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The problem with ‘embryo adoption’

One of the strangest outcomes of the ongoing debate over embryonic stem-cell research is the government’s use of taxpayer money to support a little-known private organization called Snowflakes.
Snowflakes is a private organization that encourages infertile couples to 'adopt' frozen embryos.
Snowflakes is a private organization that encourages infertile couples to 'adopt' frozen embryos.

One of the strangest outcomes of the ongoing debate over embryonic stem-cell research is the government’s use of taxpayer money to support a little-known private organization called Snowflakes. Devoted to encouraging couples to “adopt” human embryos, Snowflakes has received over $1 million from the Bush administration and Congress.

While helping people have babies is ethically commendable, there is something very strange about extending the use of the term “adoption” to embryos. Children get adopted, but ... embryos?

And it is even stranger that the federal government is buying into this way of thinking.

So where do all these embryos that supposedly need adopting come from in the first place?

When couples seek treatment for infertility, they often wind up using in-vitro fertilization, or IVF. This is a procedure in which embryos are created outside the body in a laboratory dish and are then implanted back into the woman’s body where, ideally, they grow to full term.

It works like this: The woman takes fertility drugs that cause her to produce far more eggs than the one she normally would release during her monthly cycle. These eggs are then surgically removed from her ovaries and fertilized in a dish with either her husband’s or a donor’s sperm.

Often many embryos are created through this process. But since multiple-pregnancies — quadruplets, quintuplets, septuplets and the like — produce premature and often unhealthy babies, doctors will only put two or three embryos back into the woman’s body to try and help her become pregnant.

The clinic chooses to implant the embryos that look the healthiest and asks the couple if they want to freeze the rest. The couple also has the option of having the remaining embryos destroyed, donated to other couples, or donated for embryonic stem-cell research.

'Pre-born children waiting'
This is where Snowflakes saw a need — and a chance to score some moral points in the debate over stem-cell research.

Snowflakes is run by the Nightlight Christian Adoption agency in Fullerton, Calif. The group has no medical background. They simply believe that every embryo is a baby from the minute it exists in a laboratory dish.

The Snowflakes program deliberately uses the language of adoption to make that point clear. They created a service that matches couples who have leftover embryos with other infertile couples trying to have babies. To quote from their “By some estimates, there are over 100,000 frozen embryos in cryo-banks throughout the United States. Pre-born children waiting — waiting.”

Actually Snowflakes’ estimate of 100,000 embryos is probably very low. Most experts think there are as many as 400,000 embryos frozen in storage in the United States. As of just over a year ago, the Snowflakes program had received about 750 of them and had matched 70 donor couples with 48 other couples seeking to have children. Sixteen babies had been born.

What's the big deal?
So what’s the big deal about a religious group that believes all embryos are children and is trying to find them “adoptive” parents among infertile couples using IVF? Well, actually there is a lot that is wrong.

It’s great that 16 babies were born last year through the Snowflakes program. That makes it seem as if 16 couples had children who might otherwise have not. But that is not really the case. Nearly all infertility clinics offer couples the option of donating their leftover embryos to other couples. All that Snowflakes has done is brought the rhetoric of adoption into the process.

You might also get the impression that Snowflakes is creating an opportunity for infertile couples to access the 100,000 to 400,000 frozen embryos out there. But that is not really the case either. If you are infertile and are trying to have a baby, your best bet is not to use a frozen embryo made by a couple who had themselves been going through infertility treatment and whose embryos were not used because they did not look healthy enough.

Despite Snowflakes’ rhetoric, most frozen embryos are not healthy enough to ever become babies. The chance they will grow to full term is about one in 10 for those frozen less than five years, and even less for those that have been frozen longer. This is why so few couples have taken Snowflakes up on its idea of “adopting” frozen embryos.

Moreover, using terms like “adoption” encourages people to believe that frozen embryos are the equivalent of children. But they are not the same. In fact, infertile couples who want children can frequently make embryos but they cannot make embryos that become fetuses or babies.

The older a woman gets, the less likely her embryos are to become babies. For women over 45, the chance of her embryo becoming a baby is almost zero. The inability to make embryos that become babies is why couples turn to donor eggs or donor sperm. Almost no one who is going to spend $10,000 per try to use IVF is going to want to try it with another infertile couple’s frozen embryo whose chances of properly developing grow less with every year it is frozen.

A government sham
The Bush administration and Congress know all these facts, but have nevertheless poured more than $1 million of taxpayer money into the Snowflakes program and others aimed at facilitating “embryo adoption.”

This is a nice way to score points with those who advocate the view that embryos are actual babies and should not be used for research purposes. But it is not the best way to help couples who want to have actual babies.

One million dollars would be far better spent matching fertile couples willing to make embryos with infertile couples, rather than trying to get them to use unhealthy frozen ones.

One million dollars could also help defray the staggering costs of IVF, which only middle- and upper-class couples can currently afford.

But when the money is spent on programs like Snowflakes, the only explanation is ideology not medicine.

Arthur Caplan, Ph.D., is director of the Center for Bioethics at the University of Pennsylvania in Philadelphia.