Welcome to the NRFA Embryo Adoption (Embryo Donation) Academy! The following four courses will both educate you about Embryo Adoption and inspire you to consider it in a new light.
EAED 101: Introduction to Embryo Adoption (Embryo Donation)?
Embryo adoption (also referred to as “Embryo Donation”) is a relatively new process in which couples who have completed their families through the use of in-vitro fertilization and have remaining frozen embryos in storage, can give the embryos a chance at life with an adoptive couple. The intent is that the embryos will be transferred into the womb of the adoptive mother so her family may experience the pregnancy and birth of that child.
Embryo donation and adoption exist today because of an assisted reproductive technology procedure called in-vitro fertilization (IVF).
The world’s first child conceived in vitro was born in Great Britain in 1978, and six years later, a technique was developed for freezing embryos. By freezing unused embryos, couples could have additional transfers at a later time without having to harvest and fertilize additional eggs. As IVF procedure success rates continued to increase, so did the number of frozen embryos.
The first embryo adoption was facilitated by Nightlife Christian Adoption in 1998. Nightlife coined the term “Snowflake” in reference to embryos because they are all frozen, unique, and created by God. Read more about the very first Snowflake baby here.
As of 2012, there were approximately 600,000 frozen embryos in storage facilities across the country. When the information was released, it made people question, “What will happen with all these embryos?” There are only a few options for these embryos, and the only life-honoring choice is embryo adoption (embryo donation). Embryos can destroyed, donated to research (to later be destroyed), or they can continue to be frozen indefinitely while families wrestle with their fate.
Let’s revisit the status of those 600,000 embryos who are being cryogenically preserved in storage facilities. Of these 600,000 embryos, reports state that approximately 87% are earmarked for couples that are still building their families. But as to the remaining 13%, their fate is unknown. Assuming a frozen transfer success rate of only 30%, these 138,000 embryos could result in the birth of more than 41,400 children.
Who is Eligible for Embryo Adoption?
Medically speaking, if your Reproductive Endocrinologist says that you (or your partner) can carry a pregnancy, then it is worth looking embryo adoption. Couples affected by male factor infertility, which doesn’t affect the female, and can find embryo adoption a good alternative to those who would prefer not to use donor sperm.
While some clinics and agency programs limit their recipient pool by age, sexual orientation, number of children already in the household, and other variables, many do not. Private matching, international programs, and anonymous donations are typically open to most situations.
How Much Does Embryo Adoption Cost?
Adopting frozen embryos and then having them transferred must cost a FORTUNE, right? Wrong! It can actually cost less than a traditional adoption. While most domestic and international adoptions cost upwards of $20,000 – an embryo adoption and FET (frozen embryo transfer) can be as little as $3,000. Here is the breakdown of expenses you can expect to incur:
Legal Fees: A standard legal contract and processing typically runs around $500.
Transportation: The shipment of the embryos to your clinic usually costs $400-500.
Medical Expenses: $2,500-$3,500. Depending on the clinic, most doctors charge an estimated flat fee which includes all appointments, sonograms, and the frozen embryo transfer (FET). There is usually an additional fee to use the laboratory, embryologist, and facilities for the Embryo Transfer.
Medication: Depending on the medication that your doctor chooses to prescribe and your insurance coverage, your cost here can greatly vary. Typically you are prescribed Estrogen (a pill or patch) to be taken for two weeks prior to the transfer, and progesterone (a pill, suppository, or shot) to be taken for a few weeks after the transfer. Typically, these are pretty inexpensive fertility drugs and there is a possibility that insurance will cover it partially or completely.
Embryos: While it is illegal for anyone to sell their embryos, it can cost $0-10,000 for you to locate your embryos depending on the method you use. If you use a website such as NRFA.org to locate a family with extra embryos, there is simply the monthly fee that you choose. If you use an agency to find embryos, it can cost $10,000-15,000 to be matched with a donor family.
Why Choose Embryo Adoption (Embryo Donation)?
1. Reduced Costs. Oftentimes it is lower in cost compared to traditional adoption, egg donation, or IVF.
2. Reduced Wait Times. The average time between submitting an application to receiving a donation is approximately 6 months, much shorter that the average time to receive an egg donation or complete a traditional adoption.
3. High Success Rates. According to the Center for Disease Control and Prevention, embryo adoptions have a national pregnancy success rate of 43 percent and live birth rate of 35 percent.
4. Take Home Babies. Should a pregnancy result, there is no risk of failed placements or changes of heart after the birth.
5. Pregnancy & Childbirth. The adoptive mother will have the ability to control the prenatal environment and xperience the joys of pregnancy, childbirth and nursing her adopted child.
6. Maternal Age Non-Applicable. If a woman is experiencing premature menopause, or another infertility condition in which her own eggs are not viable for reproductive purposes, she can still become pregnant with a donor embryo.
7. Reveres the Sanctity of Life. The discarding of embryos is ethically problematic for some individuals. Allowing these embryos to be used to help create a new life is an alternative to disposal or use in research.
8. Siblings. Often times multiple embryos are available from an embryo donor. This can result in several genetic siblings being born from the same group of embryos. If the recipient does not use all of these embryos – they can be returned to the original donor to be re-adopted out to another family in need.
9. Medically Safe. This adoption process is regulated by the government and all appropriate disease screening is required by law to protect the recipient.
10. Legally Safe. Despite the connotations associated with the name, an embryo adoption is actually a transfer of property – not the adoption of a child. Therefore, the donating couple is not legally responsible in any way should a child be produced from the embryo.
EAED 201: HISTORY OF EMBRYO ADOPTION AND DONATION
by: Rebecca Buckwalter-Poza, Pacific Standard Magazine
THE FIRST TEST TUBE baby, Louise Brown, was born in 1978. Now, one percent of U.S. babies are born through the use of assisted reproductive technologies. IVF is growingly popular among couples without fertility issues. The Centers for Disease Control (CDC) reported in 2010 that 6.7 million American women aged 15-44 were infertile, but 7.4 million had used “infertility services.” Many of those who successfully undergo IVF end up with extra embryos, frozen for future use if the first transfer is unsuccessful or the couple decides to have more children. In 2006, news stories estimated between 400,000 and 500,000 frozen embryos were in storage across the U.S.; some proponents of embryo donation claim that there are at least 600,000 now.
As the use of IVF grows, so, too, will the number of embryos in storage. Physicians and patients reduce costs and patient discomfort by minimizing the number of procedures performed and optimizing the results of each. Put simply, the physicians try to harvest as many eggs as possible, then create as many embryos as possible. At the same time, fertility specialists are moving toward a consensus that the optimal number of embryos to transfer is just one. Early recognition of these trends led to the emergence of embryo adoption. In 1998, the same year that Louise Brown turned 20, another couple welcomed America’s first “snowflake baby,” the term advocates of embryo adoption use to describe the children born from this practice.
On December 31, 1998, Hannah Strege was born to proud parents, John and Marlene Strege. Hannah was the first baby ever delivered after having been adopted as a frozen embryo. These babies are often referred to as “snowflake babies”.
Snowflake babies begin their journey to an adoptive family when the in-vitro fertilization process of another couple generates “leftover” embryos. When this occurs, the genetic parents of these embryos have the option to give them up for adoption rather than allow for them to be simply destroyed. As evidenced by Hannah (and many more after her), the result can be truly life-giving, and can help couples realize the desire of welcoming a child into their family.
Embryo Adoption – Historically Marginalized
Embryo Adoption has historically been marginalized, but it may–and should–become more popular. President George W. Bush began an initiative to promote embryo adoption through the Department of Health and Human Services (HHS). President Obama continued the program. To date, Obama has signed off on the use of $13.4 million to promote embryo adoption—bringing the total U.S. federal funds used for this purpose to over $24 million. The program is administered by HHS, but the department doesn’t carry out the program’s mission to “educate Americans about the existence of frozen embryos … available for donation/adoption” directly: The office makes grants to agencies and clinics that create embryo adoption programs. Its grantees have facilitated embryo adoptions resulting in 630 infants.
The early proponents and recipients of “frozen embryo adoption awareness” grants were conservative Christian activists and adoption agencies. They tended to be strongly pro-Christian, anti-single parent, and anti-gay. But the newest grantees are less polarizing and more transparent. The National Embryo Donation Center (NEDC), although endorsed by the Christian Medical and Dental Association (CMDA), uses inclusive language. A medical practice, Boston IVF, received a $1 million grant to make embryo donation a possibility for more of its patients, while RESOLVE, an adoption agency, makes a point of saying that they support unequivocally a couple’s right to choose what to do with their embryos.
As new, more moderate advocates have begun promoting embryo adoption, the process has reached both parents with embryos already in storage and would-be parents contemplating creating embryos. Not all will choose to give their embryos away to be adopted, but an increasing number are open to the possibility—and even those who don’t give their embryos up for adoption may think about donating them to research.
Embryo Adoption – Unfairly Labeled
Embryo Adoption (Embryo Donation) has been unfairly labeled as ineffective and ideological. It need not be either. According to the NEDC, the success rate for adopted embryo transfers—involving a healthy embryo and an adoptive mother with no medical obstacles to pregnancy—may be nearly 50 percent, higher than many clinics’ overall IVF success rates. The embryo adoption movement is no longer primarily religious. Persuading would-be parents to adopt embryos instead of creating new embryos averts the creation of “extra” embryos and gives extant frozen embryos a chance to become children, an objective good if you believe that life begins at conception. But embryo adoption has other major advantages for single parents and couples who need IVF to conceive.
Many Americans prefer pregnancy to adoption, for the experience of carrying a child and giving birth, having the opportunity to bond immediately—and for more pragmatic reasons. Pregnancy, and even surrogacy through IVF, allows parents to conduct genetic prescreening and exercise control over a child’s in utero environment and birth. Adoption seems riskier: The prevalence of fetal alcohol syndrome, for example, is “between nine and sixty times higher” among adoptees and foster children. Parents’ concern may now legitimately extend beyond fetal exposure to drugs, alcohol, or other substances, as research gives usreason to worry about how maternal behavior affects childhood development.
IVF is expensive, often cripplingly so. Only 10 percent of insurance plans cover IVF, and the average cost of a cycle of IVF in the US is $12,400. Those open to adopting will still encounter financial obstacles. Most parents prefer to adopt an infant—and most such adoptions are private and cost between $30,000 and $34,000, depending on whether parents use an attorney or agency. While adopting from foster care may cost less than $3,000, the process may be lengthy as few infants are available.
Embryo Adoption – Affordable
By contrast, embryo adoption is affordable. The total cost of embryo adoption and transfer may be just $2,500 to $4,000. Affordability means that parents may be able to attempt an embryo transfer earlier, with a higher likelihood of success, rather than delaying until they are able to finance more expensive fertility treatments. It also means parents may be able to afford more than one attempt at implantation, rather than pinning hopes on a single procedure. The potential complications associated with embryo donation are the same as those attached to other fertility procedures. The potential threat to genetic diversity (and probability of “accidental incest”) is higher with sperm donation than embryo donation, which is not geographically concentrated.
Embryo adoption offers a viable alternative to invasive fertility procedures or adoption proceedings—and a compromise for members of the subset of parents who cannot conceive naturally but prefer pregnancy to adoption. Those who would not otherwise get to become parents have that opportunity; children who would otherwise have remained frozen are given the chance to develop and lead full lives.
Continue reading the original article in it’s entirety here:
The Frozen Children: The Rise – and Complications – of Embryo Adoption in the U.S.
EAED 301: LEGALITIES OF EMBRYO ADOPTION (EMBRYO DONATION)
More efficient than in vitro fertilization and cheaper than traditional adoption, embryo adoption, which also provides parents with the experience of carrying a child, is becoming more popular. But our legislature is still struggling with serious legal issues surrounding the practice.
Legal Status of Embryo Adoption
The promise of embryo donation is only limited by the questions that remain surrounding legal status. Obvious as it seems that embryos deserve some standing as potential lives, states generally treat them as personal property. Just eight states have legislation regulating embryo donation. In most states, the birth mother is a child’s legal mother; if she is married to a man, her husband is the child’s father. Where no superseding embryo-related law exists, a child who develops from an adopted embryo legally belongs to her birth parents.
Until legislators establish embryos’ legal standing—or lack thereof—judges and parents alike are operating in a legal vacuum.
Laws that treat embryos as property conflict with laws barring violence against “the unborn.” The federal successor to “born-alive” laws, the Unborn Victims of Violence Act of 2004 (UVVA), amended the United States Code “to protect unborn children from assault and murder, and for other purposes.” The perpetrator need not know his victim was pregnant, nor have intentionally caused harm to the fetus, to be charged. Those perpetrators who knowingly attempt to harm a fetus, however, are charged with “intentionally killing or attempting to kill a human being,” an offense that carries stiffer penalties. The law grants unborn children an attenuated form of legal standing. When Senator John Kerry voted against it, he cited concerns about its interaction with abortion rights,stating, “the law … provide[s] that a fetus is a human being.” Kerry’s fears have not been realized: Most federal and state laws exempt abortion from prosecution.
A number of states don’t specify whether feticide laws protect non-viable fetuses, but others specify when the product of conception acquires rights. The word “embryo” appears in Idaho, Michigan, Tennessee, and West Virginia laws; Alabama, Arizona, Georgia, Kansas, North Carolina, and Utah use the “any stage of development” definition for “unborn child.” (Alabama’s statute applies “regardless of viability.”) Other states use “quickening”—the first time a pregnant woman feels a fetus moving—as the critical milestone for fetal development, which takes place as early as 13 weeks after the woman’s last period.
The conflict between the default of treating embryos as property and the imperative to grant them special consideration has been limited to one particular type of legal proceeding: embryo custody disputes, cases in which ex-partners battle over the possession, transfer, or destruction of embryos. Property law encourages courts to treat embryos like any other asset; abortion law and criminal laws don’t address the status of pre-implantation embryos, although statutes targeting assailants who harm a fetus regardless of viability suggest destroying embryos without consent should be a crime. Adoption law potentially provides a basis for determining that genetic parents should have special, superseding rights over embryos, as birth mothers have over infants in adoptions.
Difficult as the question of embryo custody is, the issues surrounding the children embryos become—and accompanying parental rights and responsibilities—will be even harder to resolve. The laws we have don’t address whether transferring ownership of an embryo terminates genetic parental rights; conversely, they can’t answer how firm the rights of birth parents are over children not genetically theirs outside of surrogacy. While contract law seems an obvious solution, courts have rejected contracts in sperm donation cases. For example, a sperm donor may still have to pay child support, regardless of a contract with the birth parent. If a court tried to apply similar restrictions to embryo adoptions, that could mean genetic parents who transfer embryos remain financially responsible for the children they may become—a position more precarious than that of genetic parents who give children up for adoption at birth.
American lawmakers’ reluctance to define an embryo’s legal status stems not just from the internal contradictions of existing laws—property versus criminal, abortion versus adoption—but a broader reluctance to place legal limits on fertility medicine. While using pre-implantation genetic diagnosis (PGD) to select for gender is illegal in Canada, China, India, and the United Kingdom, sex selection is legal in the United States—and it’s a $100 million industry. Although peer countries—Italy and Germany, for example—limit the number of embryos that can be transferred in a single procedure to protect mothers and children, the U.S. has not chosen to do so. The failure of the fertility industry’s efforts at self-regulation in the United States has spurred ethicists to call for legal regulation, to no avail.
The solution proposed by Americans United for Life (AUL), representing the original, conservative advocates of embryo adoption, is to extend adoption law at the state level to apply to the transfer of embryos. Their proposal, however, veers too far from the current default—and too close to usurping abortion law—to be palatable to legislators. The better option is to define and protect the right of contract in embryo adoptions, permitting individuals and couples to reach enforceable agreements predicated on mutual beliefs about the legal status of embryos.
However it goes about it, a legislature is the only body that can resolve the questions implicated in embryo adoption. Until legislators establish embryos’ legal standing—or lack thereof—judges and parents alike are operating in a legal vacuum. Few judges are up to the task of carving out a new status for embryos as both property and potential people, but fewer still will get the opportunity to do so, as long as parents know embryo adoption is subject to legal uncertainty. The full promise of embryo adoption cannot be realized until the law catches up to technology to protect the rights of parents in this brave new variation on adoption.
EAED 401: EMBRYO ADOPTION MANAGEMENT & IMPLEMENTATION
Private, Agency, or Clinic?
There are 3 methods through which you can pursue an Embryo Adoption (Embryo Donation). It is important to know the benefits and drawbacks to each of these so that you can choose the right method for your individual situation. Every adoption agency and fertility clinic handles this process in a unique way. Some organizations require steps that elongate the process but are intended for your benefit. Private methods of matching will allow you to control the length of the process but puts more responsibility on your shoulders. Some families choose to match themselves with a donor by posting a profile online or networking through personal relationships.
• Legal Work. Fertility Clinics will require that you have the proper legal work completed, and in most cases will procure the documents for you or refer you to their preferred adoption attorney.
• Transportation. Fertility Clinics house their own embryos, so there is no need for transportation. Transporting embryos carries the risk that something might happen to them during shipment.
• Decreased Wait Time. If you are willing to adopt anonymously donated embryos, the wait time for a clinic program can be dramatically decreased.
• Open Selection. Instead of viewing one profile at a time, you can often times view multiple profiles and select the one most compatible with your family.
• Limited Information. Depending upon the program, you may receive little to no information regarding the embryo donating family, especially in the case of anonymous embryo donations.
• Limited Control. Embryos are donated directly to the clinic, and the clinic determines who receives them.
• Limited Sibling Contact. The embryos may be given to multiple families (e.g.: The genetic family donates 10 embryos, 4 are given to family A, 3 are given to family B and three are given to family C).
• Limited Relationship. There will likely be very little communication between you and the embryo donor family. Few historical records of the donation are maintained by the clinic.
• Decreased Cost. You can achieve the same end goal (Embryo Adoption / Donation) without incurring an agency or program fee.
• Open Selection. Instead of viewing one profile at a time, you can view multiple profiles and select the one most compatible with your family.
• Increased Flexibility. Many benefits to an adoption agency and fertility clinic programs become optional in a private match. When matching privately you can still request/complete a home study, background checks, and an intermediary to moderate communication; although these are not mandatory.
• Increased Control. Instead of allowing the process to be regulated by an adoption agency or fertility clinic, you can take control over the pace, communication, and decisions.
• Increased Responsibility. Once a private match has been secured, the responsibility is upon you and the embryo donating family to arrange for the legal, medical, and logistical necessities of the donation.
• Decreased Security. Even though it is not required with a private match, it is highly recommended that you receive professional legal counsel and medical guidance before committing to a match.
• Decreased Support. You may not have a third-party caseworker to guide you through the process and will need to depend upon professional legal counsel, medical guidance, support groups, or customer service departments to answer questions that may arise.
• Homestudy. This screening provides the embryo donor family peace of mind that their embryos are going to a adoptive family that has completed background checks and an extensive interview with a licensed caseworker.
• Matching. Families provide information regarding their current family structure, economic status, and social and medical history. The adoption agency then works to match them with a family who best meets their criteria.
• Relationship Management. The families agree upon a mutual level of future communication. The communication may be facilitated by the agency if desired. Historic records of the embryo donation are maintained by the agency.
• Legal Work & Transportation. The adoption agency procure legal documents for the transfer of property (the embryos) from the donating family to the recipient family. The agency will coordinate with the fertility clinics involved regarding medical testing required by the FDA and shipment of the embryos.
• Increased Cost. Agency fees can be high (between $8K and $14K), and sometimes do not include legal fees or the actual medical procedures.
• Increased Wait Time. Extra time must be factored in for the required approval steps, paperwork approvals, and home-study creation.
• Closed Selection Process. Profiles of potential families/embryos are typically presented one at a time. Most of the matching decisions are strongly influenced by the case worker.
• Limited Control. The process is driven and paced at the discretion of the adoption agency.
For more information on managing the embryo adoption (embryo donation) process, click here.