Embryo donation is a form of third party reproduction. It is defined as the giving—generally without compensation—of embryos remaining after one couple's In vitro fertilisation, or IVF treatments, to another person or couple, followed by the placement of those embryos into the recipient woman's uterus to facilitate pregnancy and childbirth in the recipient. Most often, the embryos are donated after the woman for whom they were originally created has successfully carried one or more pregnancies to term. The resulting child is considered the child of the woman who carries it and gives birth, and not the child of the donor. This is the same principle as is followed in egg donation or sperm donation.
Embryo donation can be handled on an anonymous basis (donor and recipient parties are not known to each other), or on an open basis (parties' identities are shared and the families agree to a relationship. Occasionally, a "semi-open" arrangement is used in which the parties know family and other information about each other, but their real names and locating information are withheld, in order to provide a layer of privacy protection. Some writers use the term "embryo donation" to refer strictly to anonymous embryo donation, and "embryo adoption" to refer to the open process. Others use the terms synonymously because regardless of whether the arrangement is open or anonymous, the donation of embryos and a clinical assisted reproduction procedure is involved, and the recipient couple is preparing to raise a child not genetically related to them.
In the United States, those donating embryos must, if possible, be screened for a series of infectious diseases. The rules for screening are outlined by the U.S. Food and Drug Administration (FDA). If the donors are not available to be screened, the embryos must be given a label that indicates that the required screening has not been done, and the recipients must agree to accept the associated risk. The amount of screening the embryo has already undergone is largely dependent on the genetic parents' own IVF clinic and process. The embryo recipient may elect to have her own embryologist conduct further testing.
Alternatives to donating remaining embryos are: discarding them (or having them implanted at a time when pregnancy is very unlikely), or donating them for use in embryonic stem cell research. Although embryos can, theoretically, survive indefinitely in frozen storage, as a practical reality someone must eventually decide on a permanent disposition for them.
A US study concluded that embryo donation is approximately twice as cost-effective as oocyte donation in terms of cost per live birth, with a cost of $22,000 per live delivery compared to $41,000 for oocyte donation.
Not long after IVF came into common clinical practice, clinicians discovered a way to maintain (cryopreserve) embryos in frozen storage and thaw them once again for implantation later, thus, in some cases sparing the woman a second egg harvesting procedure,.
At about the same time, clinicians reasoned that more couples could be helped toward parenthood by substituting donor sperm for men who have no viable sperm, or donor eggs for women who have no viable oocytes – or both. Thus what was called gamete and embryo donation, came into being. A careful reading of the 1983 clinical report often cited as the first instance of embryo donation reveals that the donated embryo was actually created for the recipient at the same time that four embryos were made for the donor couple’s own use. The menstrual cycles of the donor and recipient women were synchronized using medications, and the transfers occurred on the same day. None of these embryos had been cryopreserved.
Soon thereafter, reports were published documenting successful pregnancies and births from cryopreserved donor embryos. Again, however, these were embryos made from donor gametes specifically for the recipients.
No one knows for sure when the first true embryo adoption occurred. The term was used as early as the mid-1980s, in the legal literature. Devroey et al., Dr. Maria Bustillo in Florida, and Dr. Howard Jones in Virginia have reported embryo transfers occurring between 1986 and 1990 that clearly represented adoption of remaining embryos.
Prior to this, thousands of women who were infertile had regarded adoption as the only available path to parenthood. These scientific advances set the stage to allow open and candid discussion of embryo donation and transfer as a solution to infertility. In some ways, it is similar to other donations such as blood and major organ donations. Some see the embryo as "tissue", others see it as a "gift of a potential life", while still others believe that a new human life begins at the time of fertilization. The third group sees embryo donation as little different from traditional adoption, except that the recipient woman has the experience of pregnancy and childbirth, and that no court action is required to establish legal parentage for the recipient.
Embryo donation is legally considered a property transfer and not an adoption by state laws. However, Georgia enacted a statute called the "Option of Adoption Act" in 2009 which provided a procedure for, but (importantly) did not require—a confirmatory court order of parentage following embryo adoption. One advantage some embryo adoption couples in Georgia have derived from this law is that they have become eligible for the federal Adoption Tax Credit.
Embryo donation can be carried out as a service of an individual infertility clinic (where donor and recipient families typically live in the local area and are both patients of the same clinic) or by any of several national organizations. The process described below is typical of an "adoption-agency-based" national program:
Genetic parents entering an embryo adoption program are offered the benefits of selecting the adoptive parents from the agency's pool of prescreened applicants. Embryo ownership is transferred directly from the genetic parents to the adoptive parents. Genetic parents may be updated by the agency when a successful pregnancy is achieved and when a child(ren) is/are born. The genetic parents and adoptive parents may negotiate their own terms for future contact between the families.
Prospective adoptive parents entering a program complete an application, traditional adoption home study, adoption education, health checks and in some cases, depending on the requirements of both the home study and placement agencies, court certification of adoption eligibility. Their completed paperwork and fees are submitted to the placement agency, which reviews their file and matches them to genetic parents with similar preferences including desired level of openness post-adoption. Genetic and prospective parents are then given the chance to approve the match. Once all parties agree, the embryo is transferred to the adoptive mother's clinic for a frozen embryo transfer.
None of the procedures involved with embryo adoption by either the genetic or adopting parents are legal requirements of embryo transfer. The process is entered into willingly by both sets of parents because of the added safeguards, knowledge and communication offered to both parties by the system. The Snowflakes Embryo Adoption Program refers to the uniqueness of each embryo. Because Nightlight Christian Adoptions was the first to publicize the option nationally and, for several years, handled most cases in which families were matched outside the confines of an individual clinic, the term "Snowflake Babies" has become common vernacular when referring to the embryo-adoption process, though no longer referring exclusively to Nightlight's Snowflake Embryo Adoption Program.
As of July, 2011, Nightlight has reported 271 children born through the embryo adoption program. Concurrently, the National Embryo Donation Center (NEDC) reports 280 born through their program since its inception in 2003.
Located in Knoxville, Tennessee, NEDC is the nation's only clinic-based, non-profit, national embryo donation entity. Its primary difference from Nightlight and other adoption-agency-based programs is that the clinical services, rather than being performed at a separate infertility clinic, are performed at the NEDC facility in Knoxville. This allows the family to receive all the services in a comprehensive manner at one location under the guidance of a trained coordinator. The only exception is the home study, as described above. The Embryo Donation Services of Cedar Park, located near Seattle, Washington (www.adoptanembryo.net) is the nation's only church-based embryo adoption enterprise. Founded by an embryo adoption mother, it operates on principles similar to the Snowflake Program.
- Snowflake Program, Nightlight Christian Adoptions
- National Embryo Donation Center
- Finger R, Sommerfelt C, Freeman M, Wilson CK, Wade A, Daly D (April 2009). "A cost-effectiveness comparison of embryo donation with oocyte donation". Fertil. Steril. 93 (2): 379–381. doi:10.1016/j.fertnstert.2009.03.019. PMID 19406398.
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- Devroey P, Camus M, van den Abbeel E, van Waesberghe L, Wisanto A, van Steirteghem AC. Establishment of 22 Pregnancies After Oocyte and Embryo Donation. Br J Obstet Gynaecol 1989 Aug;96(8):900-906
- National Embryo Donation Center: Questionnaire Study of Prospective Embryo Donors
- The White House. President Discusses Stem Cell Research. Office of the Press Secretary, August 9, 2001. http://georgewbush-whitehouse.archives.gov/news/releases/2001/08/20010809-2.html
- Embryo Adoption & Donation