Tiny, vulnerable lives

In the wake of the Alabama Supreme Court’s February ruling that the state’s Wrongful Death of a Minor Act applies to embryos that have not been transferred into a womb, the bioethics center I lead has received a number of questions on the ethics of reproductive technologies like in vitro fertilization (IVF).

One of the most difficult questions we receive is, What should we do with our frozen embryos? This is a deeply personal question, one that few couples anticipated when they started down the path of infertility treatment. One of the reasons this happens is there is little encouragement for ethical reflection once treatment begins. Treatments A, B, and C are offered one after the other, and the couple is simply moved along to the next step.

Many couples find that when they are finished with IVF, either because they have the number of children they want or because health or finances keep them from continuing, they have extra embryos kept in cryopreservation. Consequently, couples who want to do the right thing when it comes to their Christian and pro-life commitments find themselves in a situation with few good options.

One option is to do nothing and leave the embryos frozen indefinitely. Many people end up choosing this option even if their choosing comes about because they simply don’t do anything else. The result is that there are currently anywhere from 500,000 to well over one million embryos in cold storage in the United States, although the exact number is unknown. This situation is ethically problematic because it leaves nascent human beings in a state of indefinite suspended animation without any prospects for being allowed to grow and thrive.

Another option is “donating” the embryos to science. This will almost certainly lead to the destruction, that is, the death of the embryos. To make this option doubly troubling, their deaths will come about for utilitarian purposes—for the good of science. This treats embryos as means rather than as ends in themselves.

Couples could place the embryos for adoption through a service like Snowflakes, which may be the least ethically troublesome option for couples who, for medical reasons, cannot transfer the embryos into the body of the mother. However, even this option has its ethical drawbacks. Christian bioethicist Gilbert Meilaender finds embryo adoption problematic when there are so many children who are awaiting families who will provide them with a home. Furthermore, he says that we can never adopt our way out of the frozen embryo problem.

While I greatly respect Dr. Meilaender, and I take seriously his points, I want to allow that some couples may be called to adopt embryos. Nevertheless, he is correct that there are more frozen embryos than can possibly be adopted.

Another option is to allow the embryos to thaw, leading to their deaths. Some have suggested offering a liturgy that acknowledges their lives and mourns the fact that they never had the opportunity to grow, develop, and fully flourish. This is a controversial option as it simply ends the lives of human beings, and thus I am hesitant to endorse it.

The best, or perhaps least bad, option would be for couples to attempt to transfer their frozen embryos into the uterus of the mother and provide them with every opportunity to grow and develop and flourish. I say least bad because some 10 percent will not survive the thawing process, while some of those that survive thawing will not implant and go on to generate a pregnancy or birth. Again, though, there may be medical reasons why this is impossible for some couples.

Some who are otherwise physically able may protest that it is too expensive or that the number of children they currently have is all they can handle, or more pointedly, all they want to have. Perhaps this is an opportunity for churches to support couples and families financially by defraying the cost of the embryo transfer and practically by easing the burden of raising a family that is larger than what the couple was prepared for.

Ultimately, we need to stop freezing embryos (and perhaps consider the ethics of engaging in IVF at all, a subject for a different essay). One simple solution is to provide better information and time for reflection before a couple starts the next sequence of infertility treatments. Even better, our churches need to teach on these important issues so couples can prayerfully consider what they would do before they find themselves in a doctor’s office coping with an infertility diagnosis. Perhaps then, the question of what to do with our frozen embryos will cease to be an issue at all.

I am grateful to be able to point readers to several pieces on my organization’s website.