A journalistic thaw on the deep freeze

embryoConsidering how common in vitro fertilization and other assisted reproductive technologies are, isn't it surprising how little the media discuss the attendant issues? I'm ashamed to say that I didn't really understand much of in vitro fertilization until a few years ago when I lost a bet about whether excess embryos are routinely created and discarded in pursuit of a successful pregnancy. And boy was I wrong. Really, really, really wrong. But there's been a noticeable lack of interest by the media on all the issues. And when they are discussed, the biological processes that are already too euphemized are euphemized beyond meaning in most stories. I also wonder if the problem with coverage isn't related to this being considered something of a "women's issue" that's not of interest to a primarily male journalism corp.

Anyway, I was just flabbergasted to read this fascinating, detailed and provocative article by Bob Smietana, religion reporter for The Tennessean. Here's how it begins:

After Kim Best and her husband, Walter, went through in vitro fertilization treatment, they ended up with twins, Caison and Kelsea -- and 14 extra embryos.

That was 1994. Fifteen years later, the embryos remain frozen and the Brentwood couple continue paying a clinic to store them. The mother wants the embryos to die of natural causes while in storage.

"I know that sounds selfish," she said. "You can't ask people to give up a child, or expect them to share. We're not talking about cookies here, like I've got extra cookies and should share them with someone who has none."

Doctors estimate 500,000 embryos are stored in fertility clinics across the United States. While many will be thawed and transferred back to their genetic mother, others will be discarded, donated to research or given to infertile couples. And some will spend years in limbo, waiting for their parents to make up their minds about what to do with them. No one really knows how long the embryos will last.

Now that President Barack Obama has lifted the limits on federally funded embryonic stem cell research, there is growing public pressure to donate excess embryos to science.

But for couples like Julie and Joerg Strangfeld, donated frozen embryos may be their only chance to become parents. Married for 15 years, the couple from Apple Valley, Minn., have been trying to get pregnant for nine years.

What makes the story so interesting is that Smietana packs it with real people making these life-altering decisions. It centers around the National Embryo Donation Center in Farragut, Tennessee. I never even knew that such centers existed, much less that couples seeking to adopt could adopt children at the embryonic stage.

Smietana takes readers through the clinical process of thawing the frozen embryos, incubating them and transferring them to infertile couples. It's clear that various parties in the story have different ideas about whether a human being at one of its earliest stages of existence is, well, a human being and the issue is engaged but not fleshed out completely. Here is a section that I didn't even really understand:

But not all embryos are created equal. Although every human being begins as an embryo, not every embryo becomes a human being.

I assume the reporter means that not all embryos survive the transfer or make it to birth but I'm not sure. Of course, every embryo is a distinct, living member of the species Homo sapiens in the earliest stage of development. All human beings go through stages -- embryonic, fetal, infant, child, adolescent, adult, etc. There are people who think that some members of the species are not persons -- either because of stage or disability -- but that's a moral question rather than a scientific determination. Either way, that's not exactly the point of the article. What we do get from the article are interesting stats about how many frozen embryos survive the thaw, why some scientists are so interested in using embryos for research, success rates for natural conception and success rates for IVF.

This is some information that is surprising to find in a mainstream article:

During in vitro, doctors typically start with 15 or 20 eggs in hopes of getting five or six embryos. They usually transfer two embryos to the woman, and freeze any extras.

Some couples will try for fewer embryos, some will try for more, obviously. Some will discard the embryos that aren't implanted, some will be frozen. We learn about how long embryos may spend in the freezer and what they're being held for. There are no government statistics for how many embryos are currently frozen.

Before 2001, Hill's patients could choose to donate embryos to research. That wasn't an option under President George W. Bush, and still isn't a viable solution, Hill said. Although Obama lifted Bush's embryonic stem cell limits in March, no new rules are in place yet.

While I'm not sure if it's true that patients could not donate embryos for stem cell research that was not federally funded, it's definitely not true that parents couldn't donate their embryos to research in general. Here's a March 2009 story from Reuters about how one woman protested President Bush's stem cell policy by donating the embryos she created for research that didn't involve stem cells.

Anyway, the story explains the contractual agreements clinics and parents make and how other countries regulate IVF.

But the embryos belong to their parents, not the clinics. And those parents have the final say over what happens to them. Dr. Jeffrey Keenan, director of the National Embryo Donation Center, requires his patients to use all of the created embryos or donate them to another couple since he believes his vocation is to "help people have children, not destroy embryos," which he views as human life.

As for the religious angles discussed here, the story mentions the case of a Washington couple that couldn't afford the storage fee for their embryos. As Catholics, they believed discarding them was wrong so they donated them to the National Embryo Donation Center. The couple who adopted their embryos had a baby girl.

The story even includes audio interviews of three couples who are adopting embryos and a doctor explaining some of the process. They're brief, very compelling and informative. One couple is clearly motivated by religious reasoning and the interview lets them discuss that at length. It's a humanizing addition to an already human-interest driven story. More, please!

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