Embryo donation raises a series of challenges. In Australia, the market for embryo donation is comprised of high demand and low supply. In addition, embryos cryopreserved for future reproduction are only kept frozen for a maximum of ten years; then the family must decide whether to destroy or donate the embryos. However, there is no legislation in Australia to direct this decision or to protect the interests of families who choose to donate.
While the thought of destroying an embryo feels unethical to many individuals, the decision to donate may not seem acceptable either. Australian law prohibits anonymous donations and presumes that, at the age of 18, a person is entitled to know the identity of those who donated gametes from which he or she was conceived. Yet, Australia has no legislation that requires people who conceive using donated embryos to inform their children of the embryos’ origins or to inform the donors about the children their embryos helped conceive.
Although the law does not clearly protect the interests of donors, some Australians have found positive experiences when deciding to donate rather than destroy their embryos. Koby and David Argall, for example, explain that the possibility of an embryo staying “frozen in time” was not an option for them and believe that the decision to donate is one of the most important and positive decisions an individual can make.
In an article dated October 18, 2016, it was reported that “selective reduction”—the practice of aborting one or more healthy fetuses in a multifetal pregnancy while leaving another intact—is now legal in Norway. While proponents of the procedure say that selective reduction should not be thought of any differently than any other abortion procedure, opponents claim that the procedure should not be performed if the fetus is healthy, exposes the remaining fetus to unnecessary risks, and may lead to “abortion tourism” due to its unavailability in neighboring countries.
From The Independent, “Norway Allows Foreign Women Pregnant with Twins to Have Selective Abortions”
Excerpt from article:
“Dr Birgitte Heiberg Kahrs, a specialist in fetal medicine at St Olav’s Hospital in Oslo said: ‘We have not found any medical benefit from this. On the contrary, it exposes the second child in the womb to danger as the abortion risk increases.’”
Veterans who were wounded during service receive free health care provided by the Department of Veterans Affairs (“VA”). However, the care does not include in vitro fertilization (“IVF”) to assist with fertility issues resulting from injuries sustained in combat or training. Congress passed a law in 1992 that prohibits the VA from providing IVF to veterans, forcing thousands of veterans to pay out of pocket to start a family.
IVF is, however, provided to active military service members. Unlike the VA, the Defense Department provides such services in seven hospitals if an active member’s infertility is a result of an injury sustained in service. The Defense Department hopes to expand their coverage of fertility services to a wider population, but it would nonetheless exclude veterans who receive services through the VA. Many wounded service members do not undergo IVF while in active military status because they are concerned about recovery and rehabilitation. By the time they consider procreation, they are retired or discharged from the military, placing them in veteran status and without coverage for IVF.
Senator Patty Murray has made several attempts to change the 1992 law, most recently by introducing a bill that would allow IVF to be covered by the VA. At a Senate Committee meeting, the VA expressed support for the bill as long as it would receive the necessary funding to provide such services. However, Ms. Murray withdrew her bill after amendments were made by Republicans that would ban the VA from working with Planned Parenthood and other centers that provide both fertility treatments and abortions.
For the time being, veterans with fertility issues are left with few options. Some fertility centers and clinics offer wounded veterans a discounted rate for IVF. But even with the discounted rate, many couples cannot afford the treatment and are forced to either abandon their hopes of a family or resort to other measures, such as taking out a loan.
Two studies published in Pediatrics have found that women using assisted reproductive technology (“ART”), including IVF, give birth to children with a higher risk of developmental disorders and cancer. The first study was a cancer study that combed through all birth records in Norway from 1984 to 2011. The birth records were compared to the cancer registry data. The researchers concluded that ART-conceived children had a 67% higher risk of leukemia. However, the overall risk of cancer was not significantly greater for ART children. The second study focused on developmental disabilities in children. Researchers analyzed the birth records of more than 330,000 children and found that ART children had a 27% higher chance of being referred to Early Intervention, a program designed to help disabled infants and toddlers. Since ART babies are more likely to be premature, the researchers took into consideration the link between preterm babies and developmental disabilities and concluded that premature births were not the primary cause of ART children being referred to Early Intervention.
Because the studies are preliminary, the authors are not suggesting that women avoid IVF and other reproductive technology procedures. There can be other contributable factors that need to be considered, such as advanced maternal age, hereditary genetic diseases and reproductive health of women seeking reproductive treatments. The lead author on the developmental disability study, Dr. Hafsatou Diop, acknowledges that there are risk factors undergoing IVF, but states that, no matter how children are conceived, women can take certain measures in reducing the risk of pregnancy complications by avoiding smoking and drinking, maintaining good health and eliminating stress. Dr. Diop further explained: “While there is an increased risk, we don’t necessarily think that it is enough to influence one’s decision about whether or not to proceed with ART.”
While debates over the personhood of fetuses have been raging for years, a new issue has been arising with increasing frequency: what is personhood status of frozen embryos? There have been many recent disputes about how to deal with frozen embryos when the progenitors of such embryos disagree about their use. For example, a divorced Missouri couple is currently involved in a custody battle over their frozen embryos, which were created when the couple were married and went through the process of in vitro fertilization. While the former wife would like to keep the embryos to have more children, the former husband would like the embryos to be destroyed. Similar issues arose for actress Sofia Vergara, whose ex-fiancé wants to use frozen embryos they made when they were engaged.
Cases of this nature beg several important questions. How should embryos in vitro be classified? Does the embryo have rights? What are the rights of each progenitor? Anti-abortion activists have argued that embryos should be treated like other children, while pro-choice advocates contend that people should not be forced to procreate. In the Missouri case referenced above, the Court has tried to avoid these difficult issues with a compromise, calling the embryos “a unique form of marital property” and awarding joint custody to the disputing parties. Under the Court’s holding, the embryos may only be used if both progenitors agree. While this decision provides a temporary solution, it still leaves many issues unresolved and significant questions unanswered.
The UK is now drafting regulations for the use of “three person IVF” – a technique designed to eliminate certain mitochondrial disease. Mitochondria produce energy within cells, and mitochondrial DNA, which comes only from the mother, determines how mitochondria function in an individual. Three-person IVF replaces “bad” mitochondrial DNA from the mother with mitochondrial DNA from a donor’s egg.
Doctors are now able to screen for potential chromosomal abnormalities in embryos created via In vitro fertilization (IVF). The screening method uses DNA sequencing, known as next-generation sequencing (NGS), in order to identify embryos with the normal number of chromosomes. Many embryos created via IVF carry “lethal genetic abnormalities,” and fail to implant in the womb as a result. The new screening method not only lowers the cost of IVF treatments for couples by increasing pregnancy rates, but also lowers the number of miscarriages for recipients of IVF treatments. Recently a couple in the United States gave birth to the first baby conceived through IVF treatments using NGS.
NGS allows doctors to scan the human genome cheaply and rapidly; and the price for NGS is falling. Some offer caution because of concern that NGS may lead to a generation of “designer babies.” To read more, click here.