use in research.

Despite the advances being made in IVF, I can't imagine "hundreds of millions" of people wanting to go through unnecessary medical procedures that have both psychological and physical repercussions for the woman especially if they can cure their infertility in other ways. For the majority of families, natural conception would most certainly be better and more meaningful than endless technological manipulations. And that goes for a lot of other medical interventions as well.

Braddock said at June 13, 2005 4:47 AM:

The frozen embryo industry is due for a major uptick, once women catch on to the idea of fertilizing their eggs early for freezing, then bearing the children (or hiring a surrogate) once they've achieved their career goals and a degree of financial security. Technology will allow women to come closer to "having it all" than a lot of people would like. Males become closer to mere sperm donors. A long way from the hunter-gatherer society.

Kurt said at June 13, 2005 10:57 AM:

Braddock:

Or ectogenesis (exowombs).

I considered "egg banking" as a potential business start-up several years ago. Since I have contacts with people who have developed vitrification (as alternative to cryo-preservation), this seemed like a good idea to pursue.

One problem is the cryopreservation of ova, which are quite large compared to other cells. Vitrification gets around this problem but has yet to be perfected (although they are close). The other problem, as Lei has pointed out, is that the ova harvesting process is not exactly an benign one for the woman undergoing it and is rather expensive. It is is the most expensive component of IVF, which usually runs around $14K per try.

I believe that a process has been developed where ova can be made from stem cells and visa versa. This gets rid of the need for ova harvesting, which is the "barrier of entry" into the market place for IVF and ectogenesis. Also, this will reduce cost because cryo-preservation of the precurser stem cells (or even regular cells) is much cheaper than cryopreserving ova. Hense, once the need for "original" ova is eliminated for making babies, the whole business becomes much more viable. This is what we are waiting for.

Once the molecular "reprogramming" of cells is achieved (in about 5 years), it will be possible to harvest any cell from the body, say a skin cell, then to reprogram that cell into any kind of stem cell and even to make sperm or ova out of it. Microfluidics technology is being developed that will automate the whole process, thus making it far cheaper than it is now.

My wife (who is Japanese) believes that there is tremendous market for biotechnological option of preserving one's genetic code in one form or another and then having kids later in life; especially in Asian countries like Japan, Korea, and China. She also believes that exowombs (which are being developed in Japan and China) will also be tremendously sucessful in the Asian marketplace.

This is a business opportunity I want to pursue in another few years.

Garson Poole said at June 13, 2005 11:37 AM:

Researchers are working on a technology for freezing eggs that might dramatically alter the number of frozen embryos in the future. Currently when an egg is frozen and thawed it often loses viability. I think that the difficulty of freezing eggs is the main reason that embryos are created and frozen at IVF (In Vitro Fertilization) clinics. Progress on safely freezing eggs is reported here. The process uses vitrification as discussed in this excerpt:

Freezing eggs is one thing; thawing them safely so they can lead to pregnancy is the challenge. In the past, efforts to freeze a woman's eggs, or oocytes, have not worked well because the cells are large. When the egg is thawed, ice crystals cause damage that prevents the egg from being fertilized.

University of Michigan researchers looked beyond traditional techniques to a method of freezing cells called vitrification. This cryopreservation technique allows the eggs to be cooled fast enough that the transformation from liquid to solid is instantaneous. ...

Using mouse oocytes, 80 percent of eggs that had been vitrified became fertilized with ICSI (intracytoplasmic sperm injection), with a live birth rate of about 30 percent, comparable to conventional IVF when eggs are not frozen. The fertilization and birth rates for vitrified eggs are similar to the rates for control eggs that were not vitrified.

The technique is motivated by the desire to allow a woman who is undergoing a cancer treatment that would normally destroy her eggs to instead preserve her eggs outside the body. It seems that the technique would also be applicable in IVF clinics. Instead of freezing embryos one might freeze eggs and sperm separately.

Jim said at June 13, 2005 12:38 PM:

an out-of-place comment, thought you'd be interested.... notice it's all private financing. i wonder how these numbers compare to what you found regarding the cost of nuclear/coal/gas-fired power

" Zilkha Renewable Energy of Houston plans a $500 million wind development, to be completed in the summer of 2007. It will include 243 of the 40-story-tall structures. Chicago, by comparison, has 152 buildings at least that tall, with five more under construction, according to a Tribune survey.

It would harness enough wind energy to power an estimated 120,000 Chicago-area homes. With an output of 400 megawatts, it would outpower a 300 megawatt project in California that is now the nation's biggest."

http://www.chicagotribune.com/news/local/chicago/chi-0506120555jun12,1,6719104.story?ctrack=2&cset=true

John said at June 14, 2005 8:45 PM:

"The reluctance of couples to donate their embryos to other couples strongly argues against Bush's position."

I don't get it. It sounds to me as if the couples think of embryos as offspring, which is exactly Mr. Bush's point.

Randall Parker said at June 14, 2005 9:18 PM:

John,

The couples are more willing to let the embryos be thrown away than they are to donate them. So they don't think of the embryos as human lives.

Engineer-Poet said at June 14, 2005 11:04 PM:

They:

  1. Do not think of them as human lives, and
  2. Seem to take the concept of their biological children being borne by their friends or neighbors as just a little creepy.

When you consider how many people fall in love with the kid next door, it would be really good if those kids weren't biological siblings.

I wouldn't personally have a problem with donating frozen embryos, but I'd want the other couple(s) to be far enough removed that romantic attachments between biological offspring would be unlikely.

Randall Parker said at June 15, 2005 7:53 AM:

E-P,

I doubt most would be willing to let their embryos be used by distant strangers either. They don't want to risk, for example, their genetic offspring being raised by someone who would turn out to be a bad parent. They also would think their offspring might show up some day and ask why they didn't raise the kid themselves.

Garson Poole said at June 15, 2005 1:06 PM:

Randall Parker said: I doubt most would be willing to let their embryos be used by distant strangers either. They don't want to risk, for example, their genetic offspring being raised by someone who would turn out to be a bad parent. They also would think their offspring might show up some day and ask why they didn't raise the kid themselves.

Yet, some men do engage in sperm donation. Thus some men are willing to risk having their children raised by strangers in unknown locations. In fact, the willingness to be a sperm donor is not too surprising based on arguments typically presented by evolutionary psychologists. Some men supposedly engage in "cheating" with multiple semi-anonymous women to spread their genes. Men who are willing and able to create children that require little or no "investment of paternal resources" are placed in an advantageous position for genetic selection according to evolutionary psychology.

Of course, not all men are willing to be sperm donors. Also, the donation of an embryo presumably requires the consent of both creators, and obtaining consent from multiple parties is more difficult.


Randall Parker said: "The reluctance of couples to donate their embryos to other couples strongly argues against Bush's position." also "The couples are more willing to let the embryos be thrown away than they are to donate them. So they don't think of the embryos as human lives."

This pair of comments seems a bit odd. We already know that abortion is legal in the United States and many other countries. Thus, we already know that many millions of couples are already willing to destroy entities that exhibit considerably more development than embryos. These couples prefer destruction to adoption. In fact, couples are willing to destroy fetuses that have partially developed nervous systems and can react aversively to stimuli. Thus, the willingness of couples to destroy embryos and fetuses is not a new fact emerging from IVF clinics. (Of course, arguments over the "morality" of a behavior are not usually definitively decided by the prevalence of the behavior.)

Ralph Ekwall said at June 18, 2005 2:05 PM:

I know that fertility clinics have routinely discarded fertilized embryos for many years. It is also true that in the normal course of a woman's life that she will, from time to time, spontaneously abort embryos for unknown reasons. We have never heard any outcry from President Bush and the far right about these events. Now we learn that stem cells may offer great promise for the cure of a number of diseases such as Parkininson's Disease and Multiple Sclerosis.

As soon as Bush and the far right wing evangelists learned that stem cells might do some good for sufferers from killing diseases, they decided that it was equivalent to murder. They never said a word about it previously. One can only conclude that President Bush and right wing evangelists prefer to have people suffer from life destroying diseases.

President Bush and the evangelists might profit from reading the numerous Gospel accouts that tell about the healing miracles of Christ. I wonder if Bush thinks that Christ should have allowed them to suffer? That seems to be the Bush position now.

Ralph Ekwall

Randall Parker said at June 18, 2005 3:12 PM:

Ralph Ekwall,

A lot of people who think an embryo is a human life have been pretty consistent about that over the years. If they haven't fought every political battle over embryos I take that as a sign that they didn't use to be as well organized and coordinated. Their organizations and mediums of communications have grown over the years. So I'm not surprised they are putting up a bigger battle over human embryonic stem cells than they did over IVF.

Very few Christians I've ever met want people to suffer from diseases. The people organized against human embryonic stem cell use in research are not opposed to adult stem cell research and adult stem cell research funding has grown dramatically while Bush has been in office. A recent bill to increase funding for umbilical cord stem cell research got a near unanimous vote for it in the House of Representatives (I think it got just 1 nay vote if memory serves).

The debate is about what is a human life. I don't have a convincing definition of my own for where to draw the line in all cases. I am not surprised that people differ on where to draw the line. Not all differences of opinion indicate ill will on the part of anyone involved.

Ralph Ekwall said at June 22, 2005 5:13 PM:

To Randall Parker:

You say, in your reply to my comments, that people opposed to embryonic stem cell research have always been opposed to such research. I challenge you to provide one or more examples of such opposition that go back as much as a year. I do not think you will be able to find any such opposition.

I think that you are correct that few Christians want people to want to suffer from diseases.It is only a small number of fanatics led by President Bush, Jerry Falwell and Pat Robertson and his ilk. These are the ones who appear to want to make people suffer. The mainline Christian protestant denominations such as the Methodists, Presbyterians, Congregationalists would favor stem cell research. They would favor helping people.

Ralph Ekwall

Randall Parker said at June 22, 2005 5:27 PM:

Ralph,

I have a hard time believing that you really mean what you say here:

You say, in your reply to my comments, that people opposed to embryonic stem cell research have always been opposed to such research. I challenge you to provide one or more examples of such opposition that go back as much as a year.

Why did Clinton and Congress ban human embryonic stem cell research in the late 1990s? Why in 2001 did George W. Bush legalize it for use only with hESC lines that were already created? The opposition has been around since it first became possible. Go back 20 years and you'll find little opposition because it wasn't possible and people were not thinking about it since it was still a distant prospect. But once it became possible it became a hot potato for 2 US Presidents of opposing political parties. Clinton's position is not consistent with your little theory.

Again, are you sure you wanted to say what you said above? 1 year? Are you really serious? I figured you might mean some longer length of time. The hESC debate has been raging for years. Though it is harder to go back and find quotes from 1998 or 1999 when the web was young and fewer quotes made then were put on the web.

Ralph Ekwall said at June 23, 2005 2:47 PM:

Randall:

You need to do a little research and get your facts straight. I made it clear in my comments, if you will bother to read them, that I was talking about fertilized eggs which might be called embryos. I said that they had routinely been discarded and nothing was ever said about that. I stand by that statement. I also said that women frequently abort fertilized eggs for reasons unknown. I said that Bush and the evangelists had never objected to that.

When I did my research this is what I found out. In 1995 Congree moved to prohibit the the use of Federal funds to create human embryos solely for research purposes. This prohibition said embryos could not be CREATED. It said nothing about unused embryos from fertility clinics.

Ralph Ekwall

Ralph Ekwall said at June 28, 2005 7:50 AM:

Has Randall Parker suddenly been struck speechless?
Or, have I succeeded in enlightening him?

Ralph Ekwall

Randall Parker said at June 28, 2005 8:42 AM:

Ralph,

I told you that embryonic stem cell research opposition didn't just pop up last year. You said:

As soon as Bush and the far right wing evangelists learned that stem cells might do some good for sufferers from killing diseases, they decided that it was equivalent to murder.

Why'd Congress block human embryo creation for research purposes back in the 1990s? The opposition to embryonic stem cell research has been around for a long time.

Look, you are making absurd assertions. No, I'm not going to spend an hour of my precious time googling prove that you are saying something absurd.

Your request here:

You say, in your reply to my comments, that people opposed to embryonic stem cell research have always been opposed to such research. I challenge you to provide one or more examples of such opposition that go back as much as a year. I do not think you will be able to find any such opposition.

Have you not been paying attention? Where were you in 2003, 2002, 2001, 2000? Off visiting another planet? No, I'm not going to waste my time on this. If you told me to prove that opposition to Darwinian natural selection doesn't go back more than a year my reaction would be the same and for the same reason.

Ralph Ekwall said at July 7, 2005 7:45 AM:

Randall:

My, but you are getting testy. I am sorry that you refuse to continue the dialogue. If you have a weak position it is hard to make rational arguments.

Ralph Ekwall

Becca said at October 16, 2006 6:07 AM:

Embryonic stem cell research is actually just exploitation of human life and maybe someday people might use embryos as a natural resource. I sympathize with those who have spinal cord injuries, Parkinson's disease etc., but are we willing to end the lives of thousands of unborn children to try and find a cure. Bush does not just "throw away" 400,000 embryos. Embryos can be stored in a fertility bank for up to 10 years, then they must be thrown out. But in those 10 years, programs like the Nighlight Christian Adoptions Snowflakes Program have been started to try as hard as possible to make sure embryos are not thrown away, but give a home.

Anthony said at March 12, 2008 7:33 AM:

May find it interesting that new research techniques as of 1/01/08 allow human embryonic stem cells to be removed from blastocysts without the destruction of that parent cell. This gets around all moral obligations of using human embryonic stem cells. Removing a very small number of stem cells without killing the parent cell is embryonic stem cell research without the moral ramifications. The stem cells, as you already know, aren't humans by anyone's standards. The blastocyt/embyro/baby/etc. may be considered human by some people. I do, yet I'm doing a persuasive speech on the morality of human embryonic stem cell research based off of this new research.

For proof, please check out http://www.advancedcell.com/ and go to the article entitled "Human Embryonic Stem Cell Lines Generated without Embryo Destruction"

By the way, I am a Christian, but I am not a rightwing fanatic conservative dogmatic evangelical. I simply believe the Bible is true in all aspects.

Rafael said at March 7, 2009 4:49 PM:

Anthony...and all the others dancing around the central issue...

It doesn't matter if there are other techniques, like removal of stem cells from blastocysts, or other more "morally defensible" procedures one wants to come up with. These are not procedures that can replace the current source of embryos that provide stem cells, because they are produced for a different purpose.

The fact is that the same human embryos that would go to stem cell research will be destroyed anyway because they are left over from parents who performed IVF but no longer want to implant these particular embryos. Unless you want to somehow ban IVF, there are no more embryos destroyed when embryonic stem cell research is legal than when it is banned. (I would guess that a good proportion of those who are against stem cell research for "moral" reasons actually relied on IVF). When you do IVF you don't choose the number of embryos that are fertilized--you fertilize as many oocytes as you can extract, and then you choose the best ones for implantation (and the second best for freezing).

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