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Thread: 400,000 Human Embryos Frozen in U.S.

  1. #1

    400,000 Human Embryos Frozen in U.S.

    400,000 Human Embryos Frozen in U.S.
    Number at Fertility Clinics Is Far Greater Than Previous Estimates, Survey Finds

    By Rick Weiss
    Washington Post Staff Writer
    Thursday, May 8, 2003; Page A10



    The freezers of U.S. fertility clinics are bulging with about 400,000 frozen human embryos, a number several times larger than previous estimates, according to the first national count ever done, released today.

    The unexpectedly high number -- by far the largest population of frozen human embryos in the world -- is the byproduct of a booming fertility industry whose success depends on creating many embryos but using only the best. Although most of the embryos are being held for possible use by the couples who wanted them, a large proportion will never be needed, experts said.

    That reality, and the sheer scope of the phenomenon, has reignited a debate among scientists, theologians and parents about the moral standing of those microscopic entities. The question is philosophical, but the implications are practical. With clinics concerned about accidental meltdowns and insurance, and storage fees for parents reaching $1,500 a year, many people are wondering what should be done with the nation's prodigious stores of nascent human life.

    "None of us really want to hang on to these embryos in perpetuity," said David Hoffman, a fertility doctor and past president of the Society for Assisted Reproductive Technology, the Birmingham-based professional group that conducted the survey with the Rand Corp. of Santa Monica, Calif.

    The problem has taken on new urgency with the recent recognition that human embryos have scientific and perhaps commercial value as sources of stem cells, which researchers hope to transform into lifesaving therapies. The nationwide survey found that the parents of at least 11,000 embryos have given explicit permission for their embryos to be made available for research. But a policy imposed by President Bush in 2001 forbids federally funded scientists from doing such research -- a roadblock that left scientists all the more irritated yesterday upon learning just how many embryos are out there.

    By contrast, religious conservatives and antiabortion advocates yesterday chastised the fertility industry for what they described as its profligate overproduction of embryos. Some called for more "embryo adoptions," in which donated frozen embryos are transferred to the wombs of infertile women.

    More than anything, experts said, the large number of embryos being preserved in icy timelessness is an indicator of the ambivalence many couples feel as they consider what to do with their hard-won but unneeded potential offspring.

    "Some people just can't cope with the decision," said Pamela Madsen, executive director of the American Infertility Association, a New York-based patient education and advocacy organization. "Even though their religious or moral perspectives about when life begins are all very individual and different, still most of them will agree that their embryos are very special."

    American women underwent about 100,000 fertility treatments in 2000, the latest year for which statistics are available, resulting in the birth of about 35,000 babies. The most common procedure, in vitro fertilization, usually generates more embryos than are immediately needed, and extras are typically frozen for possible use later.

    Previous estimates have ranged from the tens of thousands to 200,000 frozen embryos, with many hovering around 100,000. Fertility clinics, which are ineligible for federal funding and so are free of much regulatory oversight, have long sidestepped the question.

    The new findings come at an awkward time for the publicity-shy industry. It has been the focus of increased attention from the Food and Drug Administration, which has gradually imposed new layers of oversight, and the President's Council on Bioethics, which is toying with recommendations for added regulation.

    The census surveyed all 430 U.S. fertility practices, asking how many embryos they have stored and their "disposition" -- a reference to the fact that virtually all fertility patients must sign a form saying whether they want leftover embryos stored, destroyed or made available for donation, either to researchers or infertile women.

    All but 90 doctor's offices and clinics responded, and the team estimated the number of embryos at 58 of the 90 on the basis of their number of clients and other details. The team tallied a "conservative" total of 396,526 embryos.

    About 3 percent were earmarked for research; 2 percent for destruction and a like number for donation to women; and 1 percent for quality-assurance studies. Most of the rest -- about 87 percent of the total -- were reserved for ongoing fertility efforts.

    The survey, detailed in the May issue of the journal Fertility and Sterility, did not ascertain how long embryos had been in storage -- a detail some experts said would make clear that most embryos saved for further fertility work are unlikely to be used for making babies. Frozen embryos can remain viable for a decade or more, but with each passing year, couples are increasingly unlikely to use them, because they have either given birth or given up.

    There are no easy answers to the embryo glut. In the United Kingdom, where 52,000 human embryos were in storage as of 1996, the government triggered an uproar when it imposed a policy of destroying "abandoned" embryos after five years.

    "In the U.S., it would be pretty tough to tell someone that," said study leader Hoffman, a director of the IVF Florida Reproductive Associates in Margate, Fla. "In this country, it's the patients who determine what's done with their embryos. Not doctors, not the government or the bureaucracy."

    Harvard University stem cell scientist Douglas Melton reacted to the new census with frustration. "These embryos could be put to a number of good research purposes," he said, including gaining a better understanding of birth defects and developing cellular therapies for serious diseases.

    But opponents of embryo research said the report should prompt fertility doctors to find ways to waste fewer embryos. The situation, said Douglas Johnson, legislative director of the National Right to Life Committee, "bespeaks a mind-set that does not regard these as members of the human family."

    Jeffrey Kahn, director of the University of Minnesota's Center for Bioethics, said the discovery that so many embryos are being made and maintained by fertility doctors puts in perspective claims by Johnson and others that stem cell researchers want to create "human embryo farms" for their studies.

    "It shows that the place where embryos are made is largely not in the private research enterprise but in the reproductive medicine clinics," Kahn said. "In a way, people who are upset about the mass production of human embryos have been barking up the wrong tree."

    "Don't worry about the world coming to an end today.
    It's already tomorrow in Australia!"----- Charles Schultz


  2. #2
    Vast Majority of Cryopreserved Embryos Slated for Future Family Building



    Embargoed for release Contact:
    Sean Tipton
    Thursday, May 8, 2003
    stipton@asrm-dc.org

    202-863-4985


    Warren Robak
    robak@rand.org 310-451-6913

    Washington, DC - The first ever definitive study of the number of embryos created in infertility clinics in the United States and then placed in frozen storage found that nearly 90% of the embryos are slated for future family building uses by the patients who created them.

    The study performed by the Society for Assisted Reproductive Technology (SART) and RAND surveyed more than 430 Assisted Reproductive Technology (ART) practices in the United States. The study reports there are nearly
    400,000 (396,526) embryos currently being stored in cryopreservation facilities across the country.

    The SART/RAND researchers also examined what the intentions of the patients regarding their embryos were. The overwhelming majority(88.2%) are being held to help the patients have children at a later date.

    Treating patients with infertility using ART techniques often results in the creation of more embryos than can be used to create a single pregnancy. When this occurs, patients must decide what to do with the embryos that are in excess of their immediate clinical need. Many patients choose to freeze them for later use. If the initial treatment cycle does not produce a pregnancy, the patient may use the frozen embryos right away. If the cycle does lead to the birth of a child, the patients may wish to use the frozen embryos to have another child at a later date.

    During the treatment process, the physicians, nurses and mental health staff at the
    infertility clinic will work with the patients to help them understand the process, and fully explore the options available to them. "It
    is important to remember that decisions about what to do with these embryos are, and should be, in the hands of the patients," stated Robert Brzyski, MD, PhD, and President of SART.

    The investigators in this study found that only a very small percentage of the embryos (4%) are available for donation. Eleven thousandembryos are available for donation for research with 9,000 available for donation to other patients for family building use. As directed by the patients, an additional 9,000 will be thawed without transfer.

    Dr. David Hoffman, lead author of the study and a past president of SART commented, "We are pleased to be able to bring some real data to bear on this topic.Too often, policy discussions about reproductive medicine seem
    to be driven by emotion rather than fact."

    "This study provides the best evidence to date about the number of frozen embryos in storage across the country and how patients intend to use them," said Gail Zellman, a RAND researcher and co-author of the report. "This is a key piece of information that has been missing from the debate over frozen embryos."

    The paper appears in the May issue of Fertility and Sterility.

    SART was established in 1987, in an effort to provide support and direction
    for the IVF programs in the United States.Since that time, SART has provided education, practice guidelines, oversight and, most importantly, data collection for IVF programs. The data collection function has resulted
    in publication of clinic specific data since 1989 and has been published in conjunction with the CDC since 1995.

    RAND is a nonprofit institution that helps
    improve policy and decision-making through research and analysis. The embryo project was done through RAND's Health and Law Program, which seeks to develop reliable information about how legal processes affect healthcare quality, costs and access in the nation.

    (Hoffman, et al, Cryopreserved embryos in the United States and their availability for research, Fertility and Sterility, Vol. 79, No. 5, May 2003).

    "Don't worry about the world coming to an end today.
    It's already tomorrow in Australia!"----- Charles Schultz

  3. #3
    That is a lot to throw away. Wise.

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