Why Embryo Donation shouldn’t be called Adoption

by Sue Taylor **

Let me start out by saying that embryo donation is an amazing gift and a wonderful option for family building. And traditional legal adoption of a living child is equally amazing; it is a true gift to be selected to parent a child through adoption. However, the language that is used by some in the industry who have decided to call embryo donation by the term “embryo adoption” needs some deliberate attention and careful thought by industry professionals and society.

My opinion is that the term “embryo adoption” is primarily being used by organizations simply as a marketing gimmick primarily for financial gain. By making it “just like adoption” it is a way to appeal to broad groups of people wanting a child (who might not be considering assisted reproductive technologies for their own myriad reasons) and it allows the organizations (often religious) to promote this form of fertility treatment as having the added benefit of also being a good deed with a “save the frozen embryos from a freezer” appeal. Sometimes, they even add the “orphan” label, which I find terribly insulting.

For the sake of this conversation, I am not even going to broach the “life begins at fertilization – or implantation – or viability – or birth” issue that is often at the crux of the embryo adoption movement. Instead I am going to focus simply on the language being used.

In marketing embryo donation as a form of adoption, I think it minimizes or trivializes the feelings and experience of birth parents and “real” adoptees from a traditional, legal adoption (the ones who were living, breathing persons when they were legally adopted and their birth parents relinquished their rights).  Let me explain.  

What birth parents go through in making the difficult decision to place a child for adoption is not to be taken lightly. Unlike a person choosing to donate embryos (typically under no time pressure or duress of an impending birth), birth parents are making a very difficult decision under great pressure and stress about parenting or adoption - often agonizing at great lengths while the child is growing in their body or they have just given birth. I doubt that a birth mother would feel like she is "just like" the woman who chose to donate her embryos. I am not diminishing the angst that goes into making a choice to donate embryos - but it is generally done with deliberate intention and great joy in the opportunity to help someone else once your own family building pursuits are complete.  And that is a far different emotional situation than making an adoption plan for a child born or about to be born. In my experience, families choosing to donate embryos typically don’t experience the same type of angst and ongoing grief about their choice as many birth parents often do.  They are making a willing choice to donate.  They rejoice that they were able to share their own joy of parenting by donating embryos to help fulfill the dreams of another family. In contrast, despite the fact that birth parents may have confidence that the decision they made was the best thing for the child, it is typically a huge personal loss. And the circumstances that bring them to that loss-or even their confidence in their decision-doesn't diminish the fact that it typically has an emotionally charged lifelong impact.

And, what about the adoptees? As an adoptee myself, I think the term embryo adoption is dismissive of adoptees feelings and experiences.  Regardless of the circumstances of your adoption, there is a loss that is far different than simply a loss of genetics. Being separated at birth from the woman who created me, carried me in her body for 9 months, gave birth to me, and agonized over placing me for adoption does not in any way make me feel similar kinship to a child who was born through embryo donation. A child of embryo donation is carried by and born into to the family who will parent them (and with the benefit of epigenetics, the expression of genes influenced by the mother carrying the child).  Add that the child of embryo donation was very much wanted and longed for throughout the pregnancy and from long before the embryo was even received or transferred, and THAT is a very, very different scenario with little in common to adoption.

You just can’t compare that to the experience in utero of a baby growing in a woman who is oftentimes in a crisis pregnancy that may not have been planned or wanted (or may have tragic circumstances involved).  The woman who is agonizing over an adoption plan is in a highly charged emotional decision, under pressure and stress - forced to make a parenting choice where often none of the options are necessarily ideal.  Experts are mixed in their opinions of how much the fetus/baby is impacted by adoption – by the expectant mother’s stress and state of mind, and then being removed immediately after birth from the only human the baby has known. But, there is no question that there is a loss.  Surely we can agree it isn’t the ideal scenario of gestation and birth regardless of how amazing the adoptive family may be. I can tell you that I feel that my experience as an adoptee has very little in common with that of a child born of donated embryos. I think it is insulting to suggest otherwise, truth be told.

In my mind – the only similarity between embryo donation and adoption is that children are being parented by adults who don't share their DNA. Period – that is it! So, calling embryo donation a form of “adoption” is as if you are trivializing adoption down to it being only an issue of not sharing DNA with the parents raising you.  I can assure you that adoption is far more complex than that.

If we’re making comparisons, most everything else about embryo donation has far more in common with using donated gametes for reproduction via assisted reproduction. That might include double donor IVF or even egg or sperm donors - where one or both sets of DNA were donated. Again, in all of these scenarios, the child was very much wanted from before they were transferred into the uterus and the parent(s) were likely moving heaven and earth to be a parent, donated embryos are simply a means of how they got there. But that intention and desire to be parents from before pregnancy is far different from a crisis, unplanned pregnancy and I am not convinced that the baby doesn’t feel this difference.

Embryo donation is a medical procedure; it is not the adoption of a living person.  It is a chance for pregnancy where realistically, the odds of it not working are greater than the odds of it resulting in a live birth.  There is something wrong with equating or giving equal value (through our words) to a living, breathing child being placed for adoption and the donation of embryo that is more likely not to survive and grow.  Our US legal process is clear that a child can only be adopted (or have parental rights relinquished) after they are born. A donation of embryos is  a legal relinquishment of rights to embryonic tissue, not an adoption.  

I want to say specifically that I don’t take so much issue with families who elect to talk to their children about embryo donation using the language of adoption - how they want to present their family to the world is their business. I do hope that they are considering the language with great care and consideration though for the children’s sake.  I also have no judgment for anyone who chooses to go through an embryo adoption agency and the quasi-adoption process required by them as a way to get their embryos or as a way to donate their embryos.  I think however your embryos or children come to you is your business as long as it is done ethically. And however you decide to share the gift of embryos is also your business if you are donating.  My frustration is with industry professionals and these non-medical organizations who are exploiting the term adoption to create a new industry primarily for financial gain.

My opinion is that many are using the term “adoption” as a way for those agencies to make money off of families desperately wanting to be parents.  They charge agency fees, home study fees, fingerprinting fees, background checks, training/education fees, etc.  And often that money is paid all before they even qualify you to match you with embryos (that themselves statistically give them about a 25 - 40% chance of a live birth).  Realistically, adding an “adoption” component to embryo donation can easily double or triple the cost of embryo donation to the recipients.

And for those organizations trying to promote it as doing a good deed and “saving the embryos” or "save the orphan embryos" movement the reality is that in the US today, there isn’t an  excess or surplus of available frozen embryos already donated and waiting for families.  In most clinic based embryo donation programs or private matching services, there can be months long waiting lists for embryos - people truly wait years for the chance of receiving donated embryos. Perhaps in trying to create an “embryo adoption” industry that allows them to add middle man and third party costs that are, in my opinion, unnecessary, the organizations advertising this have created even more demand for embryos that are in short supply. 

I think the ASRM was spot on when it gave the opinion that embryo donation is a medical procedure, it is NOT adoption. Here is what their report said:

“Requiring infertile patients who need donor gametes or patients who need donor embryos to suffer the imposition of unnecessary administrative and legal trappings of adoption and the costs that accompany them is not ethically justifiable. The donation of embryos for reproductive purposes is fundamentally a medical procedure intended to result in pregnancy and should be treated as such.”

  

The full ASRM report is available here

For these reasons, I prefer that we use language for this new form of family building (involving donation of embryos) that doesn't imply that this is "just like an adoption".

Maybe embryo donation isn't the right language.  Interestingly enough, the primary synonym to ‘donation’ is ‘gift’.  And some families who have been created through embryo donation choose to use the term “gifted embryos”.  I think that beautifully conveys the feeling of gratitude and appreciation that recipients feel toward the donating families.  Perhaps that is a term for the community to consider when pondering this issue.   I am hopeful that the industry professionals and our society can thoughtfully come together to develop positive language that is respectful of others and celebrates the uniqueness of the beautiful thing that is embryo donation.

 

**Sue Taylor is an experienced IVF consultant with a passion for helping others on their journey to parenthood. With over 27 years experience in the healthcare industry, she now assists patients with selecting a clinic, or going abroad for more affordable IVF and donor egg IVF treatments. Ms. Taylor can provide assistance for prospective patients deciding if IVF treatment abroad is a good choice for them, assist with clinic selection, and has provided full facilitation services (including cycle & travel coordination). She has assisted hundreds of donor IVF patients seeking treatment abroad. Her blog, www.ivftraveler.com/blog, offers practical details for patients traveling for IVF services or an IVF vacation. Sue Taylor can be reached at sue@ivftraveler.com.