EMBRYONIC STEM CELLS: Willingness to Donate Frozen Embryos for Stem Cell Research by Anne Drapkin Lyerly and Ruth R. Faden, Science 6 July 2007: Vol. 317. no. 5834, pp. 46 – 47 DOI: 10.1126/science.1145067
We conducted a survey of 2210 infertility patients receiving treatment at one of nine major, geographically diverse infertility centers and asked these patients about their intentions for the embryos they currently stored. Participating centers were located in California, Colorado, the District of Columbia, Maryland, Missouri, New Jersey, North Carolina, Oregon, Pennsylvania, and Virginia. The respondents were asked to answer a set of questions with one of the following: very likely, somewhat likely, somewhat unlikely, very unlikely, or unsure/don’t know.
/Figure legend. Disposition option for some or all of cryopreserved embryos currently stored. SCNT, somatic cell nuclear transfer. Key: Somewhat likely (lavender), very likely (gray).
CREDIT: MIODRAG STOJKOVIC/SCIENCE PHOTO LIBRARY /
A total of 1244 patients returned the survey, for a 60% response rate overall [63% for women, 51% for nongestating partners (male or female)]; surveys were sent to only one member of a couple. We made clear at the outset that the embryo is destroyed if used for research.
Of the 1020 respondents who reported that they have embryos currently stored, 495 (49%) indicated that they were somewhat or very likely to donate their embryos for research purposes. These 495 individuals controlled the disposition of from 2000 to 3050 embryos. Even if only half of these embryos ultimately were donated, this finding suggests that around 1000 of the 3900 to 5900 embryos currently stored by the infertility patients in our sample would be available for research purposes.
Respondents to the survey expressed even greater willingness to donate embryos to research when certain characteristics of the research were specified. In particular, the percentage reporting that they would be somewhat or very likely to donate increased from 49% for medical research (in general) to 60% for research in which stem cells are derived. [Similar increases were observed for research to understand or develop treatment for human disease or injury (62%) and for research to improve infertility treatment (61%)]. Perhaps most surprising, 28% indicated that they would be somewhat or very likely to donate embryos to improve cloning techniques for medical science.
Our data suggest that it is reasonable to assume that 50% of infertility patients with cryopreserved embryos would be willing to donate their embryos for stem cell research. If only half of these embryos were to be donated, then, based on the Hoffman et al. (7) finding that 400,000 embryos are currently cryopreserved in the United States, as many as 25% of them, or 100,000 embryos, could be available for stem cell research. If we continue with the Hoffman et al. assumptions about the success of deriving lines from cryopreserved embryos, we can calculate that if 65% of the embryos survive the freeze-thaw process, then 65,000 embryos would be available, 25% of which (16,250) could be expected to develop to the blastocyst stage. Of these, a conservative 15% could be expected to become a viable stem cell line, resulting in roughly 2000 to 3000 viable stem cell lines, about 100 times the number of lines currently available for federal funding.
When infertility patients choose research, more appears to be at issue than the belief that scientific progress justifies the instrumental use of early human life. In contrast to broad acceptance of the option of donating embryos for research, many fewer respondents in our survey expressed a willingness to donate their remaining embryos to another infertile couple. In fact, only 22% of individuals with embryos currently stored indicated that they were somewhat or very likely to donate them to another couple intending pregnancy–comparable in number to those who indicated they were likely to thaw and discard them. Thus, research emerged as the preferred option for supernumerary embryos–the reflective preference of those facing the very personal moral dilemma of what to do with embryos not used for infertility patients’ reproductive goals.
The prevailing view has been that beliefs about the moral status of human embryos should be fully predictive of moral views about the acceptability of research requiring their destruction–that a respectful stance would entail giving existing embryos the chance to develop into children (14). But our data suggest that for most of the individuals who create embryos in hopes of having a baby, the preference is not that their remaining embryos have a chance at life, but rather that they be used in a way (research, and if not, simply destruction) that ensures that they do not.
There is a possibility, of course, that the reluctance of infertility patients to donate embryos to another couple is a prudential rather than a moral preference–that the idea of someone else gestating their embryo and raising their genetic child is experienced by these patients as intolerably worrisome, rather than as morally wrong. But qualitative work with infertility patients suggests a different moral view–that there are deep responsibilities to one’s own embryos–responsibilities that preclude allowing them to develop into children without the knowledge, participation, or love of those who created them (6, 15, 16). Our data suggest that the way that infertility patients resolve the very personal moral challenge of supernumerary embryo disposition is consonant with the conclusions of the American public, the majority of whom support human embryonic stem cell research.