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Embryo relinquishment for family building – what's in a name?

28 November 2011
By Professor Eric Blyth and Dr Lucy Frith
Professor Blyth works in the School of Human and Health Sciences, University of Huddersfield and Dr Frith in the Department of Health Services Research at University of Liverpool
Appeared in BioNews 635
In the US the relinquishment of embryos for family building is the subject of intense ideological debate. This has occurred not least because of the competing discourses of – on the one hand – a model of 'embryo donation', the traditional model espoused by some fertility professionals that to a large extent promotes anonymous donation (1), and - on the other - a model of 'embryo adoption', promoted by faith-based infant adoption programmes that have branched out into home-finding for unused embryos.

The latter incorporates certain aspects of contemporary infant adoption placement practices, such as enabling relinquishing couples to choose recipient families for their embryos, making available information on genetic origins for infants conceived as a result, and promoting information-exchange and ongoing contact between relinquishing and recipient families.

An aspect of the political stakes were heightened when, in 2002, the George W. Bush administration announced federal funding to support 'public awareness campaigns on embryo adoption' with an initial grant of $1 million (3). This programme has been maintained by the Obama administration and currently receives annual funding of $4.2 million and has received a total of $19.4 million in federal grants since 2002 (4). For its part, the Ethics Committee of the American Society for Reproductive Medicine criticised the concept of 'embryo adoption' on the grounds that the embryo is not a person and therefore should not be the subject of adoption procedures (5).

Behind the rhetoric, however, lies the reality that, in the US, couples who have completed IVF treatment and have embryos they wish to relinquish to others for family building have a choice between the largely anonymous donation programmes or using a faith-based agency to ensure some continuing connection with any resulting child. Often, relinquishing couples perceive these children born from their embryo(s) not only as their own genetic children but as the full siblings of their children – albeit being brought up in another family (2).

Two studies of couples who have unused embryos remaining in storage following IVF treatment have identified such couples' preferences for a form of directed or conditional relinquishment that satisfies their needs for continuing contact and the interests of children in both relinquishing and recipient families to know about and have contact – if so desired – with their genetic kin (6, 7). All too often such services are available only through the services of an embryo adoption programme, as our own recent study, undertaken with couples who have relinquished embryos through a Christian embryo adoption programme, has shown (8, 9).

These studies show that, quite apart from what we regard as the general preference for non-anonymous gamete and embryo donation on ethical grounds (10-12), at least some patients with unused embryos, i.e. prospective embryo donors, desire some measure of conditional relinquishment that can include choosing recipients and varying forms of openness and future contact.

For these couples, abstract concepts of the moral status of the embryo – and associated concerns related to 'abortion politics' – have little salience. Rather, their preferences are based on their perception of their embryo as a future child whose significance is derived from future kin relationships with themselves and their existing children and the difficulty, stress and expense that they have undergone to create it.

In our view, the rhetorical and ideological gulf that sets apart advocates of 'embryo donation' and 'embryo adoption', is bridgeable by facilitating genuine choice in this area. The range of options available for those with unused embryos, such as providing conditional donation programmes, should be extended so that patient choice is increased and individuals' reproductive autonomy enhanced.

SOURCES & REFERENCES
01) Sean Tipton of ASRM, cited in Motluk, A. Canadian court bans anonymous sperm and egg donation.
Nature |  27 May 2011
02) Embryo relinquishment for family-building: how should it be conceptualised? (Blyth, E., Frith, L., Paul, L. and Berger, R.)
International Journal of Law, Policy and the Family |  13 May 2011
03) Federal Register (2002) Embryo adoption; public awareness campaigns
Federal Register 67: 48654–48660 |  20 August 2019
04) Announcement of the Anticipated Availability of Funds for Embryo Donation and/or Adoption Cooperative Agreement Projects
Department of Health and Human Services |  20 August 2019
05) Ethics Committee of the American Society for Reproductive Medicine: Defining embryo donation
Fertility and Sterility |  14 October 2009
06) Changes in patient preferences in the disposal of cryopreserved embryos (Newton, C. R., Fisher, J., Feyles, V., Tekpetey, F., Hughes, L. and Isacsson, D.)
Human Reproduction |  24 October 2007
07) Attitudes of couples with stored frozen embryos toward conditional embryo donation (McMahon, C. A. and Saunders, D.)
Fertility & Sterility |  29 November 2007
08) Relinquishing frozen embryos for conception by infertile couples (Paul, M. S., Berger, R., Blyth, E. and Frith, L.)
Family, Systems, and Health |  27 January 2011
09) Conditional embryo relinquishment: choosing to relinquish embryos for family building through a Christian embryo 'adoption' programme (Frith, L., Blyth, E., Paul, M. and Berger, R.)
Human Reproduction |  21 September 2011
10) Topic avoidance and family functioning in donor assisted families (Paul, M.S. and Berger, R.)
Human Reproduction |  22 June 2007
11) Family Secrets and Family Functioning: The Case of Donor Assistance (Paul, M. and Berger, R.)
Family Processes |  24 November 2008
12) Donor-conceived people's access to genetic and biographical history: An analysis of provisions in different jurisdictions permitting disclosure of donor identity (Blyth, E. and Frith, L.)
International Journal of Law, Policy and the Family |  16 April 2009
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