Embryo Adoption in the News

I have an embryo adoption friend who recently was interviewed by People magazine about her personal adoption story.  This past week, her story aired as a three part online special.  Part one was Liz's story, part two was the genetic mother's story, and part three was an interview with Liz's reproductive endocrinologist.

All in all, they were amazing interviews that, hopefully, brought some positive attention to embryo adoption in the United States. 

One point could bear elaboration:  there are three different routes one can chose from when seeking embryo adoption:  agency adoption, a private match, or a clinic's donation program.  Liz and her husband exemplify scenario two, the private match, while my family has grown through an agency adoption.  I have no interest in saying one is better than another because that point varies by personal situation.  I merely want to lay out some of the similarities and differences between the three paths.

AGENCY ADOPTION

To date, there are three main facilities that offer agency-type embryo adoption services:  Nightlight's Snowflake Program, the Embryo Adoption Services of Cedar Park, and the National Embryo Donation Center (NEDC).  I've examined these programs at length before, so, for the sake of brevity, I'm just going to look at some common points. 

All three require a home study from adoptive families.

The first two facilities write up contracts that carefully outline the relinquishment of the genetic parents' rights.  (As NEDC retains rights to the embryos, not the genetic parents, its contracts are different in nature than the former two establishments.)

All three provide matching services.

All three offer open, semi-open, or closed adoptions. 

All three offer the adoptive family the complete batch of embryos.

All three offer biographical information on the genetic family.  Snowflakes and Cedar Park offer extensive information on the placing family.  NEDC offers varying amounts of information given the different levels of openness (an closed match often means a more limited amount of information available on the donors).

Snowflakes and Cedar Park offer counseling services to both the donating and adopting parties, if desired.

Both Snowflakes and Cedar Park oversee the physical transportation of the embryos from wherever they are housed to the adoptive family's transferring clinic.  (NEDC is a clinic and already houses the embryos.)

This route tends to be the most expensive due to the involved role the agency plays in the whole process.

Additional costs consist of the home study (though Cedar Park offers one in house for an additional cost), medication, and the embryo transfer (except for NEDC which performs the transfer on site).


PRIVATE MATCH

There are two ways to pursue a private match:  through "word of mouth" or through a matching forum.  With the advent of social media and chat groups, finding embryos through "word of mouth" is not an impossible scenario.  However, many adoptive families are turning to one of the two "matching forums" in existence.

Miracles Waiting is essentially a classified advertisement service for donating/adopting couples to find each other.  One pays a flat fee to join ($150) and then one can obtain full access to the listings.  Embryos may not be bought or sold, as that is illegal, but otherwise, there are no regulations or requirements of donors or recipients.

NRFA is a relatively new forum for finding a match.  The price for membership varies, based on the number of months purchased.  This is less like a classified advertisement service and more like a personal look at placing/waiting families' life books. 

Home studies are usually not required, though some placing parents may show preference to those adoptive families who have a current home study.

Usually a private match results in some sort of openness between the placing and adopting families. 

While a private match appears much less expensive than an agency match, there are a few other costs to include:  transporting the embryos to your transferring clinic, legal fees, and all the fees associated with the embryo transfer itself. 


CLINIC DONATION PROGRAM

Some clinics have their own in-house embryo donation programs.  The clinic may or may not have full rights to these embryos.  If the clinic has full rights, then the paperwork is just between the clinic and recipients.  However, if the genetic parents retain rights, then legal paperwork must include them.

Home studies are not required.  Some clinics require counseling services for all patients using "donated material" (embryos included); some do not.

Typically clinics offer only anonymous donation programs.  The adoptive parents have access to whatever details the genetic parents provided which could range from full life history with pictures, to just minimal characteristics.

While other clinics may offer it on a case by case basis, Embryo Donation International (EDI) is the only clinic I know of that has an option for a level of openness.

Many clinics offer enough embryos for a single transfer only.  The receiving couple typically does not receive the whole batch of embryos.  Some clinics, like FIRM, allow the recipients to reserve a whole embryo set.  Others do not. 

Some clinics charge just the standard embryo transfer fees.  Some clinics have additional fees for using embryos from their donation program.

Overall, a clinic donation program is usually the least expensive route, but with the greatest limitations.



From a Catholic perspective, there is no "morally superior" path out of the three.  A potential adoptive couple should carefully weigh their personal needs, finances, and goals for the future (both their own and any resulting hypthetical children) before chosing a route.  And pray, pray wholeheartedly for guidance and direction.  Obviously it goes without saying that, when pursuing any route, the utmost care must be taken to preserve the dignity of each embryo. 


EDIT:  While I find there to be no morally superior path out of the three options, I personally have a hard time with programs that split embryo sets into single transfer portions only (usually groups of two or three).  Try to keep the good of the embryos in mind, including their future well-being.  Will they want to know more about their genetic parents one day?  Quite possibly.  Will they want to know more about their genetic siblings one day?  Most likely.  How important is it for you to be able to assist them in searching for answers?

Increasingly antsy

The clinic contacted me last week so I could get the ball rolling on shipping the embryos from the genetic family's clinic to ours.  I don't have to do much really, just make sure the agency and the clinic are communicating with each other.

Basically, the clinic said, "we're ready!"  (Last Monday)

And I told the agency, "go!" (Last Monday)

And nothing happened.

I did get an email confirming my request for shipment and that someone would be contacting me soon to line it all up.  (Last Tuesday)

Nothing.

I reached out to both clinic and agency last Friday, to see if maybe they were working out details without me.  I'm not the clinic's first Snowflake patient; there is already an established relationship between the two entities.

Nothing.

I emailed the clinic again this morning (Tuesday). Got an answer - shipping coordinator has heard nothing on her end.

I emailed the agency again this morning.

Nothing.

I'll give them one more day and call Thursday.  This is my fourth transfer over the years to orchestrate with the agency so I can honestly say this is uncharacteristic behavior for them.  Regardless, I can't help but wonder, where are my embryos?!

Could you please say a quick prayer that these communication difficulties be resolved quickly?  As my title indicates, I'm getting increasingly antsy.  Thank you!

A Hypothetical Catholic EA Agency

As mentioned in my brief overview on embryo adoption, there is a range of ways that one can “participate” in embryo adoption.  Not all methods award the proper dignity and respect to each embryo or even to each marital relationship.  As of today there are at least nine self-proclaimed “embryo adoption agencies” (here is a list of eight EA agencies; here’s one more agency).  And there are over 500 fertility clinics nationwide that have some sort of embryo donation program (click here for a partial list by state).  Just as regular domestic adoption agencies vary in their services provided, so too do all of these programs in their services provided.

Unfortunately, since embryo adoption is not recognized as a legal form of adoption under federal law, there are no laws in place to regulate embryo adoption practices.  I think it’s worthwhile, then, to define what an ideal Catholic embryo adoption agency would look like.  Though this discussion is hypothetical at this point, it should provide some measure with which to compare existing agencies.

Please note, the absolute best scenario would be for the genetic parents to complete the embryo transfers themselves with their own remaining embryos and care for them for the duration of embryos’ lives (be it moments or decades).  However, I do realize this scenario cannot always be achieved either due to mental, physical, or financial reasons.  The decision to place embryos for adoption should not be (and I doubt it ever is) a decision lightly made.

I would like to propose several criteria for a hypothetical Catholic embryo adoption agency.  First, adoptive parents should complete an adoption home study at least in accordance with their home state guidelines.  Home studies are required for domestic and international adoption; they should likewise be required for embryo adoption.  As part of the home study process, adoptive parents should receive tips on how to share with their child(ren) their unique origin.

Second, all fees associated with the embryo adoption AND frozen embryo transfer should be kept to a minimum and be as affordable as possible.  I’ve seen it argued that the placing parents (aka genetic parents) should “foot the bill”.  Honestly, I don’t think this is a reasonable request.  This is not expected of traditional forms of adoption, why should it be for embryo adoption?  It goes without saying that genetic parents should not be reimbursed in any way for expenses they undertook in the creation of the embryos or in storage of the embryos up until they are relinquished to the care of the adoptive parents.

Third, all adoption legalese should be patterned as closely as possible off of current domestic adoption legalese.  If one day our federal government wakes up and decides to recognize the embryo as a person and to recognize embryo adoption as a legal form of adoption, then there’d be fewer questions on the validity of the contract.  I’m sure they’d be grandfathered in if such a situation were to happen, but you get the idea…

Fourth, there must be strict mandates in place.  Absolutely no surrogates.  Absolutely no selective reduction.  Thaw only the embryos you are healthfully prepared to carry to term, regardless of the statistics.  (Typically anywhere from one to three embryos are frozen in a straw; you cannot thaw a partial straw.)  Do not refreeze thawed embryos.  No genetic testing of any sort.

Fifth, as with normal infant adoption, the placing parents need to accept responsibility for the life/lives created.  They should participate in the matching process as much as reasonably possible.  I favor the idea of a mutual matching process (both placing/adoptive parties few each other’s profiles and say yea/nay), but recognize there may be some instances in which the placing parents have relinquished their rights to the agency.

Sixth, to truly honor and respect each embryo, the agency must keep track of every embryo that passes through its system.  Each adoptive couple should report back with thawing/transfer details along with pregnancy information should one occur.  Normal adoptive post-birth visits should be held by social workers.  Post birth records should be completed by the adoptive parents and filed by the agency. 

Embryo adoption is undoubtedly a unique form of adoption.  I would strongly suggest that all placing parents provide at least two generations of medical history to the adoptive parents to accommodate the special nature of embryo adoption.  However, I believe the adoption could follow normal open or closed communication arrangements as negotiated by the two families with the agency.

Based on my research up through 2008, Nightlight’s Snowflake program was the closest match to this hypothetical list, though there is no exact match in existence.  (Many of the nine agencies listed were just coming into existence when we did the bulk of our research and so were not reviewed.  I’m in the process of gathering more information now…)   I have three issues with Nightlight:  cost, they’ll work with surrogates on a case by case basis, and they don’t have any regulations regarding refreezing.  The majority of EA agencies in existence seem to be more affordable than Nightlight but also seem to offer less to both placing/adopting families.  Some agencies, like Miracles Waiting or Embryos Alive, seem to be just a forum for matches to take place.  Without more oversight, I fear that each embryo may not receive its due dignity in such an arrangement as Miracles Waiting or Embryos Alive. 

However, my thoughts continually are evolving on the formation of a Catholic embryo adoption agency.  What do you think?  Is there anything I have omitted?  Or should edit?