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In vitro parents face a difficult decision : Should extra embryos go to other would-be parents -- or to the science that made their babies possible?

November 15, 2009|Manya A. Brachear

CHICAGO — In vitro fertilization made it possible for Adriana and Robert Potter to welcome twins Anabella and Matteus into the world. For the same reasons many couples can't conceive, IVF was their only option if they wanted children of their own.

But with that choice, came another: what to do with two other embryos created in the same petri dish but never placed in the womb. On that issue, the Potters have agreed to disagree for now.

If the Elmhurst couple decides they don't want more children, Adriana Potter believes that donating the embryos to advance reproductive technology or treat debilitating diseases would be the most life-affirming choice.

"Think about it. The only way we got this far with IVF is because there was research in the past," Adriana said. "There were sacrifices to help families like us have kids. . . . When it comes to promoting the creation of new life, you have modern medicine and the choice to use it for good, to fulfill dreams."

Robert Potter imagines having more children to fulfill God's mandate to be fruitful and multiply. But if they decide to have no more, he favors donating the embryos for another couple to do the same. Viable embryos should not be taken for granted, he said.

"It's not just a moral [issue]. It's a waste," he said. "Why would you waste an opportunity if it's a good one?"

As thousands of frozen embryos continue to accumulate and pressure mounts to decide their fate, doctors say more families must weigh the promise and perils of adoption and research.

At this time last year, doctors say, the absence of government funds combined with the economic downturn stalled most meaningful embryonic science, making donations to research a riskier and more radical option. Some laboratories stopped accepting donations, forcing some fertility centers to hold on to embryos despite parents' preference to devote them to research.

In the minds of many fertility doctors and patients, President Obama's decision to lift the ban on federal funding for embryonic stem cell research also lifted a stigma, inspiring some IVF patients to give research -- stem cell and other kinds -- more serious consideration.

Likewise, the sheer volume of embryos in storage has spurred fertility centers to form new partnerships with research institutions that have only recently received federal funds and adoption agencies that want to match embryos with potential parents. Such decisions, doctors say, are often informed and framed by faith.

Adriana, a lapsed Roman Catholic, and Robert Potter, a lifelong Methodist, married in June 2000. The Methodist pastor who presided over their wedding advised them to draft a list of goals and revise them together every year.

For the first five years, those goals revolved around education and travel. Robert earned a master's degree in management. Adriana earned a doctorate in physical therapy with a specialty in women's health. By the time they moved to Illinois and reviewed the list in 2005, the only goal left was having children. So they started to try. But after three years, trying began to lose its romance.

Adriana charted her ovulation, took her temperature, and bought all the gimmicks at the supermarket to boost fertility. But nothing happened.

After a series of tests, doctors finally broke the news. For a number of reasons, including Robert's sperm count, shape and motility, a natural pregnancy without a little help from science was nearly impossible.

It took two attempts. On the second try, four embryos were produced -- but only two with a likelihood of survival at the moment of implantation. They implanted the two most likely to last.

Later that day, they got a call. The other two blastula had become viable too. The Potters froze them in case the second attempt also failed or the pregnancy resulted in a miscarriage. But it didn't. In October, they delivered twins.

Now the couple faces the dilemma of what to do with the other embryos.

They could use the embryos when they are ready to have more children. Another couple could adopt the embryos. They could donate them to science. Or they could thaw the embryos and discard them.

Marie Davidson, a staff psychologist with Fertility Centers of Illinois, said that only in recent years had frozen embryos become the source of discord and debate between couples pursuing reproductive technology.

Davidson attributes the heightened tension to public debate and timing. As time goes by, the decision becomes imminent for more couples.

"We bring it up with people early, before they're in that position," Davidson said. "When they sign that consent form, they know they may have a difficult decision ahead of them." The Illinois fertility service now stores about 20,000 embryos from about 4,550 patients.

Davidson advises patients to seek professional advice from physicians, counselors, specialists in reproductive law and clergy. But every decision has its pluses and minuses, she said.

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