The lack of acceptable options fuels patients' reluctance to make a decision. "Either the options they prefer aren't available or they are unacceptable," explains Lyerly.
In the survey, the researchers presented four embryo disposition options: thawing and discarding; reproductive donation; indefinite freezing; and donation for research. The majority were unlikely to choose any of these options except for one: research donation.
In a previous paper published in Science, Lyerly reported that 60 percent would be likely to donate unused embryos for stem cell research, an option not readily available. But even if federal policies on funding stem cell research change, Lyerly says that doesn't solve patients' conundrum.
"For many of these patients, the need to make a decision about disposing these embryos is not discussed up front. Understandably, fertility patients have hard times thinking about destroying their embryos when they are emotionally and financially invested in trying to make a baby," she says.
The conundrum arises when reproductive goals change without a renewed discussion about what to do with the embryos that have been stored. "Many centers don't make available all the options for disposition," Lyerly says. "Even in places where embryo research is not conducted, it's possible that embryos can be transferred to another center, yet this might not be discussed."
Two methods that were considered somewhat acceptable by about 20 percent of the fertility patients were placement of embryos in a woman's body at an infertile time, and the idea of a ritual disposal ceremony. Yet, Lyerly says these alternatives are rarely offered to patients even though "these may be the answers to many patients' desires as they allow the embryos to pass in a wa
|Contact: Debbe Geiger|
Duke University Medical Center