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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.
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Coastal Fertility Medical Center offers one of the most affordable fertility treatments and is completely transparent regarding the costs of procedures and any other expenses that you may have to pay before commencing your treatment. This differentiates us from some fertility clinics that reduce prices before the signing of the contract but charge you extra later on. We make sure our patients are well aware of any possible extra pricing that may occur over the course of their treatment.
Following the Preimplantation Genetic Screening process, which helps ensure there are normal chromosome numbers and detects possible genetic disorders, the most healthy embryo(s) are selected to be implanted into your or your chosen surrogate’s womb. 2 weeks after the transfer of the embryo, your physician will conduct a final blood test to determine the level of hCG (human chorionic gonadotropin) in your body. Increased hCG levels usually indicate a positive pregnancy test.
For fertilization to take place, the collected egg and sperm are combined in a petri dish and cultured in an embryo incubator. This dish is closely watched to check whether any of the eggs have been fertilized. Once the egg is fertilized, it is referred to as an embryo or a blastocyst on the 5th day of development. Our in-house embryologist carefully nurtures every embryo to the right time, even if it means working outside the standard business operating hours. For instance: If an oocyte is not mature, our laboratory will wait for it to mature and then ICSI it at the right time.
The egg retrieval is a slightly invasive medical procedure that takes about 20 to 30 minutes. You will be given an anesthetic to make you sleep for the duration of the procedure. Using ultrasound technology, your doctor will harvest your eggs transvaginally with a small, hollow needle connected to an ultrasound probe. Once your eggs are collected, your partner’s semen or donor sperm you have pre-selected is used for fertilization. The sperm are washed and prepared, and the top-quality sperm extracted is used to fertilize the eggs.
Your doctor will create a customized medication schedule that contains information about the fertility medications and hormone injections you have to take. Medication and injections are taken to encourage your ovaries to mature a large number of eggs for fertilization. Since women don’t respond to fertility drugs and hormones the same way, personalized protocols are crucial to the IVF cycle success. At Coastal Fertility, we will monitor you closely, letting you understand the changes occurring in your body and keeping track of how your egg follicles are growing.
On-site consultations typicallyinclude a standard fertility evaluation, consisting of a physical examination, complementary follicular ultrasound, and testing to enable your doctor to know your present fertility status and draw up a treatment plan.
This consultation includes a detailed medical evaluation with a doctor. You and your physician will review your health records and have enough time to talk about your goals and get answers to your questions. We recommend that you jot down all your questions before the visit to allow you to make the best use of the time spent with your doctor.
Your Reproductive Endocrinologist will take all factors into consideration and create a comprehensive plan of care, otherwise known as the treatment plan. This plan will include treatment recommendations from the physician and enable your financial coordinator to make a precise quotation once you meet.
Our globally respected team of specialists are helping improve IVF technologies to enter into a generation of better outcomes for infertility. Although you’ll have a doctor guiding you, you are also going to benefit from the experience and insights of other doctors during case review collaboration meetings, which take place every week. So, you won’t just rely on the expertise of a specialist but benefit from the knowledge of many reputed fertility experts.
The infertility industry is currently segmented, with each service or treatment being handled by a different provider. Our all-inclusive model simplifies an otherwise complex and difficult process. We are here to revolutionize the infertility industry by offering a one-stop-service model to assist our patients through infertility challenges while reducing physical, emotional, and financial risks.
Our fertility clinic focuses on helping you build your family regardless of your sexual orientation or the gender you choose to identify with. We are even taking further steps to make LGTB people feel more welcome at our fertility clinic. Each of our patient-facing staff goes through LGTB training to let family-building clinicians provide necessary support and make you feel highly welcome.
We know that every situation is different and that everyone requires different treatments. Unlike facilities that take “a one-size-fits-all” approach for all cases, our fertility specialists use more than 40 customized protocols to raise the chances of success. The customized approach even extends to our fertility laboratory. Our on-site lab director and his highly-experienced team nurture every embryo and egg to increase the odds of success of each cycle.
Our team specializes in difficult cases and help patients who may have been considered “hopeless” at other fertility clinics. Thanks to our personalized solutions, expertise, and internal collaboration, weare able to maximize pregnancy success rates that are well above the industry average, even in difficult infertility cases.
Upon your arrival, you will check in with a Patient Care Coordinator. We will obtain your insurance information for benefits verification, a copy of your identification and take a picture for your electronic medical chart
Coastal Fertility is the leading provider of fertility solutions located in Orange County. Join us to get free updates on fertility news, treatments, infertility solutions and more.
Coastal Fertility is the leading provider of fertility solutions located in Orange County. Join us to get free updates on fertility news, treatments, infertility solutions and more.