MANY CLINICS TREAT EMBRYOS WITH RESPECT
Fertility patients often don't use all of the tiny cell clusters. Disposal procedures
vary.
By DAVID B. CARUSO
The Associated Press Writer
Saturday, September 18, 2004
PHILADELPHIA – The nation's fertility clinics vary widely when it comes
to how they perform one of the most delicate aspects of their jobs: disposing
of unused frozen human embryos that were created to help infertile women become
pregnant.
In a survey believed to be a first, 217 in-vitro fertilization clinics across
the country described the variety of methods they use to dispose of the frozen
clusters of cells, which are the size of a dot and incapable of living outside
a womb.
The reverence that some clinics gave to the task surprised researchers at the
University of Pennsylvania and Rutgers University.
Seven clinics said they performed a quasi-religious ceremony, including a prayer,
for each embryo they destroyed.
Seven others took the technically unnecessary step of culturing the cells in
a lab dish, then allowing them to multiply on their own, briefly, before they
perish.
Four insisted that, whatever method was chosen for disposal, the patient be
present when it happens. Others barred them from being in the room, or recommended
that they be uninvolved.
University of Pennsylvania bioethicist Arthur Caplan said the survey results,
published last month in the journal Politics and the Life Sciences, show that
the clinics have a level of moral sensitivity unrealized by the public.
"I don't think anyone who deals with these frozen embryos considers them
to be persons," Caplan said. "But I think that they feel they are
deserving of respect. ... They see the potential for life in this material."
At Coastal Fertility Medical Centers in Irvine and Aliso Viejo, patients have
options for what to do with unused embryos, said Dr. Lawrence Werlin, medical
director.
"Most couples try to use all of their embryos," Werlin said. "Others
keep their embryos frozen indefinitely until they make a final decision. Some
donate their embryos to other infertile couples. We've had two patients who
delivered babies and used donated embryos that were frozen 13 years ago."
Other studies have estimated that there are about 400,000 frozen embryos in
storage in the United States. Each has fewer than 100 cells.
Some religious groups, including the Roman Catholic church, have condemned both
the creation of embryos in a laboratory and their destruction if they go unused,
saying children should only be created by sex between a married man and woman.
In 2001, President George W. Bush said he would no longer allow federal tax
dollars to be used to make discarded embryos available for stem-cell research.
Of the 217 clinics that responded to the survey, 33 said they were willing to
create extra embryos as part of the in-vitro fertilization process but were
not willing to dispose of them.
Almost all were willing to permanently preserve the frozen embryos in cold storage.
About three in four clinics allowed patients to donate them to be used by other
couples. Sixty percent allowed them to be donated for research.
Four clinics said they gave the thawed embryos back to their clients.
Dr. Stephen Somkuti, medical director of the IVF program at Abington Reproductive
Medicine, said ethics policies at the Abington hospital, where his clinic is
based, bar it from destroying any embryos itself.
Some patients simply toss the embryos out themselves, Somkuti said. Others take
the small straws containing the cells home with them.
"Some people just decide to have us keep them in the freezer ad infinitum
because they can't come to terms with what to do with them," he said.
Seven clinics, or about 3 percent of all that participated in the study, said
that because of religious or ethical concerns, they would not create more embryos
than they intended to implant, and thus had no cells to freeze or destroy.
Dr. Vincent A. Pellegrini, a fertility doctor in West Reading, Pa., said he
wrestled with the issue for two years before deciding that destroying surplus
embryos would be akin to "throwing away human life."
"It just wasn't an option," Pellegrini said. "Once we have a
dividing embryo, it is human material I can't discard."
The policy poses an additional burden for patients.
It requires that the clinic sometimes implant more developing embryos in a woman's
body than they generally need to ensure a successful pregnancy, meaning that
the women carry an increased risk of having twins, triplets or quadruplets.
Pellegrini said some patients decide to go elsewhere because of his policies
but that he also attracts patients who share his views.
