Ethics for extra embryos: Doctors face a dilemma

Adoption? Disposal? There are no legal rules on what to do, so the number of embryos keeps growing

By Andis Robeznieks, AMNews staff. Feb. 14, 2005.

News reports concerning the nation's inventory of 400,000 cryopreserved embryos can conjure up images of overflowing fertility clinic freezers surrounded by clinicians scratching their heads over what to do with all of the embryos that have been abandoned by the couples who created them.

The number, much higher than previous estimates that ranged from 30,000 to 200,000, comes from a 2003 embryo census conducted by the Society for Assisted Reproductive Technology. But reproductive specialists note that the vast majority of stored embryos -- almost 350,000 -- are still earmarked for future fertility treatments. And of those, 35% likely would not survive the thawing process.

Arlene J. Morales, MD, medical director of the Sharp Fertility Center in San Diego, thinks the perception that fertility clinics are overstuffed with extra embryos is the result of press sensationalism. "The media seems to highlight couples who don't know what they want to do," she said. "But in my experience, most couples intend to save them for future use."

The American Society for Reproductive Medicine recommends using one to five embryos per treatment, depending on the woman's age and other risk factors.

Better technology and more sensitivity is leading fertility clinics to use and create fewer embryos in the first place, said both Dr. Morales and Jeffrey Keenan, MD, medical director of the Southeastern Fertility Center in Knoxville, Tenn.

"I think the biggest hot topic is single-embryo transfer," Dr. Morales said. "We are certainly working toward decreasing multiple births with the goal of a delivering a single, healthy baby."