What to do with leftover embryos in fertility clinics?

Sep 24 2008

The majority of infertility patients are in favor of using left-over embryos for stem cell research and would also support selling left-over embryos to other couples, according to a recent survey.

The survey is published in two related studies in the September issue of the journal Fertility and Sterility.

The researchers surveyed 1,350 women who presented for infertility at a large, university hospital-based fertility center in Illinois. The survey included 24 questions on patient demographics, obstetric and infertility history, and opinions about using extra embryos for stem cell research and selling extra embryos to other couples.

Assisted reproductive technology has resulted in the creation and cryopreservation of extra embryos at fertility centers across the country. It was estimated in 2002 that 396,526 embryos were in storage at U.S. fertility clinics, according to previously published research.

These embryos may be used for future pregnancy attempts, donated to other couples or agencies, given to researchers, or discarded.

Because infertility patients are the gatekeepers of these leftover embryos, it is important to understand their opinions, according to Dr. Tarun Jain, University of Illinois at Chicago assistant professor of reproductive endocrinology and infertility, clinical IVF director, and lead author of the study.

When asked if using leftover embryos for stem cell research should be allowed, 73 percent of the 636 respondents who stated a definitive opinion answered yes.

"Infertility patients, in general, are altruistic, and it makes sense that they would try to advance medicine and help others," said Jain.

African Americans and Hispanics were less likely to approve of using leftover embryos for stem cell research, compared with Caucasians. Patients younger than 30, Protestant, less wealthy and single were also less likely to support using leftover embryos for stem cell research.

The researchers also asked infertility patients if they would be willing to sell their extra embryos to other couples, a practice that is considered ethically unacceptable by the American Society for Reproductive Medicine and the American College of Obstetricians and Gynecologists.

There is an emerging demand from infertility patients who cannot conceive using their own oocytes, or eggs, to purchase left-over, pre-existing embryos because it is a more cost-effective option than using an egg donor, according to the authors.

When asked if selling leftover embryos to other couples should be allowed, 56 percent of the 588 respondents who stated a definitive opinion answered yes.

Hispanics were less likely to approve of selling extra embryos when compared with Caucasians, but all East Indian respondents approved of the practice. Women who had never been pregnant were also less likely to approve, according to the study.

The authors say this is the first survey to examine the opinions of a general infertility population related to the use of leftover embryos and to analyze the results based on the patients' sociodemographic and reproductive backgrounds.

"Given the potential for a significant increase in the commoditizing of spare embryos, medical societies and policy makers may need to pay close attention to this controversial area," conclude Jain and co-author Stacey Missmer from Brigham and Women's Hospital and Harvard Medical School.

For more information about reproductive endocrinology and infertility at the University of Illinois Medical Center at Chicago, visit www.uicivf.org