As more and more couples start thinking about starting a family and their future plans, new technological innovations are now often considered, including egg and embryo freezing. While this is especially relevant in women struggling with infertility, it is also common in couples deciding to have children later in their lives. IVF or freezing embryos is beneficial due to the fact that as a person ages, so do their eggs. By freezing eggs when someone is young, the health of the eggs is preserved. Freezing embryos used to be considered a more viable option due to their higher survival rate. This changed, however, when the method of vitrification was introduced, which requires flash freezing the eggs in liquid nitrogen. (Pennings, 2000.) Deciding which process to undergo is one that should be heavily considered, as both have similar survival rates. In terms of choosing freezing embryos, it largely comes down to that fact that such a process involves more information upfront.
Such information is especially helpful because couples are able to know how many eggs are healthy as well as when they began development. Additionally, couples where one person may be undergoing cancer or other debilitating illnesses can choose to freeze their embryos due to the risk of the patient dying. (Pacific Fertility Center.) That way, an embryo is preserved and can be taken to term despite one of the parents no longer living. This does, however, create conflict regarding the embryo’s ownership rights. While provisional directives are strongly recommended prior to the procedure, recent cases about patients dying before expressing the desires about the disposition of their gametes. Additional concerns regarding couples freezing their embryos and then divorcing frequently result in legal issues regarding the ownership rights of the embryos and whether or not they should be taken to term. (Pennings, 2000.) While the current complications about freezing embryos raise legitimate concerns, this wasn’t always the case. Couples not finding success in IVF processes often resorted to freezing their embryos due to the higher success rate. Starting in 1978, a physician in India named Subash Mukhopadyay created the first child using IVF by storing the embryo for 53 days before thawing and inserting into the mother’s womb. (P., & G. (2000.) While this pregnancy was ultimately successful, Mukhopadyay received harsh backlash from the Indian government and media. Facing such insults eventually led Mukhopadyay to commit suicide in 1981. It wasn’t until after his death that received adequate recognition for his efforts, including the very child he helped create releasing several personal statements about her views on IVF, praising Mukhopadyay. From then up until 2008 it has been estimated that nearly half a million people were born from frozen embryos. (Mitra, P., & Ganguly, A., Durham University.)
With an increase in IVF participation, legal issues have become a prominent concern regarding frozen embryo ownership. Beginning in 1944, the Ethics Committee of the American Society for Reproductive Medicine declared that each couple is required to give written consent regarding the disposition of the embryo. This both protects the interest of individual’s reproductive capabilities as well as the link between the gametes and the identity of the parents. (P., & G. (2000.) This process is considered to be a fundamental right, however, it does not mean it doesn’t create conflict. Despite this standard solution remaining intact over the years, several legal complications and negative public biases have forced the issue of frozen embryo ownership to be ethically questionable. While some members of the public had spoken out on the matter of whether or not societal rules, such as the issue of written consent, should restrict individuals on what they wish to do with their gametes. (P., & G. (2000.) Others were more quick to claim that the entire science behind IVF is unethical. Stemming from common biblical beliefs, many believe that the destruction of excess embryos through IVF violates religious ideology. (The Ethical Dilemmas Associated with Frozen Embryos, 2015.)
There are several reasons, however, that must be considered in the ethical dilemma regarding IVF. One of the most prominent regarding cancer patients and their wishes to create offspring. A patient undergoing chemotherapy is often unable to maintain enough physical strength to experience a successful pregnancy. Efforts often result in failure, or possible reparations putting the fetus and mother in jeopardy. Additionally, several fertility problems are found in men with cancer, including damage to the sperm and decreased sperm production. (Fertility Concerns and Preservation for Men. (2018.) In these instances, IVF is especially beneficial. Patients suffering from illnesses are able to preserve their embryos in hope of one day being able to carry the embryo to term. This allows many patients to have options due to the higher risk of unsuccessful pregnancy as you age. Additionally, freezing embryos contributes to the prevention of ovarian hyperstimulation syndrome, which is a potentially life-threatening complication resulting from controlled ovarian stimulation. (Tokhy, O. E., Kopeika, J., & El-Toukhy, T. (2016.) Patients undergoing IVF can be susceptible to ovarian hyperstimulation syndrome, and when visible signs leading to the syndrome are seen, patients can be put into a ‘controlled drift period’ which is an effective preventative strategy. What this does come down to is embryo transfer, and incorporating that process into IVF. This allows patients to be at less risk of OHS while still undergoing IVF.
Despite arguments promoting embryo transfer, it can still present a series of concerns regarding the success in the process and health of the patient. For instance, the transfer can yield a presence of fluid in the uterus which may be toxic for the embryos resulting in a less receptive uterine lining. In addition, there often is a premature rise in progesterone levels, which can be present in all pregnancies, but is especially relevant in embryo transfer. Ultimately, heightened levels most often result in a miscarriage.
While physical issues continue to raise legitimate concerns, embryo transfers face prominent legal and ownership complications. In terms of the presentation of options for patients, this varies internationally. In Brazil, for example, citizens are given little liberty in what they decide to do with their gametes. Other countries such as Norway are more explicit in their legislation, stating that no gametes may be given as donation and that any fertilized egg can only be implanted into the mother from which it came from. The greater conflict, however, comes from the providers and the fertility centers on who has control over the embryos. For example, the providers are given initial options on how long they would wish to store their embryos. Whatever is chosen remains as a strict contract, due to the over-accumulation of from embryos in many of the centers. If providers wish to extend their storation period, they are able to, however, the costs can become expensive. The concerns within these contracts arise when couples decide to no longer take their embryo to term, resulting in the destruction of the embryo in the hands of what is perhaps most controversial, however, regards the instance of postmortem utilization.
The validity of these instances comes down to the specific circumstances, with some being completely unacceptable and others being considerable. Some believe that postmortem use should not be an option, as the issue of consent cannot be declared. A couple should not be able to decide the disposition of his gametes postmortem, due to the fact that it violates the acceptable view on the parental project. For instance, “a man who indicates that after his death his spermatozoa should be used to impregnate a surrogate cannot be seen as working on a parental project since neither he nor his present partner will be the future parents of the child. We only have to consider some extreme possibilities to know that the use of gametes is not only a matter of personal desire and individual decision making.” (P., & G. (2000.) This ideology can be compared to that of divorced couples. Due to the fact that frozen embryos are considered personal property under the law, they legally belong to both parents. This is different from women undergoing IVF or men donating their sperm. When a couple had decided to freeze their embryos and later got a divorce, the only way the embryo would be able to be taken to term is if both parents consent to it. This can create conflict when the case is taken to court. One of the most notable examples entails actress Sofia Vergara and former fiance Nick Loeb experiencing an ongoing custody battle regarding the fate of of-of their two frozen embryos created during their relationship. Loeb reportedly sued Vergara under the contention that the two embryos would be unable to receive the trust both Vergara and Loeb had set up for them. Having this case occur in the pro-life state of Louisiana, the frozen embryos received special legal protection, making arguments for their destruction especially difficult. (Marzilli, A. 2006.) While their contract included the circumstances of post-mortem arrangements, it failed to mention the future of the embryos if Vergara and Loeb separated. Despite a California judge ultimately ruling in Vergara favor, this case serves as appropriate evidence for embryo ownership creating legal controversies. (Smith, E. (2016.)
While embryo freezing presents successful solutions to infertility and other concerns, the prevalent issue regarding corporations owning frozen embryos and the rights associated with that raises too great of a concern to not be acknowledged. With circumstances such as patients undergoing cancer or experiencing infertility, embryo transfer can be a great option for allowing people to have successful and healthy pregnancies. With that in mind, it is vital that extensive contracts and liability agreements must be considered and agreed upon prior to the transfer process. This is all due in hope of reducing the extreme conflicts faced with the process, such as ownership controversies and ethical stances. While moral agreements can and are often put into question regarding this issue, the decision to undergo embryo transfer should not come down to whether or not it is ethical, but rather if it is the best option given the personal circumstances.