What
are the advantages of Embryo Donation over adoption?
Adoption is an excellent
option for many couples. For some, however, Embryo
Donation may be a preferred alternative:
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Embryo Donation is quicker with
delivery often within one year of the first visit.
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Embryo Donation is often much
less expensive than adoption.
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Embryo Donation is usually less
complicated and less expensive than many alternative
ART procedures.
-
If there are enough Donated Embryos
available, more than one child may be delivered
by the Donor Embryo Recipient, all with similar
genetic inheritance.
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Unlike adoption, one has a tremendous
amount of medical information regarding the mother
and the true father of the Donated Embryos. At
times in conventional adoption, the genetic father
of the gestation is incorrectly identified leading
to uncertainty and future custody/legal issues.
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Unlike adoption, the Donor Embryo
Recipient can choose the genetic trains they value
by looking for Donated Embryos from specific genetic,
social and religious backgrounds.
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Unlike adoption, the Donor Embryo
Recipient can protect and nurture the pregnancy
minimizing the prenatal exposure to drugs, poor
nutrition and Sexually Transmitted Infections
(STI's).
-
Unlike adoption, the Donor Embryo
Recipient may go to the Obstetrician of her own
choice. In conventional adoption, the pregnant
mother goes to the physician of her choice.
-
Embryo donation offers a greater
level of privacy compared to conventional adoption.
-
While quite variable, some insurance
plans will cover for some aspects of the Frozen
Donor Embryo Transfer (FDET) process while they
will not cover adoption fees.
Adoption is still an excellent option for some couples
while Embryo Donation has a number of interesting
advantages.
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Who
are the potential Donor Embryo Recipients?
The following are some of the potential patients who
are Donor Embryo Recipients:
- Both partners have significant
fertility issues.
- Patients are seeking a less expensive
alternative compared to other technologies and adoption.
- Patients are unable to adopt
(i.e., cancer survivor, single, lesbian or in their
40's).
- Patients with a family history
of genetic disease where direct reproduction is
not recommended.
Significant medical
conditions such as diabetes and recurrent pregnancy
loss may exclude a Donor Embryo Recipient from participation
in the program.
In addition, because of the fact that SRMS has a fewer
embryos donated than people requesting them, we will
often limit the donations to individuals and couples
who essentially have limited options.
If either of the partners (where applicable) have
had children from other relationships, they may also
have to be excluded from the FDET process.
We do not mean to be judgmental, but donated embryos
are a relatively rare commodity and we must ration
at this time.
Some of these stipulations may be able to be relaxed
in the future as SRMS obtains more donated embryos.
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How
do I choose the donated embryos?
You may choose your donated embryos using a number
of parameters. Recipient couples often try to match
such characteristics as race, eye/hair color, height/weight,
blood type, educational background and general interests.
Highly Desired Donor
Parent Characteristics
- History of conception from
the same batch of embryos (i.e., the fresh embryo
transfer resulted in a pregnancy of the Donor
parents and the excess cryopreserved embryos from
that same cycle were donated)
- Donated maternal age less than
34 at the time of ART
- No family history of genetic
diseases
- No history of sexually transmitted
diseases.
Moderately Desired Donor Parent
Characteristics
- Maternal age 35-40 at the time
of ART
- Family history of genetic diseases
- Past history of treated sexually
transmitted disease*
*A donated Embryo Recipient who already has Hepatitis
may receive donated embryos from Donor Parents with
Hepatitis.
Donated embryos will
frequently differ in quality based on the following:
- If the original fresh transfer
resulted in a conception, the entire batch of
embryos will tend to be excellent.
-
The larger the number of cryopreserved
Donated Embryos, the greater the likelihood for
success.
-
The more advanced the embryo is
in development at the time of cryopreservation
(i.e., morula or blastocyst stage cryopreserved
donor embryos), the healthier the embryos and
the greater the likelihood of implantation.
-
The larger the number of cryopreserved
Donated Embryos, the more likely the recipients
can have more than one child from the same Donor
Parents.
-
The younger the female Donor Parent,
the better the implantation rates.
-
The younger the female Donor parent,
the less likely that a genetic amniocentesis will
need to be performed during a successful Frozen
Donor Embryo Transfer (FDET) pregnancy.
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What
kind of screening did the Donating Parents receive?
All Donating Parents underwent intensive screening processes
including history & physical exams, detailed genetic
histories and extensive laboratory testing for communicable
diseases. Please remember that
these couples had medical problems just like you, so
their medical histories were not perfect. Nearly
all of them will have some reproductive issues.
Per standard of care, all Donating Parents underwent
various evaluations including screening for Sexually
Transmitted Infections (STI's) including hepatitis,
syphilis and HIV. Ideally, the Donating Parents should
be re-screened for STI's before the Donated Embryos
are thawed and transferred. This is not always possible
and adds further costs to the Recipient Couple. The
likelihood for ART patients, such as you, to be negative
for HIV just prior to ART, only to turn positive later,
is quite low. SRMS simply has a very low risk population
for these types of concerns. We
must always keep perspective on this issue since conversion
to an active infection is extraordinarily unlikely.
In addition, it should always be remembered that you
are considering the transfer of very minute quantities
of tissue (i.e., multi-celled embryos) compared to organ
and blood donation where billions of cells are donated.
Even if the Donating Parents were positive for STI's,
the chances of transferring
HIV or Hepatitis to a Recipient Couple are astronomically
small, and perhaps, only a theoretical concern.
It is of interest that the cryopreserved process itself
may also render some underlying infections harmless.
If you desire re-testing of the Donating parents, please
discuss these issues with SRMS. Some of the parents
will have agreed to be re-tested upon request, although
doing so will increase the costs of the Embryo Donation
procedure.
In
summary, the probability for transmission of disease
is quite remote and is minimized though the original
screening laboratory testing of the Donating Parents. |
Was
genetic screening performed on the Donating Parents?
Routine genetic screening laboratory tests, including
Sickle Cell for African-American patients and Tay Sachs
for Jewish patients, were inevitably offered to the
Donating Parents during their original ART cycle. If
there was a significant history for other genetic diseases,
testing for these disease were also offered. Offered
does not necessarily meant that they were done.
Changing recommendations regarding genetic screening
now make the FDET process more complex. For example,
Caucasian couples considering conception are now to
be offered genetic testing for the gene that causes
Cystic Fibrosis. A Caucasian woman is estimated to have
a 1/29 risk for carrying the abnormal gene, which can
result in Cystic Fibrosis in one out of every 3,400
deliveries (http://www.cff.org/).
It is an uncommon disease, but genetic testing is now
offered to couples considering conception.
In all likelihood, the Donating Parents did not have
this level of genetic screening. If the Donating Parents
are currently available and willing, this genetic test
can be performed in addition to the updating of other
STI’s. Once again, if requested, this will increase
the costs to you. Genetic screening and repeat testing
for STI’s will, therefore, remain optional to
the Recipient Couple assuming the consent for retesting
by the Embryo Donors. |
Are
the children born via Embryo Donation different than
other children?
Gestations that result from the Frozen (Donor) Embryos
are essentially the same to children conceived through
a more “natural” process. There are, however,
a few potential exceptions:
- If the embryos were created
from subfertile parents, the offspring may have
similar reproductive issues when they reach adulthood.
For example, there does seem to be genetic predisposition
to gynecologic diseases (i.e., endometriosis)
much as the way that cancer and heart disease
may run in various families.
- Along the same lines, additional
data has been published that indicates some male-factor
problems may be passed on to the children. This
seems to occur at a very low rate, but can occur.
The overall outcome is usually similar to that
of the father (i.e., reproductive issues). Fertility
and other medical issues may occur to the male
child or the female offspring may carry a genetic
problem that could eventually affect her children.
Once again, the medical outcomes are usually no
different than the male partner who originally
provided the sperm.
- Please keep in mind that what
ever brought you to the FEDT process may have
been transmitted to your genetic offspring. In
addition, these concerns generally pale in comparison
to conventional adoption, where much less are
known about the genetic parents and their family.
- There have been some studies
which indicate the average ART pregnancy will
deliver somewhat earlier with a smaller-for-gestational-age
baby compared to those conceived through natural
means. This is probably due to the fact that the
patients are simply at higher risk for problems
due to the issues that made them subfertile in
the first place.
In summary, ART conceptions are not more prone to
significant abnormalities. We offer no guarantee,
however, that the child will be normal, but tens of
thousands of children have been created by the IVF
process and the children are generally as healthy
as those conceived through a more “natural”
means.
To reiterate, it
is very important that the Donor Embryo Recipients
not try to seek “perfection” in finding
the “ideal” Donated Embryos. It is doubtful
that your own genetic children would have been perfect
given the issues that have brought you to the point
of considering Embryo Donation. Please keep your perspective!
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What
are the success rates for Embryo Donation?
As data accumulates, these success rates will be published
on the SRMS web site. While often under construction,
you can view the most current statistical
success rates.
Do the Donating Parents
have any legal rights to the Donor Embryo offspring?
Currently, there are no parental rights of the Donating
Parents to the offspring from embryo donation here
in the state of Florida. As with blood and other organs,
once donated, the donor looses all legal rights to
the tissues.
It should be noted that the
Donating Parents are free to change their mind and
request that their Donated Embryos be returned up
to the point of the actual thaw and transfer, although
this is expected to rarely, if ever, occur. We
allow this to encourage patients to consider Embryo
Donation, but do not want them to feel that they could
not reclaim their embryos should their own children
pass away. Once the embryos are transferred to the
Embryo Recipient, the Embryo Donors will loose any
legal rights to the offspring.
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Will
we ever meet the Donating Parents?
The Embryo Donation process remains anonymous. The
Donors and recipients will not meet.
Can
the children ever find the Donating Parents?
The Embryo Donation program is anonymous. In addition,
SRMS is required to keep medical charts for only seven
years, so requests made years in the future may not
be able to be honored. SRMS intends to honor the contacts
that specified anonymity and so appropriate legal
means would be drawn upon to protect all parties.
If an offspring from Donated Embryos needed to find
the Donating Parents for medical reasons (i.e., bone
marrow or kidney transplant) and upon request, SRMS
would act as a neutral entity to assist all parties
while keeping confidentiality intact.
Are
Donating Parents paid for their embryos?
The Donating Parents have donated by their own free
will and were not compensated for their decision.
Upon occasion, any remaining cryopreservation fees
have been waived when the parents decide to donate
the embryos. SRMS does this to encourage couples to
consider donating their embryos, but do not want to
entice them inappropriately to do so. This may eventually
change given the fact that sperm and egg donors are
paid for their services.
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How
long can the donated embryos stay frozen?
We really do not know the limit of the cryopreservation
process. Animal research has shown that offspring
are possible after many years of cryopreservation.
More research will need to be done before this question
can be adequately answered. We will not hold donated
embryos indefinitely and will certainly encourage
their transfer as quickly as possible.
Will you accept Donated
Embryos from other ART facilities?
In short, we will accept some cryopreserved Donated
Embryos from other facilities. We will not accept
all embryos offered and will have to evaluate each
donation on a case-by-case basis. Below are some of
the reasons why SRMS will reserve the right to refuse
to accept the transport of Donated Embryos:
- The ART facility that is called
upon to transfer Donated Embryos has very poor
Frozen Embryo Transfer success rates.
- The embryos originated from
women with advanced maternal age.
- Very few embryos are available.
- The embryos originated from
minority combinations that are rarely represented
in our patient population.
Please understand that our goal is to accept the transport
of embryos likely to be chosen by our patient population.
We are certainly not biased towards or against any
individuals or programs. We simply do not want to
become an international storage facility, but would
like to offer the option of embryo donation to couples
that would otherwise choose to destroy their healthy
embryos.
It should be noted that in the past we have had difficulty
in estimating the success rates for (donated) frozen
embryos from other programs. It would appear that
the success rates are somewhat dependent on the quality
of the facility that froze the donated embryos. In
addition, the post-thaw and embryo transfer procedures
(i.e., the techniques used here at SRMS) also influence
the success rates. While not actually certain, the
take-home-baby rates will probably be somewhere in
between the rates for the two ART facilities.
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Could
the children from Embryo Donation inadvertently meet
their siblings and reproduce (Inadvertent Consanguinity)?
It is quite common to be concerned about the potential
for related siblings raised in different families
meeting and reproducing.
Similar concerns have existed and have been examined
in detail for egg and/or sperm donation cycles. According
to existing guidelines, it is recommended that we
limit a single egg/sperm donor from producing no more
than 15 offspring per 500,000 population. Please recall
that we here at SRMS cater to a large population here
in Southwest Florida conservatively estimated at over
1,000,000, not even including the other states and
countries we service. According to the guidelines,
we could easily have
over 30 offspring residing in Southwest Florida per
egg/sperm donor before retiring the donor.
We here at SRMS will
try to limit an embryo donation couple to no more
than six successful donated offspring within the Southwest
Florida Region. Where
possible, we will also list the location of the donor
parents and encourage the use of donated embryos in
different cities and counties.
What
are the psychological affects of the Embryo Donation
process?
Embryo donation is clearly a new path to parenthood,
bringing with it the potential for complex psychological,
social, emotional, and ethical considerations. We
have neither significant long-term experience nor
psychosocial research to draw upon. While possible,
it seems unlikely that there will be any significant
psychological impacts to all parties involved, but
this is uncertain.
The issues regarding disclosure to friends, family
and the offspring are important. We will attempt to
cover some of these topics at the web site. It is
also encouraged for all interested parties to discuss
these issues with qualified personnel. Psychological
counseling will always be available upon request.
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How
do we get started?
You have already started the first step by reading these
segments here on the web site.
A full packet of information is available for your immediate
review visitng our Download
Center. These forms are in a PDF file format. You will want to click on the "Embryo Donation, Recipient" packet and download each pdf file one at a time or all at once.
If you prefer, you may simply call the office and we
will send you a printed packet of information.Tthe materials
here on the web site are identical to the printed materials
and we strongly encourage the savings of a few trees and keep the files in an electronic format except for those marked as "(Sign & Return)" which have to be printed, signed and eventually returned.
You may next want to review the specific information
we have on our available donated embryos (see below).
After you review the pdf files and web site information
and you are still interested in the program, you should
next complete the Preliminary Recipient Application and e-mail or fax (239-275-5914) the completed application to us. Once we review this, we will contact you and discuss the process in greater detail. Please give us at least two business days to get back to you.
Eventually, if accepted, we will ask that you make an appointment to be seen by the staff here at
SRMS. You will be asked to forward all pertinent medical
records, laboratory tests, copies of prior operative
procedures, radiology X-rays such as the hysterosalpingogram
(HSG) and any pertinent information on the evaluation
of you and your partner prior to being seen by SRMS.
Depending upon the age of the recipient, additional
testing including an EKG, treadmill, psychological evaluation,
mammogram, vaginal ultrasound and screening blood tests
may be requested. We try to be as cost-effective as possible but we also want to make sure the recipient has the best chance of having a healthy pregnancy and that the embryos have a wonderful chance at life.
Two Ways To View The
Donated Embryos
Unlike many programs, we have a fair number of donated
embryos waiting for homes.
Our embryo donation program has been active since 2001
although we only recently put upgraded the database
to include a tremendous amount of information on our
donors.
Click here to begin viewing our Embryo Donor Database. |
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