Adopting Embryos to Achieve Pregnancy: A Summary of Important Facts
Dr. Reginald Finger, MD, MPH
This summary is intended for physicians, nurses, social workers, and other health and human services professionals who may be in a position to advise, counsel, or inform couples who have had difficulty conceiving a child naturally and are weighing options to assist them in becoming parents. One of the first choices many couples in this situation think of is the adoption of an infant. However, for Caucasian couples who prefer to raise a child of their own race and ethnicity, very few infants are available. Options are somewhat less limited for African-American couples, or for those who wish to adopt a child of a different race, or one of mixed race.
The adoption of frozen embryos remaining after another couple's IVF procedures have been completed ("embryo adoption") can be a fulfilling option for parents who either have sought to adopt an infant but have not been successful in finding one – or who would have chosen to undergo IVF but either or both partners cannot produce gametes (egg or sperm). In addition, some couples are attracted to adoption but do not wish to risk the possibility of having a birth mother back out of the arrangement, or the possibility that the infant may be exposed to harmful drugs during pregnancy. Couples in any of these situations are good candidates for embryo adoption.
Unlike with traditional adoption, embryo adoption does not require action of a court of law in order to establish parentage for the adopting couple. State laws in the United States utilize gestation (not genetics) as the legal basis for motherhood. Thus, since the embryo adoption mother carries the child, no additional legal action is needed. The custody of the embryos is transferred by a contract, from the donor couple to the adopting couple, before the clinical transfer of the embryos to the recipient mother's uterus occurs. This transfer is then performed under ultrasound guidance in the same manner as for IVF.
Embryo adoption is offered by several different types of agencies. About half of all infertility clinics in the United States, when asked, respond that they would offer embryo adoption if a couple in their practice wanted to pursue it, and a couple could be found within the practice who wished to donate their remaining embryos. This is known as "intracameral" (within the same clinic) embryo adoption. Most clinics see the procedure strictly as a variation on IVF or egg donation, do not recommend a home study for the adopting couple, and use the term "frozen embryo transfer with donor embryo" rather than "embryo adoption". Recently, two U.S. clinics expanded on the arrangement by advertising the availability of embryo donation on this same model to donors and recipients nationally or internationally.
Embryo adoption is also offered by a number of adoption agencies – some Christian and others secular in their orientation. In these agencies, embryo adoption is seen as a variation on traditional adoption; the adopting couple undergoes a home study, and more attention is paid to the preparation of the couple to raise a child not of their own genetics. These agencies work with an infertility clinic of the adopting couple's choice to accomplish the clinical placement of the embryos in the recipient woman, once the match is made and the counseling and home study have been done. The "Snowflake" program of Nightlight Christian Adoptions, headquartered in Anaheim Hills, California, is the largest program of this kind. In Bothell, Washington, a small but growing embryo adoption program known as Embryo Adoption Services of Cedar Park uses this same model but is administered by a local church rather than by an adoption agency.
The National Embryo Donation Center (NEDC), located in Knoxville, Tennessee, uses a unique combination of the two approaches. NEDC offers counseling, the match, and the clinical services necessary to accomplish an embryo adoption, all under one roof. The only thing "referred out" is the home study – to a social services agency licensed in the couple's home state of residence. Patients choosing NEDC gain the advantage of working with a clinic that is very experienced with embryo adoption, but they must travel to Knoxville at least twice (once for the clinical workup, once for the embryo transfer) to participate.
There also exist at least two primarily internet-based agencies (see the last two links below) which simply collect information from prospective donor and recipient couples, make the matches (or allow couples to match themselves), then arrange for the counseling and clinical services to be done in locations convenient to the donor and recipient couples.
Embryo adoption can be handled on an anonymous basis (couples' identities are not known to each other), or in an open arrangement similar to the open adoption of an infant, where couples sign an agreement to any of several levels of information exchange and personal contact. It is also possible to arrange for a "semi-open" embryo adoption where a full set of personal information is exchanged between the couples with the exception of full names and locating information. This allows for a degree of privacy protection – important to many couples – but still gives both donors and adopters information they would like to know. Intracameral embryo adoptions are almost always anonymous; adoption-agency based embryo adoptions are more often open; NEDC offers both, with approximately equal numbers of couples choosing each.
When averaged across the different types of agencies, embryo adoption is less expensive on a "per successful trip home with at least one live child" basis, than either traditional adoption, IVF, or egg donation. This is because couples do not have to pay court costs (as in traditional adoption), or for the retrieval of eggs from the woman (as in IVF) or an egg donor's fee. Many couples who have adopted embryos also report a sense of satisfaction from knowing that they gave frozen embryos a "chance at life".
Additional Resources for Patients and Professionals:
National Embryo Donation Center
Nightlight Christian Adoptions (The "Snowflake" Program)
Embryo Adoption Services of Cedar Park
Bethany Christian Services