What are the advantages of Embryo Donation over adoption?

Who are the potential Donor Embryo Recipients?
How do I choose the donated embryos?
What kind of screening did the Donating Parents receive?
Was genetic screening performed on the Donating Parents?
Are the children born via Embryo Donation different than other children?
What are the success rates for Embryo Donation?
Do the Donating Parents have any legal rights to the Donor Embryo offspring?
Will we ever meet the Donating Parents?
Can the children ever find the Donating Parents?
Are Donating Parents paid for their embryos?
How long can the donated embryos stay frozen?
Will you accept Donated Embryos from other ART facilities?

Could the children from Embryo Donation inadvertently meet their siblings and reproduce (Inadvertent Consanguinity)?
What are the psychological affects of the Embryo Donation process?
How do we get started?
Two ways to the Donated Embryos


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:

  • Embryo Donation is quicker with delivery often within one year of the first visit.
  • Embryo Donation is often much less expensive than adoption.
  • 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.
  • 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.
  • 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.
  • 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.

 

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.

 

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.
 

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:

  1. 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.
  2. 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.
  3. 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.
  4. 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!

 

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.

 

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.

 

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:

  1. The ART facility that is called upon to transfer Donated Embryos has very poor Frozen Embryo Transfer success rates.
  2. The embryos originated from women with advanced maternal age.
  3. Very few embryos are available.
  4. 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.

 

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.

 

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.


updated: 5/2/2010

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