DEBBIE ELLIOTT, host:
For the past year, we've been reporting quite a bit about the passionate debate around the use of embryos in stem cell research. Proponents say embryonic stem cells may be the key to a whole new world of medical therapies, but opponents point out there's a moral cost. To get human embryonic stem cells, you must destroy human embryos. The embryos scientists use typically come from fertility clinics. They are so-called leftover embryos, not implanted in women after they're created. Pundits and politicians have argued about the moral consequences of conducting this research, but we thought it was time to talk to the people who have to make the very real decisions about what to do with embryos they created that are left over following in vitro fertilization. NPR science correspondent Joe Palca talked with two couples who made two very different decisions and he joins me now in the studio.
JOE PALCA reporting:
ELLIOTT: First, explain for us why there are leftover embryos.
PALCA: Well, in the process of in vitro fertilization, what will happen is a woman will be given drugs to make her hyper ovulate and she'll release more eggs in a given month. And when these eggs are removed and put into a dish and mixed with sperm, you're going to get more embryos as a result.
Now they don't implant all the embryos because that could lead to multiple births. They usually plant two or three or sometimes four. Quite often, there are leftovers, and those leftover embryos are usually frozen so that if this first round of IVF doesn't work, the couples will have something that they can go back to and try again without having to go through the whole hyper ovulation and egg retrieval stage.
ELLIOTT: So they're kept in storage.
PALCA: They're kept in cold storage, yeah, frozen in liquid nitrogen.
ELLIOTT: So you've spoken with two couples who had some decisions to make about their leftover embryos. Can you introduce us to them?
PALCA: Right. Well, first, we'll hear from a couple who wanted to donate their embryos to an infertile couple. They call it embryo adoption. And these are Tad and Veronica Hiley who live in North Carolina. They were infertile themselves, and they decided to go for IVF. And now as it happens, they have three children, twins from in vitro fertilization. And after the in vitro process, they've had nine remaining embryos.
Now it's not like when they started the process. They were thinking, `Oh, I know what we're going to do with these spare embryos.' So here's part of the conversation I had with them.
Mrs. VERONICA HILEY: When you walk into a fertility clinic, you have a tendency to focus on baby and you don't really think about repercussions of the process. When my twins were two, we had a big surprise. We were pregnant without any medical assistance, and at that point felt that our family was complete. So that's when we were faced with the decision of what to do with our nine remaining embryos.
Mr. TAD HILEY: We really felt a parental responsibility with this embryo. So we didn't want to just blindly allow the embryo to go into a situation we weren't comfortable with. So we were looking for someone in a kind of middle-class environment, one that had the same values that we would have. Also, we were looking actually for a family where the mother would be able to stay at home with the child, to raise a child.
Mrs. HILEY: The couple that adopted our embryos, they went through nine years of infertility and this was their last chance.
Mr. HILEY: And they had a successful pregnancy and a little girl was born from one of those embryos. So we're very thrilled and very excited about that.
PALCA: And you said that you remain somewhat in touch with the girl who was born from your embryos. Her name is Mikayla(ph).
Mrs. HILEY: Correct.
PALCA: How do you feel about that relationship? I'm just curious.
Mrs. HILEY: Well, when you are matched with a family with embryo adoption, you decide on the level of contact, if any contact, that you will maintain. Some families are not comfortable with that situation. They don't want to stay in contact. They don't want to send pictures once a year. For us, our adoptive family initiated an e-mail relationship with us. We live on opposite coasts and we share this as a common goal to let people know that this is a good option when faced with remaining embryos.
ELLIOTT: That's Veronica and Tad Hiley talking with NPR's Joe Palca, who's here with me in the studio.
Joe, so this couple actually has a biological daughter, Mikayla(ph), who lives somewhere else because they donated their embryo so some other couple could have a child?
PALCA: That's right. And the deal they made with Mikayla's parents was that those parents had to agree to try to conceive with all nine of those embryos. Now as it happened, they only wound up with one child from the nine embryos.
ELLIOTT: Nine embryos. They have one girl. Did they use...
ELLIOTT: ...all of those nine in the process...
ELLIOTT: ...of trying to get pregnant?
PALCA: Yes, they did.
ELLIOTT: So there were none left over again?
PALCA: There were none--well, in the second couple, the couple...
PALCA: ...who received the donation of the embryos, tried to implant all nine; not all at once, but in several cycles of IVF, and wound up with one successful pregnancy.
ELLIOTT: What would have happened had they been successful with the first embryo and gotten pregnant? What would happen to the rest? Do we know?
PALCA: We don't know. But the commitment that they made to the Hileys was `We will implant all these embryos.'
ELLIOTT: That's interesting.
OK, now how common is it for people to give their embryos away to another family like this?
PALCA: It's still very rare. President Bush has suggested that this is an alternative to doing something with the estimated 400,000 embryos that are frozen in clinics around the country. But to tell the truth, there are legal issues, there's questions of parental rights and responsibilities and a lot of clinics and a lot of states just have not worked out any kind of legal format to make this kind of donation work.
ELLIOTT: You talked to a second family. Can you tell us about them and the decision they faced?
PALCA: OK, the second family I talked with was Jody and Greg Miller. They now have triplets. They had three embryos left over after their in vitro fertilization. They live in Maryland, just outside of Washington, DC. And the Millers also were faced with an unanticipated situation. Here's a bit of that conversation.
Mrs. JODY MILLER (Embryo Recipient): We had not thought about it at all. I think we were so focused on just getting pregnant that we didn't focus on extra embryos at all. Once we found out we were pregnant with triplets, we knew right away that would be the last cycle we attempted and we knew then we would have extras, but we didn't think about it in advance.
PALCA: Did you ever think about just saying, `We don't need 'em, let's throw 'em away,' Greg?
Mr. GREG MILLER (Embryos Recipient): No. No, we definitely didn't want to have them destroyed or not, you know, used for anything. But then again, we couldn't really bear in our mind that if we donated them for somebody else to use--I said there's no way I could think I have three other kids out there, possibly. So that's when it, you know, came to thought that we wanted to get them out of the holding tank and put 'em to use somewhere. And we took 'em up to Johns Hopkins and gave 'em to them.
PALCA: How'd you feel that day? How'd you feel the day that you actually gave away three embryos?
Mr. MILLER: I was pretty happy about it, almost relieved that, hey, they're not stuck, you know, somewhere not doing anything.
Mrs. MILLER: I think we both felt really good about it. As it turns out, we were donating them to a research program that was perfecting the testing method for pre-implantation genetic diagnosis.
PALCA: So this is a way of testing embryos to see if they have a genetic defect, essentially?
Mrs. MILLER: That's correct. Since we have been there, they've perfected the testing for cystic fibrosis.
PALCA: So how long was it after you had the triplets that you had to make--before you had to make a decision about how long you wanted to keep them in storage?
Mrs. MILLER: We could have kept them in storage indefinitely...
Mr. MILLER: Forever.
Mrs. MILLER: ...I imagine. But for us it was more of a cost issue, that we started acting upon the idea of: What should we do with them? Because we can't just keep paying every month for the fee.
Mr. MILLER: When you're trying to feed and clothe three kids and, you know, not everybody's working and the income isn't coming in and you see 55 bucks a month--wow, you know, that adds up. Six-fifty a year can go to the kids and at the same time it can benefit somebody else to not have them frozen. But, yeah, it's economics.
PALCA: Was any of this decision about what to do with these embryos influenced by your faith at all?
Mrs. MILLER: Not for me.
Mr. MILLER: No. No, I mean, there's a--you--we were talking about this before you showed up about how a lot of people's faith does dictate what they will and will not do. And you know, I'm a pretty conservative individual, but when it comes to the advancement of science and that sort of thing, I think there should be, you know, avenues taken to accomplish it. And then, you know, when you think about the whole world out there, as far as what's wrong and what's right as far as a faith or religious aspect of it all, I'm at the point where, you know, people need--people do what it takes to have a family. And people that don't believe in the way what--we might have done something with our embryos and everything, they should really just mind their own business. And you know, if they don't want to do it, then don't do it.
ELLIOTT: That's Greg and Jody Miller talking to NPR's Joe Palca about their decision to donate leftover embryos to scientific research. Joe is here with me in the studio. Joe, that couple sounded very secure that they made the right decision with what to do with their embryos, that they were somehow part of something bigger, almost.
PALCA: That's right. But I think both couples felt very secure in the decision, one for do--but for doing completely opposite things. One for donating them to couples who want to have children and the other for donating to research.
And I think the interesting thing is that we actually looked around for a couple who would say to us, `Oh, we just threw them away. I mean, we just said we were done. We had all the children we wanted and we just threw them away.' And you know, we couldn't find them. I worked with producer Anna Vigran and we worked really hard and put out a lot of calls and tried to find somebody. And I think that speaks to the moral ambiguity of what these embryos represent to people.
ELLIOTT: NPR's Joe Palca, thanks so much.
PALCA: You're welcome.
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