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The Dilemma Of What To Do With Extra Embryos After IVF

The Dilemma Of What To Do With Extra Embryos After IVF
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Annie* and her sister Carla* both wanted to be moms. But it wasn’t an easy path for either of them. Annie, who has endometriosis , had trouble with her uterus; Carla had trouble with her eggs. For years, while they were both in fertility treatments, they commiserated with one another’s struggle. They both learned to talk the unhappy shared language of people having trouble with pregnancy .

“We were in constant contact with each other, going, ‘It’s my retrieval day’ or ‘my hormonal imbalance is making me angry,’” said Annie, who spoke to HuffPost Canada under the condition her real name not be used, to protect the identities of the children in this story.

Annie and her husband tried in vitro fertilization (IVF) with embryos collected from her eggs and his sperm. She got pregnant a few times, but suffered devastating losses, including one at 18 weeks that sent her into cardiac arrest.

“On some level I felt that my body had failed me and that I was being punished,” she said. “My body was telling me for many months before my last transfer that I should be done trying.”

But after the brush with death, she described feeling a strange reassurance as she stopped fertility treatments. “I know that I won’t ever have a ‘what if,’ because my body just wouldn’t survive another pregnancy.”

Carla had also experienced pregnancy losses — more than 15. But she was still trying.

“After she hit double digits... she lost the ability to be excited about getting those two lines on the pregnancy test,” Annie said. “It was more of a ‘wait and see.’”

Carla and her husband “racked up literally hundreds of thousand dollars in debt through the IVF process ,” Annie said. “For her, every single loss, every single medication and every penny was one step closer to being a parent.”

Annie and her husband are now the proud parents of two kids through adoption. Years ago, she did something many siblings might not do: she offered her sister her embryos.

BSIP / Contributor

A lab technician prepares dishes for IVF in Nice, France.

Embryo donation isn’t a very common practice, although it’s been slowly rising in popularity over the last decade, according to Julia Milmine. She’s a program assistant at Beginnings , an embryo donation and infant adoption centre with locations in Hamilton, Guelph, and Woodstock, Ont. Last year, across their three centres, they helped about 30 people receive embryos from a total of about 18 donors.

When an egg is first fertilized with sperm, it’s called a zygote. It quickly goes through a period where it divides from a single cell to many cells, at which point it becomes an embryo. Embryos contain stem cells, the building blocks that will later grow into a fetus’ bones, muscles, lungs and other systems. Embryos are about the size of .

Lots of different kinds of people turn to IVF: straight couples struggling with fertility, lesbian couples who use sperm donors, gay men who use surrogates, single people who want to become parents. The process involves eggs and sperm that are fertilized in a lab and then transferred back into the uterus as embryos. (They have the best shot at turning into viable pregnancies when they’re transferred about five days after fertilization, at the “hatching blastocyst” stage.)

JUAN GARTNER

Invitro fertilisation being performed in a lab.

A person going through IVF will inject themselves with hormones to produce more eggs. During a single round of IVF, many embryos will be created, because not every one of them will result in a viable pregnancy.

Many people going through IVF end up with extra embryos. And when they’re done undergoing treatment, figuring out what to do with them can be complicated.

Clinics will store frozen embryos, usually at the cost of a few hundred dollars per year. Those embryos are the result of a lot of sacrifice, both in terms of the pain and complication of egg retrieval and the financial hit. (A single round costs , and many people do several rounds, especially if they have fertility issues. IVF can take years.)

And more than that, for a lot of people it’s hard to dispose of what they think of as a potential future child.

“The whole thing is kind of mind-boggling.”

- Katie Pearson on trying to decide what to do with leftover embryos

Figuring out what to do with extra embryos is something Katie and Megan Pearson ― a married couple with kids who previously opened up to HuffPost Canada about their journey to parenthood through IVF, IUI ( intrauterine insemination ) and sperm donation ― think about a lot.

“We still have four frozen embryos and we pay the storage for them every year and we have yet to come to consensus on what to do with them,” Katie said. “The whole thing is kind of mind-boggling.”

They have three kids, but don’t know if they’ll want more. They’ve considered donating the embryos to another family, or to science, but there are no easy answers. They recognize that they wouldn’t have been able to have their own children without a sperm donor, they said — but that doesn’t make the idea of donating their embryos an easy or an obvious choice.

“I’d say, rather hypocritically, I struggle with the idea of donating these embryos to a family who would not be able to get pregnant without them,” Katie told HuffPost Canada. She’s grateful to the sperm donor who allowed her and her wife to have their own children. But the idea of giving away an embryo that’s the genetic sibling of one of their kids is hard for the Pearsons to wrap their heads around.

“I think that adds a layer of ownership that would maybe make it different than me just choosing to donate my eggs,” she said. “There’s this emotional attachment.”

There’s another option for leftover embryos: to donate them to clinics, or to scientific research. Donated embryos are sometimes used in clinical training, as a way for residents working in fertility clinics to practice their techniques or improve clinic practices.

When it comes to donating embryos to science, things get a little more complicated. Creating embryos for the sole purpose of research is not allowed under Health Canada guidelines , Cattapan explained — when those rules were put together, the prevalent idea was that embryos were the “precursor” to human life, so “the idea that we would create them just to destroy them was seen to be quite problematic,” she said. But embryos created specifically for reproduction can be donated if they’re no longer needed later on.

Spencer Platt / Staff

Stem cells on a computer screen at the University of Connecticut s Stem Cell Institute.

And stem cells from embryos . Studying how these cells mature into bones, muscle, organ and tissue can help researchers understand how those parts of the body are effected by diseases. Stem cells from embryos can also be used to test the safety of drugs before they’re used on humans, and in some cases can be guided into becoming cells that can repair damaged tissue in people with specific conditions like Alzheimer’s or Type 1 diabetes.

Of course, many of the people who feel an emotional connection to their embryos may also find this difficult.

“People do really respect embryos,” Cattapan said.

Canadian law doesn’t exactly know what to do with embryos, either. The section of the Assisted Human Reproduction Act that deals with them — Section Eight — is much more difficult to understand than the rest of the act.

“The Section Eight regulations — I don’t know how to describe how dense they are,” Cattapan said. “I’m an expert, this is my job, and I think it’s very hard to parse.”

Even the language around embryo donation is somewhat fraught. In the U.S. it’s often referred to as “embryo adoption.” But some people bristle at that idea because they think to an embryo. Beginnings calls it “embryo donation” because it doesn’t fit the clear legal definition of adoption in Canada, Milmine said.

“With embryo donation, unlike the adoption of a child, there is no formal legal proceeding within the court,” she explained. “It’s considered a transfer of ownership under the law, so legal agreements are completed between the donor and recipients. But there’s no formal adoption per se.”
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