400,000 Human Embryos Frozen in U.S.
RICK WEISS / Washington Post 8may03
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."
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