The Dilemma of Spare Embryos After IVF Success: Social Workers’ Role in Helping Clients Consider Disposition Options
Keywords:In vitro fertilization (IVF), assisted reproductive technology (ART), reproductive counseling, frozen embryos, embryo disposition
Social work services for persons undergoing the in vitro fertilization process
(IVF) has greatly lagged behind the medical technology opportunities provided to these clients. Advocacy for social work services for persons undergoing IVF was advanced upon the procedure’s initial development, but there has been a stark lack of recent scholarship regarding social work in fertility health services. The existing literature suggests several talking points regarding the IVF process to be discussed with persons considering IVF, especially the medical and psychological risks of failure. This article discusses a newer and necessary topic to cover in pre-IVF counseling: the possibility of too much success in the form of excess embryos. Although the topic must be covered with sensitivity to the relatively low rate of IVF success, persons receiving care through assisted reproductive
technology (ART) need to be prepared for the difficult moral questions raised when IVF procedures result in even more embryos than intended. Social workers need to be prepared to explore the pros and cons of each disposition option with IVF clients.
Baron, N., & Bazzell, J. (2014). Assisted reproductive technologies. The Georgetown Journal of Gender and the Law, 15, 57-93.
Bergart, A. M. (2000). The experience of women in unsuccessful infertility treatment: What do patients need when medical intervention fails? Social Work in Health Care, 30(4), 45-69. doi: https://doi.org/10.1300/J010v30n04_04
Black, R. B., Walther, V. N., Chute, D., & Greenfeld, D. A. (1992). When in vitro fertilization fails: A prospective view. Social Work in Health Care, 17(3), 1-19. doi: https://doi.org/10.1300/J010v17n03_01
Blyth, E. (1999). The social work role in assisted conception. British Journal of Social Work, 29(5), 727-740. doi: https://doi.org/10.1093/bjsw/29.5.727
Carbone, J., & Cahn, N. (2009). Embryo fundamentalism. William & Mary Bill of Rights Journal, 18, 1015-1052.
Centers for Disease Control and Prevention [CDC]. (2012). Assisted reproductive technology: National summary report 2010. Retrieved from https://www.cdc.gov/art/pdf/2010-report/ART_2010_National_Summary_Report.pdf
CDC. (2017). ART success rates: Preliminary data, 2015. Retrieved from https://www.cdc.gov/art/artdata/index.html
Chochovski, J., Moss, S. A., & Charman, D. P. (2013). Recovery after unsuccessful in vitro fertilization: The complex role of resilience and marital relationships. Journal of Psychosomatic Obstetrics & Gynecology, 34(3), 122-128. doi: https://doi.org/10.3109/0167482X.2013.829034
Clark, P. A. (2014). Ethical implications of embryo adoption, pluripotent stem cell biology. In C. Atwood (Ed.), Advances in mechanisms, methods and models (pp. 213-229). doi: http://dx.doi.org/10.5772/58592 [Available from https://www.intechopen.com/books/pluripotent-stem-cell-biology-advances-in-mechanisms-methods-and-models/ethical-implications-of-embryo-adoption]
Crawshaw, M., Hunt, J., Monach, J., & Pike, S. (2013). British Infertility Counselling Association: Guidelines for good practice in infertility counselling, 2012. Human Fertility, 16(1), 73-88. doi: https://doi.org/10.3109/14647273.2013.774217
Crockin, S. L., & Debele, G. A. (2014). Ethical issues in assisted reproduction: A primer for family law attorneys. Journal of the American Academy of Matrimonial Lawyers, 27, 289-357.
Daniels, K. R. (1990). Psychosocial factors for couples awaiting in vitro fertilization. Social Work in Health Care, 14(2), 81-98. doi: https://doi.org/10.1300/J010v14n02_07
Davis, M. (2014). Maryland embryo adoption: Religious entanglement in the Maryland Stem Cell Research Act of 2006. University of Pennsylvania Journal of Law & Social Change, 17, 291-327.
Ellison, D. A., & Karpin, I. (2011). Death without life: Grievability and IVF. South Atlantic Quarterly, 110(4), 795-811. doi: https://doi.org/10.1215/00382876-1382258
Frith, L., Blyth, E., & Lui, S. (2017). Family building using embryo adoption: Relationships and contact arrangements between provider and recipient families—A mixed-methods study. Human Reproduction, 32(5), 1092-1099. doi: https://doi.org/10.1093/humrep/dex048
Fronek, P., & Crawshaw, M. (2015). The “new family” as an emerging norm: A commentary on the position of social work in assisted reproduction. British Journal of Social Work, 45, 737-746. doi: https://doi.org/10.1093/bjsw/bct198
Gosden, R. (2011). Cryopreservation: A cold look at technology for fertility preservation. Fertility & Sterility, 96(2), 246-268. doi: https://doi.org/10.1016/j.fertnstert.2011.06.029
Greenfeld, D., Mazure, C., Haseltine, F., & DeCherney, A. (1985). The role of the social worker in the in-vitro fertilization program. Social Work in Health Care, 10(2), 71-79. doi: https://doi.org/10.1300/J010v10n02_06
Johnston, J., & Gusamano, M. K. (2013). Why we should all pay for fertility treatment: An argument from ethics and policy. Hastings Center Report, 43(2), 18-21. doi: https://doi.org/10.1002/hast.155
Lino, M., Kuczynski, K., Rodriguez, N., & Schap, T. (2017). Expenditures on children by families, 2015. Miscellaneous Publication No. 1528-2015. Washington, D.C.: U.S. Department of Agriculture, Center for Nutrition Policy and Promotion.
Lyon, K. W. (1999). Babies on ice: The legal status of frozen embryos involved in custody disputes during divorce. Whittier Law Review, 21, 695-735.
Kalb, C. (2010, Jan. 19). All that remains: Couples who decide not to implant embryos often face a difficult choice and limited options. Newsweek. Retrieved from http://www.newsweek.com/what-happens-leftover-embryos-70777
Kuwayama, M. (2007). Highly efficient vitrification for cryopreservation of human oocytes and embryos: The cryotop method. Theriogenology, 67, 73-80. doi: https://doi.org/10.1016/j.theriogenology.2006.09.014
Madeira, J. L. (2015). The ART of informed consent: Assessing patient perceptions, behaviors, and lived experience of IVF and embryo disposition informed consent processes. Family Law Quarterly, 49(1), 7-28.
Mastenbroek, S., Van der Veen, F., Aflatoonian, A., Shapiro, B., Bossuyt, P., & Repping, S. (2011). Embryo selection in IVF. Human Reproduction, 26(5), 964-966. doi: https://doi.org/10.1093/humrep/der050
Mundy, L. (2008). Everything conceivable: How assisted reproduction is changing our world. New York, NY: Anchor.
Murphy, J. B. (2013). Access to in vitro fertilization deserves increased regulation in the United States. Journal of Sex & Marital Therapy, 39(2), 85-92. doi: https://doi.org/10.1080/0092623X.2011.632072
Nachtigall, R. D., Becker, G., Friese, C., Butler, A., & McDougall, K. (2005). Parents’ conceptualization of their frozen embryos complicates the disposition decision. Fertility and Sterility, 84(2), 431-434. doi: https://doi.org/10.1016/j.fertnstert.2005.01.134
Nachtigall, R. D., MacDougall, K., Harrington, J., Duff, J., Lee, M., & Becker, G. (2009). How couples who have undergone in vitro fertilization decide what to do with surplus frozen embryos. Fertility and Sterility, 92(6), 2094-2096. doi: https://doi.org/10.1016/j.fertnstert.2009.06.027
O'Brien, M. (2010). An intersection of ethics and law: The frozen embryo dilemma and the chilling choice between life and death. Whittier Law Review, 32, 171-196.
Robertson, J. A. (2014). Egg freezing and egg banking: Empowerment and alienation in assisted reproduction. Journal of Law and the Biosciences, 1(2), 113-136. doi: https://doi.org/10.1093/jlb/lsu002
Synesiou, K. (2010). The dilemma of remaining frozen embryos. Retrieved from http://www.creatingfamilies.com/surrogacy/?the-dilemma-of-remaining-frozen-embryos-169
Tucker, C. (2014). Abandoned embryos: The dilemma of eternal storage. New Hampshire Bar Journal, Spring/Summer, 54(3), 18-23.
U.S. Department of Health and Human Services, Office of Population Affairs [US DHHS]. (2017). Embryo adoption. Retrieved from https://www.hhs.gov/opa/about-opa-and-initiatives/embryo-adoption/index.html
Walther, V. N. (1991). Emerging roles of social work in perinatal services. Social Work in Health Care, 15(2), 35-48. doi: https://doi.org/10.1300/J010v15n02_04
Whittingham, D. G., Leibo, S., & Mazur, P. (1972). Survival of mouse embryos frozen to 196 degrees C. and 269 degrees C. Science, 178(4059), 411-414. doi: https://doi.org/10.1126/science.178.4059.411
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