Embryo donation is defined as the giving of embryo or both gametes to another person or couple unable to produce their own genetic embryo for implantation. Other reason is to donate embryos for research. Where it is given for the purpose of implantation, the donation is followed by the placement of those embryos into the recipient woman's uterus to facilitate pregnancy and childbirth in the recipient. 

Donated embryo origin

Unused embryos from a successful IVF of one couple may be given (depending on the local law) to other couples or women for transfer with the goal of producing a successful pregnancy. Embryos for embryo donation may also be created specifically for embryo transfer using donor eggs and donor sperm. 

Anonymity of the donor

Embryo donation is most often handled on an anonymous basis (donor and recipient parties are not known to each other), or on an open basis (parties' identities are shared and the families agree to a relationship). Occasionally, a "semi-open" arrangement is used in which the parties know family and other information about each other, but their real names and locating information are withheld, in order to provide a layer of privacy protection.

Process

Both donor and recipient have to be screened to ensure success the embryo donation treatment.

Embryo donor screening includes:

  • Optimal age of the donor is 19 – 33 years,
  • Genetic screening for family history, hereditary diseases and normal karyotype,
  • Genetic testing for blood type, cystic fibrosis and hemoglobinopathies,
  • Serologic al examination on hepatitis B and C, syphilis, HIV and re-screening before the embryos are thawed and transferred,
  • Psychological and mental screening.

Embryo recipient screening includes:

  • Ultrasound examination of uterus lining,
  • Cytology examination not older than 12 months, confirmation from a gynecologist that pregnancy is not a contraindicated, and mammographic examination (women older than 45 years),
  • Serologic al examination on HIV, hepatitis B and C, syphilis,
  • Once all parties agree, the embryo is transferred to the adoptive mother's clinic for an embryo transfer.

Embryo donation vs. embryo adoption

Some writers use the term "embryo donation" to refer strictly to anonymous embryo donation, and "embryo adoption" to refer to the open process. Others use the terms synonymously because regardless of whether the arrangement is open or anonymous, the donation of embryos and a clinical assisted reproduction procedure is involved, and the recipient couple is preparing to raise a child not genetically related to them. Lawyers who assist couples who are trying to acquire an embryo state the term "embryo adoption" is a misnomer because the transfer of an embryo is handled as property transfer. Abortion rights advocates, advocates of embryonic stem cell research, and members of the fertility industry object to referring to the transfer as an "adoption" because they feel it gives an embryo the same status as a child. Most doctors describe the process as "embryo donation".

The resulting child is considered the child of the woman who carries it and gives birth, and not the child of the donor. This is the same principle as is followed in egg donation or sperm donation. Most often, the embryos are donated after the woman for whom they were originally created has successfully carried one or more pregnancies to term.

Laws by state

In most states, the birth mother becomes a child’s legal mother and her husband is a child’s legal father, if she has any. 

Embryo donation is performed in these countries: Canada, UK, France, Spain, Italy, Australia, Belgium, India, Greece, Singapore, Argentine, Colombia, the Czech Republic, Japan, the Netherlands, Uruguay, Romania, Portugal, Venezuela, Hong Kong, New Zealand, Russia, Singapore, and Finland. In the US, all 50 states and the District of Columbia permit living embryo adoption and implantation.   

In these countries, embryo donation is illegal: Algeria, Austria, Bahrain, China, Denmark, Germany, Egypt, Israel, Italy, Latvia, Lithuania, Norway, Pakistan, Philippines, Qatar, Oman, Saudi Arabia, Slovenia, Sweden, Switzerland, Syria, Taiwan, Tajikistan, Tunisia, Turkey, United Arab Emirates and Yemen.

Embryo donation is recommended in these cases: 

  • Patients have genetic disease affecting direct reproduction,
  • Male and female infertility which reduces the chance of success using own sperms and/or oocytes,
  • Previous failed treatments,
  • Single or post-menopausal patient

There may occur pregnancy complications, especially in cases where more than single embryo is transfered - multiple gestations raise the risk of preterm births; low-birth-weight babies, with the possibility of death in very premature infants; long-term health problems; and pregnancy complications, which include pre-eclampsia, gestational diabetes, and Caesarean section.

Many complications are related to the legal terms. Unlike traditional adoption, which has multiple procedural requirements, embryo donation is largely unregulated. Some commentators warm that calling an embryo donation an “embryo adoption“ may give the recipient parents a false sense of security regarding their parental rights and responsibilities since most states do not extend traditional adoption laws to the adoption of an embryo. The problem is that there is real uncertainty in the rights of these embryos, their biological parents and their adopted parents. Other problems are ethics - with personhood of embryo, whether or not it is living organism and has his own rights. Another issue is that countries that permit relinquishment of embryos for the treatment of infertility in others have typically set in place specific criteria and procedures to regulate the practice. 

With regard to psychological side, no psychological affects to all parties involved have been observed.

Average pregnancy success for embryo donation is 35%. This statistic varies by program and clinic, but is about the same as, if not a bit better than, for a fresh cycle of IVF. The chance of pregnancy with donated cryopreserved embryos is generally lower than those pregnancies used freshly retrieved donated eggs, but donor egg embryos still have a 2-5% greater survival rate than embryos from infertile women when compared by morphology score.

Pregnancy success rate is affected by many factors. Very important is a number of embryos available, the quality of the embryos frozen, age of the egg donor and overall health of the embryo recipient. Not so much, but still important is a stage of growth when the embryos were frozen and technique used to freezing and thawing. Possible effect can have age of the male producing the sperm. On the other hand, the duration of embryo cryoconservation has probably no effect on subsequent pregnancy.

Find more about related issues

Sources

Embryo donation ―sourced from Wikipedia licensed under CC BY-SA 3.0
Third-party reproduction ―sourced from Wikipedia licensed under CC BY-SA 3.0
Ethical Implications of Embryo Adoption ―by Peter A. Clark licensed under CC BY 3.0
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