In the United States, it is extremely common for a couple to have multiple embryos created with each IVF attempt. A few other countries (Germany and Italy, I believe, though I’d have to check my facts) have laws that limit the number of embryos created to the number that one would then transfer in the same cycle, effectively eliminating any excess. America has no such laws.
United States fertility clinics typically counsel their IVF couples to choose one of the following plans for any excess embryos: leave them frozen, donate them to science, or destroy them. Some IVF couples are turning to a fourth option – donating their remaining embryos to other couples.
There are a variety of ways a couple may choose to donate their embryos. On one end of the spectrum, there are couples who may donate their embryos to their fertility clinic. If these embryos are then selected by another couple, it would be done completely anonymously. On the other end of the spectrum, there are those placing couples who work with an embryo adoption service to handpick the adoptive parents – the genetic parents may even formulate an open adoption relationship with the adoptive parents.
The first scenario described falls into the category of “embryo donation”. The genetic parents have relegated all parental responsibility to the fertility clinic. By law, embryos are considered property, not persons. With donation, the interested couple (or individual) goes to the local fertility clinic and picks a suitable match based on a list of physical characteristics. Depending on state law, surrogates may be allowed. In comparison to adoption, donation is cheaper, faster, and incredibly impersonal. The end goal of embryo donation is pregnancy. Here the embryo is considered in its legal sense, as property, rather than in its true sense, a human being.
As proof of this ideology, consider the following quote from an American Society of Reproductive Medicine (ASRM) Ethics Committee Report in 2009:
“Requiring infertile patients who need donor gametes or patients who need donor embryos to suffer the imposition of unnecessary administrative and legal trappings of adoption and the costs that accompany them is not ethically justifiable. The donation of embryos for reproductive purposes is fundamentally a medical procedure intended to result in pregnancy and should be treated as such.” ASRM Ethics Committee Report. American Society for Reproductive Medicine: Defining Embryo Donation. Fertility Sterility, 2009;92(6):1818-9.
This mindset proves just how important it is to distinguish between embryo donation and embryo adoption.
The second scenario falls into the category of “embryo adoption”. The adopting couple must complete a home study with an accredited adoption agency before any adoption proceedings may take place. Adoptive parents are counseled on ways to tell their children of their unique origin. Matches are mutually conducted between genetic parents and adoptive parents. Many embryo adoption services do not allow surrogates. The only involvement a fertility clinic plays is the transfer itself. Though not legally accepted as a form of adoption (except in the state of Georgia), embryo adoption is patterned as closely as possible off of pre-existing infant adoption standards/guidelines. The end goal in embryo adoption is saving the life of the embryo(s) and achieving parenthood.
And in between the two scenarios are a whole host of organizations. Some do not require home studies, some do. Many solely exist to facilitate matches between donating couples and adopting couples. Future posts will offer a more detailed look at many of the embryo adoption or embryo donation services in existence.