Family Matters

Avoiding Ethical Quandaries In Embryo Donation

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When it’s most successful, in vitro fertilization, or IVF, yields far more embryos than a couple could ever use (unless that couple is the offspring-obsessed Duggar family). There are frequently frozen embryos left over, and the options for what to do with them are limited: destroy them, donate them to research — or, rarely, to other couples — or continue storing them in liquid nitrogen for a fee.

There is very little consistency in terms of how fertility clinics ask patients for their preference. Now a new study from Stanford University looks at one option — donating embryos to science — and makes the case that many more couples may choose to do so, if fertility centers implemented a simple no-pressure policy. (More on Stress Doesn’t Hurt Chances of Success with IVF)

Patients at 40 clinics in 20 states were included in the study. Researchers did not track the percentage of patients who donated their embryos to research, but they do know that a total of 403 couples donated 1,356 embryos, which struck senior author Christopher Scott as a pretty high number. It indicated to Scott, who is director of the Program on Stem Cells in Society at Stanford and on the faculty at the school’s Center for Biomedical Ethics, that the percentage of interested donors is probably considerably higher than the 10% or so that previous research has estimated. “I was surprised to see the numbers,” says Scott.

There’s not a lot of data on frozen embryos, but a 2003 study estimated that 400,000 embryos are in storage in the U.S.

One concern about asking patients to donate embryos for research purposes is ethics — that fertility clinics that are also involved in research may have “undue influence” on patients. “There could be a conflict of interest,” says Scott.

Consider, for example, a fertility doctor who pulls double duty as a scientist. “That doctor could say, I will freeze five embryos and use five for research to figure out why people like you can’t conceive,” says Scott. “But if the person doesn’t conceive, she would have to go through IVF again with its expense and risks, so you see there is an ethical problem there.” (More on Time.comCan Yoga Help Improve IVF Results?)

To skirt that situation, the researchers experimented with letting patients make the decision about donation at home, far from any potential pressure from doctors or clinic employees. In the journal Cell Stem Cell, the authors describe a simple process in which patients received information about potential donation for research along with their embryo-storage bill. It is then up to the patients to follow up with a phone call to bio-bank staff members who are not associated with the fertility clinic or potential researchers.

“I don’t think any of it is actually earthshaking, but what’s interesting is that it attempts to give couples a no-pressure process by which they can make an informed decision about what to do,” says Scott, who says the process described in the study is now used routinely at Stanford. “There is no pressure asking them to make a decision on the spot in the clinic. They do this on their own time with their families.” (More on Time.comIVF Linked to Elevated Maternal Death Rate)

They are also asked to fill out consent forms that direct their embryos to certain types of research — creating embryonic stem cell lines, for example, or studying human development. Those who opt for stem cell lines are informed that should their embryos end up being the foundation of a new line, their genetic material could outlive them. “Genetic material lives beyond us, of course, because we have children and grandchildren,” says Scott, “but it also lives beyond us in a Petri dish.”