In the Best Interests of Embryos?

Ellen S. Glazer

As someone whose professional life straddles infertility and adoption, I am very concerned about what I call “a shotgun marriage” between the two fields: embryo adoption. “Embryo adoption” is the emerging practice of having an embryo, originally created by an infertile couple deeply desirous of a child, gestated and parented by another couple. Some celebrate this as an “adoption” that enables parents to experience pregnancy together. Others welcome it as a solution to “the problem of extra embryos.” I have some concerns and appreciate having the opportunity to discuss them.

My first concern about embryo adoption is for the offspring. Like other adoptees, an embryo adoptee will have to grapple with questions about how he/she came into this world and became part of a particular family. In the case of an embryo adoptee this means making sense of the fact that his/her biological parents deeply wanted children, but created more embryos than they were prepared to parent. An embryologist randomly made the choice of which embryos would be parented by their biological parents and which would be adopted out. If this was my story, I would feel like I was part of a scientific experiment.

My second concern is for the biological family of the adopted out embryo. How will the full biological siblings of this person feel? What does it mean to know that you were the one that the embryologist happened to select? How strange must it be to know that you have full biological siblings--equally wanted and loved--who are being raised by other families? I can only begin to imagine the guilt and pressure that the “chosen” ones feel when they learn the serendipity of their place in the world.

And what of their parents? Can an infertile couple that finds themselves with extra embryos truly achieve informed consent? I worry that although embryo adoption may feel like a good thing when they are busy raising young children, they may look back, at a later point, with regret. “Maybe we could have handled more children?” “What did we do to our other children?” Will these parents be surprised by feelings that someone in the family is missing? I fear that all of these questions will be heightened for those whose embryos are placed in closed adoptions.

Finally, I have concerns for the adoptive parents. In “traditional” adoption, adoptive parents provide a home for a child in need of parents. Adoption is often difficult, but adoptive parents can always feel assured that they are doing something that is morally and ethically correct. But is this the case with embryo adoption? A lot has to happen to a growing fetus to prevent it from becoming a live baby in need of parents. By contrast, a lot has to happen for an embryo to become a fetus, let alone to reach live birth. Will these eager parents later question what they have done? I fear that some will be profoundly troubled when they realize that they gestated and delivered a person who will always wonder why he/she was intentionally brought into this world to be separated from their biological parents and their full biological twins/triplets.

What then is to be done with “extra embryos?” My personal preference is that they be donated to medical science. For me, this seems like a logical destiny for them since they were created through scientific advances designed to help infertile people. I once worked with a couple that struggled for two years to find a medical research home for their embryos and who ultimately felt relief and satisfaction to know they were being used to advance treatment for serious illness.

I recognize, of course, that everyone does not share my view that donation to science is the morally and ethically correct destiny of embryos. Surely other resolutions must be identified especially for those who strongly believe that life begins with an embryo. For them, leaving an embryo without parents is tantamount to abandoning a newborn baby on a doorstep. I can understand why embryo adoption feels right to them, but I hope that they--and their physicians--will do all they possibly can to avoid having extra embryos. I remind them, for example, of a couple I once worked with who “avoided creating life we can’t parent” by inseminating only a few eggs each cycle. They are now the content parents of one son and they acknowledge that they might have been able to have more children had they been willing to risk having extra embryos.

This is profoundly difficult issue. Many infertile couples deeply desire to parent their full biological children and most are willing to create extra embryos in order to maximize their chances for successful pregnancy. Of those who have extra embryos, some will choose to discard them and some will donate to medical science. Inevitably, there will be a small number who will find embryo adoption the only acceptable resolution to their dilemma. I can only hope that reproductive medicine programs will counsel these individuals throughout the IVF process, assisting them in every way to minimize their chances for extra embryos. I hope, also, that adoption agencies that become involved with “pre-pregnancy birthparents” will counsel them extensively on what embryo adoption may mean for all the offspring involved.