My Infertility Journey

Home Up

 

The problem

In vitro fertilization (IVF) was introduced in the United States in 1981 and has resulted in about 300,000 live births.  It has allowed infertile couples to achieve pregnancy in cases where they could not conceive naturally.

IVF is the uniting of sperm and egg outside the woman’s body, specifically in a petrie dish (in vitro is literally translated “in glass”). The procedure involves retrieving eggs from the female and combining them in a petrie dish with the male’s sperm.  If egg and sperm unite (fertilize), an embryo is formed and allowed to grow for a few days.  At the same time, the uterus is prepared to accept the embryo(s). Two to four embryos are usually chosen and then transferred to the uterus in hopes that they will implant and continue the pregnancy.

It can take up to 3 embryo transfers to achieve successful implantation, so several embryos are created and the remaining unused ones are frozen cryogenically so that a subsequent transfer may be possible at a later date. The root of the problem is that no plan had been developed for the handling of remaining embryos after a family has had all the children they want.  Consequently, there are an estimated 400,000 embryos in frozen storage.

Many couples that go through IVF do not anticipate having unused embryos left over after they have completed their family. If they do have embryos leftover, they are then faced with a decision about what to do with their embryos. In the past, they had three options: they could leave the embryos in a frozen state indefinitely, destroy the embryos, thaw the embryos and allow them to die or donate them to medical research.  Many, unable to make a decision, leave the embryos in a frozen state indefinitely.

Solutions

In 1997, Nightlight Adoption Agency (a licensed adoption agency since 1959) began the Frozen Embryo Adoption Program and the first “snowflake” baby was born in December 31, 1998.  According to their website, the agency has matched 2,330 embryos with adopting families, resulting in 170 snowflake children with 26 “on the way” when the data was published.  See http://www.nightlight.org/snowflakeadoption for more information about their program.

Beginning in 2002, Congress earmarked funding in the HHS annual appropriations act for an embryo adoption public awareness campaign. The purpose is to educate Americans about the existence of frozen embryos (resulting from in-vitro fertilization) which may be available for donation/adoption for family building through the development and dissemination of resource information, educational events and training opportunities. Each year, three to four new grant awards have been made through a competitive process. See www.hhs.gov for more information about these grants.

In 2003, Dr. Jeffrey Keenan began the NEDC (National Embryo Donation Center) a nonprofit organization in Knoxville, Tennessee, who handles the medical, legal and social requirements of embryo donation and placement at no cost to the patient's fertility clinic.  The Center offers a variety of placement options for couples considering donation of their cryopreserved embryos, and also provides counseling for both donors and recipients. See www.embryodonation.org for more information on their program.

Bethany Christian Services, a Christian adoption and family services agency with more than 75 offices in the United States, began an embryo adoption program in 2007.  Embryo adoption services include education and counseling related to the embryo adoption, Home Studies, facilitation of the medical transfer of the embryos to the adopting couple, assistance with openness choice, post-transfer support, and post-birth visits.  See www.bethany.org for more information on their program. 

In recent years, fertility clinics have become more responsible in their procedures, creating fewer embryos and allowing them to grow for more than the usual 3 days. Embryologists discovered that some embryos were still sustaining themselves on the material from the egg at three days, but would not ever be viable embryos on their own. In a natural pregnancy, these are the embryos that never implant in the uterus and pass through undetected.

If the embryos are allowed to grow to the blastocyst stage (5-7 days), they are already sustaining themselves and are actually at the same stage that they would be when entering the uterus from the fallopian tubes in a natural pregnancy.  An increasing number of fertility clinics and infertile couples are opting for blastocyst transfer because fewer embryos are used (only one or two are transferred) and the success rates are higher; thus, fewer embryos are produced and subsequently frozen, which reduces the number of leftover embryos.