IN IVF LIMBO
Leftover embryos present challenge for clinics and couples
Unknown numbers of embryos are stuck in limbo in fertility clinics.
Jenny Sammis can’t bring herself to donate nearly a dozen of her extras to research. She and her husband agreed to do that when they made their embryos 15 years ago, but her feelings changed after using some of them to have children.
“I have these two gorgeous, smart people who came from this process,” Sammis said. “These embryos are all like seeds that could become potential people,” Sammis said. “That reality to me was all abstract when they were in the freezer.” Tank failures at two clinics in Ohio and California last year revealed hidden issues with long-frozen embryos, including some from the 1980s when IVF began. A few years ago, medical groups developed sample consent forms clinics could use for new patients, spelling out what could happen to unused embryos. But that hasn’t resolved what to do with ones made long ago
“It’s a real dilemma for these clinics,” said Rich Vaughn, a Los Angeles lawyer who headed the American Bar Association’s assisted reproduction committee for many years. “We don’t quite know what to do with them and everyone’s afraid to act” for fear they’ll be sued if people surface later and want their embryos.
The number is growing because of changes in how it’s done. The old way was to transfer multiple fresh embryos to a womb, hoping at least one would lead to pregnancy. Now, couples usually freeze many embryos, test for health problems and transfer the most viable one at a time to avoid multiple births. That often means leftovers once the desired family is complete.
How many embryos are in storage isn’t known — centres don’t have to report that. One study estimated there were 1.4 million in the U.S.
Sara Raber of New York’s Long Island had five extras after conceiving two children.
Making a lot of embryos seems necessary because you don’t know how many tries it will take, she said. But disposing of extras brings a finality to family building that’s different for IVF couples than it is for those who conceived naturally.
Even after the Rabers agreed to donate theirs to research, which usually means to a fertility clinic to let staff practice IVF, the paperwork sat on her desk for months, Raber said.
Sammis is having a similar struggle. “I get to the point of signing the papers, and I just can’t deal with it,” she said. Sammis said a friend who couldn’t decide what to do with her embryos moved away and “didn’t give the fertility centre her forwarding address ... That was her way of dealing with it.”
Andrea Braverman, a health psychologist at Thomas Jefferson University in Philadelphia, said it’s not an easy choice. A study of 131 couples in Canada found that onethird had not returned for frozen embryos after five years. Another study found that up to 70 per cent of couples delayed a decision for at least five years, and many changed their minds about what they thought they’d do.
“This is a fluid decision. It is not a one-and-done,” Braverman said.
Dr. Craig Sweet, who runs a fertility clinic in Fort Myers, Fla., knows the problem well. About 18 per cent, or 300, of his clinic’s frozen embryos are abandoned, some for 25 years.
A study he did found that couples were more likely to abandon embryos if they had stored them a long time, had a low education level, already had many children or owed the clinic money.
The courts view an embryo as something between person and property, said Susan Crockin, a reproductive law expert at Georgetown University. When it’s in the lab as opposed to being in a womb, “people have equal rights to it” and most courts will not allow one member of a couple to use an embryo over the other’s objection, she said.
Clinics try to avoid being in the middle. Sweet started Embryo Donation International to provide embryos to couples willing to use them to have children.
Frozen embryos remain viable for decades as far as anyone knows. Sweet supplied a Chicago woman an embryo that had been frozen for 17 years and made one request:
“When the baby is born,” he said, “I want you to see if you can register the kid to vote.”