For most couples, the most difficult decision they will ever face is the one to start a family. The idea of becoming pregnant, enjoying a healthy pregnancy, giving birth and raising a child is the dream of most young couples. Although the concept of becoming someone’s parent is an exciting, yet daunting notion, at some point, many couples take the leap of faith and begin trying to have a baby. For some couples, pregnancy comes easy. For others, it is not so simple.
How a couple eventually comes to start a family is not always the same process. Just like no two babies are the same, neither is the process of creating one. Each couple’s journey can be vastly different. For some couples, the path to becoming parents is not perfectly planned, and the road to a baby takes many twists and turns. Luckily, for many, when traditional methods fail, often hope, faith and medical science prevail.
Once taboo topics, infertility and miscarriages are no longer being suffered by couples silently. It is well-documented that one in eight couples struggle with infertility and more than one million women each year find they are unable to get pregnant without the help of a fertility specialist. Infertility was once thought of as a woman’s problem, but now we know that is not true. Male infertility is a factor in a couple’s inability to get pregnant about 20 percent of the time. Forty to 50 percent of cases are due to female issues such as endometriosis, damage to the fallopian tubes or ovulation disorders. A significant percentage of infertility cases can be directly linked to having had a prior abortion. Thirty to 40 percent of infertility is caused by issues with both the man and the woman.
Because of advances in reproductive medicine, infertility statistics are more encouraging than ever. About 20 percent of couples diagnosed with infertility eventually become pregnant on their own. Of those treated for infertility, nearly 70 percent of couples go on to have a baby. In 2013, the Center for Disease Control’s National Center for Health Statistics reported infertility rates in the U.S. were falling. For the first time since the 1980s, the level of infertility was being counteracted by medical treatments developed to help couples have a child.
Despite the promising news, millions of couples across the country still struggle to conceive. One of the most popular and widely-used reproductive technologies is in vitro fertilization (IVF). IVF combines a woman’s egg with a man’s sperm in a laboratory and then the resulting embryo is transferred to a woman’s uterus. In most cases, not all embryos are used in a transfer. Only one or two embryos are implanted, leaving fresh embryos remaining. Some couples choose to have these embryos destroyed. Others freeze and use them at a later date. Yet, there is another option, one that helps millions of couples nationwide achieve a pregnancy when all other infertility options are exhausted. These embryos can be frozen, thawed and then transferred to another woman’s uterus. This process, frozen embryo transfer (FET), has given rise to the nickname “snowflake baby.”
FETs have been performed in the U.S. since the 1980s. In the medical research community, there is even growing evidence that suggests freezing an embryo after fertilization to be thawed and implanted later actually leads to higher pregnancy rates, compared to using the embryo immediately. The success of an FET depends on many different factors, such as the number of embryos available, whether or not the cycle of embryos frozen resulted in a pregnancy, the quality of the embryos and the age of the woman when the eggs were provided. A successful pregnancy also depends on the overall health of the embryo recipient.
At Dallas IVF, FETs and embryo adoption has been part of the practice for more than 20 years. One of three methods is used to help couples adopt embryos for use in IVF procedures. National agencies, such as the Snowflake Frozen Embryo Adoption and Donation Program, provides couples with legal paperwork and consents. Both the donating and adoption couples complete profiles and express the kinds of families they hope to have and the child they would like to raise, as well as the types of couples they would like their embryos to come from. Another option is direct adoption. A couple will adopt an embryo or embryos from another couple they know or have met through a third party. In-house embryo adoption is also an option at Dallas IVF. Embryos are donated to the center and then placed to couples seeking embryos after a thorough screening process.
According to Dr. Brian Barnett, a board certified reproductive endocrinology and infertility subspecialist and senior partner at Dallas IVF, current techniques of embryo freezing deliver a higher percentage of viable embryos when thawed and this is safer for both the mother and baby. “The available human data does not indicate any higher likelihood of having a problem with children born through these treatments than the children being born of embryos following fresh embryo transfers,” says Dr. Barnett. “The success of achieving a pregnancy with frozen embryos has dramatically increased over the last several years, with the advent of improved freezing techniques, known as ‘vitification,’ otherwise termed ‘rapid freeze.’”
The process of frozen embryo adoption and donation naturally creates some anxiety and questioning for many couples. The decision to donate or adopt creates a need for couples to make decisions about their children beyond what fertile couples who conceive naturally must think about. Do they want to know the family that adopts their frozen embryo? Do they want to know how the child or children are doing as they grow up? When and how will the adopting parents tell their children they were conceived as an adopted embryo?
Dr. Barnett says the embryo adoption process can take several weeks. Both the donating and adopting couple must be screened. “The couple donating an embryo has to complete an exhaustive screening process, including infectious disease screening, along with the completion of extensive medical, genetic and family history questionnaire. In addition, other psychological testing is required. The couple adopting the embryos must also undergo extensive medical and psychological testing, among other studies. Legal agreements also need to be completed. The originating couple renounces all rights to the embryos and the adopting couple takes possession.”
It can be an emotionally taxing process, not to mention expensive. The cost of embryo adoption comes at a steep price. Embryo adoption agencies run the gamut from large, national centers to small, local groups. They charge anywhere from $2,000-20,000 in adoption fees. Many require home study and family evaluations as an additional fee. The frozen embryo transfer, performed at a clinic, can cost anywhere from $3,500-6,000, depending on the number of embryos transferred. That brings the total cost of embryo adoption and embryo transfer to $7,500-30,000. Many couples create GoFundMe pages, accepting donations from friends, family and often complete strangers, to help with the long, arduous process of embryo adoption. For many, it can take years to complete the process. Couples pour their hearts out on profile pages, documenting the trials and tribulations of saving for an embryo adoption, documenting failed IVF attempts, miscarriages and sometimes even revealing the breakup of couples whose relationship crumbled under the heartache of failed adoption procedures.
One couple that worked with Dallas IVF along their journey to become parents was Frisco mother, Laurel, and her husband. “We feel very fortunate to have children. Our first was conceived naturally, soon after we married. We never expected to struggle to have a second. After our second child was born, we knew, for a variety of reasons, that our family was complete,” said Laurel. “We donated for many reasons, but the bottom line for us is that, generally speaking, parents do what is best for their children, even when it is hard. What is best for our embryos is not to be discarded, but to be given the chance to become a baby. A lot of it is our faith, but it is also our parenting philosophy that guided this difficult decision. I believe God gave us this opportunity and we will be able to bless someone who has found themselves in the emotionally desperate season of wanting children and being unable to conceive.”
David C. Cole, an attorney specializing in assisted reproduction law, believes that embryo donors are typically compelled to donate their remaining embryos based upon their faith and/or moral values. “Faith-based donors typically believe that life begins at conception and it is their obligation to give each embryo an opportunity to develop. Those morally-driven to donate their remaining embryos also desire to assist an individual or couple struggling with infertility. Regardless of their motivation for donating their embryos, I find that roughly half of our clients desire some level of communication with the embryo recipients, whether it is receiving a simple update regarding confirmation of pregnancy, receiving more detailed updates pertaining to the development of the child/children, or, in some cases, developing a more meaningful, ongoing relationship. The other half of our clients tend to desire a completely anonymous relationship,” says Mr. Cole.
Laurel says she and her husband discussed donating their embryos ad nauseum before making their final decision. They even visited a professional counselor who specializes in matters related to adoption and assisted reproduction. “We wanted to be certain we had examined it from all angles. It is not an ideal situation, but we believe we are doing the right thing,” she says. She also shares that they had specific criteria for the adopting parents of their embryos. “We wanted parents who believe in the importance of education and travel, who were practicing Christians and who would take all of our remaining embryos, so any babies born would be in the same family.”
Donating or discarding embryos is not the only option for couples. Some choose to store their frozen embryos at the IVF clinic or at cryo centers until they are ready to have another child. Another option is donating embryos to medical research. Whatever path a couple chooses, the decision about what to do with remaining embryos can be heart wrenching, leading them to turn to online support groups and counseling to help guide them in their decisions.
Laurel says she is on multiple IVF support groups on Facebook. She and her husband struggled with their decision to donate and ultimately decided it was the right path for them. “It is not a road we ever would have chosen. It is the most difficult decision of our lives, and although we feel like we are doing the right thing, it requires an inordinate amount of trust and faith. To relinquish control of your babies is extremely scary. I am certain that is why so many embryos are frozen in time.”