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Women Unhappy With Disposal Options After Infertility Treatment
Date:12/4/2008

Study suggests more choices need to be available to couples

THURSDAY, Dec. 4 (HealthDay News) -- A new survey suggests that many American women who have finished fertility treatments aren't happy with the usual options available for the disposal of unused embryos created with their eggs.

Most of 1,020 women surveyed said they were very unlikely to choose to allow the frozen embryos to be thawed and thrown away, used by other women, given to researchers, or frozen "forever."

The research suggests a conundrum: Women don't like the standard options -- with the exception of using the embryos for their own future pregnancy -- but many will be forced to choose one of them.

"People should know that they'll have a difficult decision that's awaiting them," said study author Dr. Anne Drapkin Lyerly, of Duke University. "They're facing a choice that is very morally difficult and sometimes sort of impossible in terms of finding a satisfactory solution."

Embryos are created during in vitro fertilization procedures at fertility clinics across the United States. "Oftentimes, more embryos are created than needed," said Lyerly, an associate professor at Duke University's department of obstetrics and gynecology.

"You don't know how many embryos are going to form, so you want to make as many as you can, so you can get some good ones," she said. "Another reason you make more than you need during a given fertility cycle is so you can freeze them and use them at a later time without going through the egg harvesting process."

Clinics typically allow women to keep the unused embryos frozen indefinitely, although there are storage fees that could run into hundreds of dollars a year. A study released in 2003 estimated that 400,000 frozen embryos remained on ice in the United States.

The question is: What should be done with the embryos? They could be donated to researchers, although federal law limits what scientists can do with them on the stem-cell research front. They can be thawed and discarded, although that seems akin to abortion to some people.

In the new survey, researchers asked questions of 1,020 women who had embryos frozen. The women, patients at nine fertility clinics, were surveyed in 2006 and 2007.

The survey results were published in the Dec. 4 online edition of Fertility and Sterility.

The researchers found that 54 percent of the women said they were "very likely" to use the frozen embryos in future pregnancy attempts, and about one-fifth were very likely to donate them to research.

Of women who either weren't sure about future pregnancy attempts or ruled them out, 40 percent said they weren't "very likely" to choose one of the five standard options: use them in a future pregnancy attempt, thaw and discard them, donate them to another potential mother, donate them to research, or freeze them indefinitely.

"People really didn't like their options very much," Lyerly said. Women did like two options a bit better -- inserting the embryos in their bodies at times when they are unlikely to become pregnant or disposing of them in conjunction with a ceremony. But those options aren't commonly available.

There's another option: only create a small number of embryos for use in fertilization procedures and freeze only eggs for future use.

Some clinics now offer that option, said Dr. Lynn Westphal, director of the women's health program at Stanford University. "We have some patients who are clear that they don't want to have a lot of extra embryos in the future, they don't want to think of these decisions they'll have to make," she said.

More information

Learn more about infertility from the U.S. National Library of Medicine.



SOURCES: Anne Drapkin Lyerly, M.D., associate professor, department of obstetrics and gynecology, Trent Center for Bioethics, Humanities and History of Medicine, Duke University, Durham, N.C.; Lynn Westphal, M.D., director, women's health program, and associate professor, department of obstetrics and gynecology, Stanford University, Palo Alto, Calif.; Dec. 4, 2008, Fertility and Sterility, online


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