Couples using assisted reproductive technology (ART) to get pregnant, including in vitro fertilization (IVF), may still not be able to get pregnant with their own eggs and/or sperm. If this is the case, they can use a donated egg or donated sperm or both for IVF. If a couple can obtain both donated eggs and sperm for IVF, the next logical step would be to use already fertilized embryo, which is fairly new medical and legal territory.
How many embryos are potentially available? In 2003, there were approximately 400,000 embryos frozen in the United States. The number will be larger today. Many of these embryos are going to be used by the couple they belong to. All of them, however, will not. Some couples do not need every embryo to have the number of children they want. For other families, the situation has changed. The couple may have divorced; one could have become critically ill or died. The female partner may have had complications with pregnancy, or the couple may not have enough money to do any more IVF cycles.
What should be done with the unused embryos? This question brings up emotional, ethical, religious, legal, and practical issues. Some couples may decide to donate embryos. Like adoption of children, this can be done anonymously or in an open manner. When the donation is open, the couple who is donating is involved with selecting the recipient of the embryos. They may want information about the possible recipients, such as their religion, education, income, and ethnicity.
Afterwards, the donating couple may want to keep in touch. They may want to know if there is a successful result and information about children born from their embryos. They may even want to consider having a child from a donated embryo getting the chance to learn about and even meet their children, who would be biologic siblings. In these cases, adequate legal assistance is critical. An embryo adoption agency may be very helpful.
In anonymous embryo donation, the clinic storing the embryos makes the match. They will usually try and pick embryos of parents with similar ethnic and physical characteristics and sometimes consider other factors.
There is screening and testing for both the donating couple and the recipient couple. Embryo donors usually need to be at least 21 years of age. Both partners should be screened for infectious diseases that could be transmitted by the embryos, such as various types of hepatitis and HIV. They may be tested for any inherited diseases common in people of their ethnic background. They will also get a psychological evaluation and counseling in order to make sure they understand the possible outcomes.
The receiving couple must have come to terms with their own infertility and understand why they want to adopt an embryo. They must be ready to carry and raise a child who is not biologically related to either of them. The prospective mother will have to go through all the testing required in an infertility evaluation, if she has not already done so, to make sure she can carry a pregnancy. Before and after the transfer, she will be getting hormones and other medications to prepare her uterus for pregnancy and to retain the pregnancy. If available, more than one embryo is usually transferred to improve the chance of success. This means there is a risk of multiple births.
The recipient couple needs to know that the average success rate of one IVF cycle, which would be one cycle of embryo transfers, is approximately 28%. They have to pay all of the costs, which include testing the donating couple for infectious or genetic diseases. A couple could do more than one cycle of IVF, but would probably need additional donated embryos.
If you are considering donating or receiving embryos, you need to make sure you understand all the emotional and legal consequences of your decision. Both couples may need counseling. Lawyers who are very familiar with reproductive laws need to be involved. There is very little legislation at the current time and the legal status of embryos is unclear. That means you need to address all the questions and potential problems at the onset.
Embryo donation may ultimately be a good choice for people who do not want to leave unused embryos or have them destroyed. Receiving an embryo may be the best choice for couples with specific types of infertility who still want to experience a pregnancy. If you are interested in either receiving or donating embryos, there are agencies and support groups that you can turn to for assistance.