Embryo Adoption & Donation

Donating Parents

How is embryo adoption different from embryo donation? Many adoption agencies which offer embryo donation utilize the same procedures and similar forms to those used in traditional adoption.
What are the benefits of embryo adoptions, as provided by adoption agencies and/ or attorneys? Embryo Adoptions: Go beyond the typical donation program by offering the same safeguards and education available as that in a traditional adoption; Include a homestudy which is conducted for the adopting family and include screening and education; Allow both the placing and adopting families to participate in the selection of each other, as compared to embryo donation where, most often, a doctor in a clinic decides to whom embryos are given; Recognize the importance of counseling for all parties involved.
How do we determine where we should store remaining embryos? Many clinics will freeze and store your embryos at their facility for an annual fee. Most families choose this option because they have not completed their family building. However, some families have difficulty determining the future for their remaining embryos; donation, destruction, research or leave them frozen. As a result, the number of remaining embryos continues to increase. Each year when a couple receives their annual storage fee invoice is another opportunity to face this difficult decision. There are several corporations that have been established specifically to store frozen embryos. But please heed this word of caution: Some centers that offer to store your embryos might require that you relinquish all control once the embryos are in their facility. In addition, certain centers will sell your embryos for profit. When you are making a decision regarding your embryos, it is important to carefully and completely research all of the facility's policies in order to ensure all options for your embryos remain in your control.
What kind of factors influence whether a family is interested in donating their embryos? When a family begins their IVF procedures, they may be either unaware or unconcerned that a surplus of embryos will be created as "insurance" for additional attempts at pregnancy. Once they have completed their family and have the children from their embryos looking them in the eyes everyday, the reality of what their embryos mean to them often hits them unexpectedly. The families' reactions can range from shock to frustration to guilt when they realize the magnitude of the situation facing them. These feelings can change their previous indifference at discarding the embryos to a sense of protection and concern for them instead. Different families are interested in different types of programs. Some families may want information about the recipients of their embryos; other families would rather remain anonymous. It is important to offer both types of programs.
Why would placing parents choose embryo adoption instead of donation?
- Embryo adoption provides the same safeguards that the traditional adoption process offers.
- The donating family knows that the family they have chosen to parent their child has been screened for a criminal history and child abuse record, as well as educated about how to parent an adopted child.
- The donating parents have the peace of mind of having personally selected a family to raise their genetic child. They also have the opportunity to have contact with the adopting family to whatever extent both families are comfortable. The children, genetic siblings, would also have the opportunity to connect later on if they desired.
Can a family who only has one embryo in storage donate that one embryo to a recipient couple? Yes. Because embryo adoption programs typically work with embryos in varying numbers from more than one clinic, it is possible for a donating family with only one embryo, in conjunction with another donating family with more embryos, to be able to offer that embryo to a recipient couple. In the event that embryos from both families are transferred at the same time and a pregnancy results, a DNA test should be performed upon birth of the child to determine the genetic parents of the child.
Are there families who would be interested in receiving embryos on which there is limited medical background and information? This type of situation can be analogized to the domestic adoption where the birthmother doesn 't know who the birthfather is, and yet the child is still adopted. There are families who are willing to work with a situation where there is limited information available on the embryos being offered.
If we used an anonymous egg or sperm donor when we created our embryos, can we still place them for adoption? As long as the contract you signed with the donor does not specify that the eggs or sperm are for your personal reproductive use only, you can place the embryos with another family. In addition, you will also need to provide any information you have about the donor (i.e. donor profile). Verification of the donor 's infectious disease screen results must be obtained from either the donor agency or your clinic.
The doctor said our embryos are not good quality. Can we still give them to another family? Yes. Some programs have eligibility requirements for embryos, others do not. Be sure to research all your options.
Is it more important to match according to physical attributes or to other characteristics? Families who are receiving embryos typically want children that will look like their family (with similar heredity). The placing families are concerned with the physical appearance as well, but are also interested in other characteristics that usually are similar to their own such as education, religion, if the mother will work or stay at home, the number of other children in the family, similar financial security, length of marriage, or age of the prospective parents.
What kind of information will we need to provide about ourselves and our embryos from another clinic? You will need to contact your fertility clinic and have them send you and your donation/ adoption organization the embryology reports and freezing and thawing protocols for the embryos, as well as infectious disease screens for the donating parents (or the egg/ sperm donor). If the embryos were created through gamete donation, you will need to submit a copy of the contract you had with your donor, and the information given to you when you selected your donor.
If we place our embryos for adoption, will we be able to know if a pregnancy occurred for the receiving family? Yes. Each program operates differently, but there are programs which allow you to know if a pregnancy occurred and even receive information about the child after birth if you desire.
Who handles the coordination of the embryo's travel? If you are working with a private embryo adoption provider, the agency or attorney should coordinate travel for the embryos between the two clinics.
What if our clinic doesn't have a dry shipper? The agency or attorney with whom you are working should be able to coordinate the rental of an appropriate shipping container for you.
What are the most significant legal issues associated with embryo adoption? The most significant legal issue associated with embryo donation and adoption relates to, first, the unsettled nature of embryo adoption law, and second, the contractual agreements used to legally bind donor and recipient couples.
First, both the donor and recipient couples should acknowledge that the law of embryo donation and adoption is unsettled. There are no federal or state laws specifically governing the adoption of embryos although some states do have laws generally related to embryo donation and/or assisted reproductive technology.
Second, the embryo donation and adoption process involves adoption agreement and relinquishment forms, which are legal contracts between the donor and recipient couples. These forms formalize the genetic parents' relinquishment of their parental rights prior to the embryos being transferred to the receiving mother. Once transferred, the embryos belong to the adopting parents. Parties involved should also note that embryos have a special legal status that is yet to be clearly defined. While many courts are reluctant to classify embryos as property, they also do not characterize them as human beings. As a result, embryo adoption programs may differ in how they define embryos in their legal agreements. Some may refer to embryo donation as a transfer of property while others may incorporate traditional adoption language into their legal documents.
Does the adopting family help with any of the storage fees owed by the donating parents? Typically, adopting families do not pick up any costs prior to having been matched with a donating family. Once donating and adopting families have selected one another, the embryos are shipped to the adopting family's clinic, where the adopting family then becomes responsible for storage costs incurred. Depending on how many embryos a donating family has, if an adopting family completes their family with embryos still remaining, there may be a chance that those remaining embryos would once again become the donating family's responsibility for storage fees and selection of another family.
Does it cost anything for the donating parents to place embryos for adoption? Ultimately, no. Any expenses related to placing your embryos for adoption are usually covered by the recipients.
Will offering embryos for adoption prevent waiting, available children from being adopted? No. If newborns were available at the same rate as embryos, many adopting families would most likely take the child already born, since there is no guarantee of a pregnancy with embryo adoption and donation. And yet, there are many families for whom the possibility of being able to get pregnant is a crucial factor in their decision to pursue embryo adoption over traditional adoption. It is also important to keep in mind that some families who are looking for newborns may not necessarily be open to adopting children over a certain age or sibling groups, while conversely, families ready to open their homes to a foster situation may not desire to give birth to babies.
Are there limits on the number of times embryos may be donated? It is in the best interests of the children involved that all of a family's embryos be placed with one adopting family in the hopes that one family will give birth to all the siblings from a group of embryos. If the adopting family is unable to transfer all the embryos they receive, then the original donating family should decide whether to place the embryos with a second adopting family.
What are the current FDA requirements for blood tests? The U.S. Food and Drug Administration (FDA) has published regulations regarding human tissue donation that effects embryo donation and adoption. On May 25, 2004, the FDA published final rules addressing donor testing/ screening and good tissue practice. The FDA subsequently issued an interim final rule on May 25, 2005, which amended certain sections of those regulations. For additional information on the rule, see the FDA's web site Question and Answer section at: http://www.fda.gov/cber/rules/hctdnr.htm
Previously, the FDA rules exempted sexually intimate partners engaged in reproductive treatment, from infectious disease testing prior to the creation of their embryos, which were intended for the couple's own use. The interim final rule expanded this exemption, which now permits couples who were not originally screened for infectious disease to donate their cryopreserved embryos to other couples. The regulations do suggest that attempts to test these donor couples should be made before the embryos are transferred to the recipient, but, when testing is not possible, the recipient should at least be advised of the potential communicable disease risk. Given that FDA regulations may change, you should be sure to understand what screening and testing requirements are in effect at the time of your donation.
When issuing the interim final rule, the FDA stated, "We are now adding a new exemption from screening and testing in Sec. 1271.90(a)(4) for cryo preserved embryos that, while originally exempt from the donor eligibility requirement because the donors were sexually intimate partners, are later intended for directed or anonymous donation. When possible, appropriate measures should be taken to screen and test the semen and acolyte donors before transfer of the embryo to a recipient. This change reflects the fact that sexually intimate partners may decide to donate their cryopreserved embryos long after their fertility treatments are completed. Because the embryos were intended for use in a sexually intimate relationship the donors would not have been required to be screened and tested for communicable disease agents at the time that oocytes and semen were recovered. The new provision recommends that appropriate measures be taken to screen and test the semen and oocyte donors before transfer of the embryo to the recipient, when possible.
What counseling should be offered to the donor family as well as to the adoptive family? Counseling is an important component of the services that should be offered in an embryo adoption and, in fact, is specifically included in the American Society for Reproductive Medicine's (ASRM's) guidelines for donating embryos. The type of counseling services made available and offered in an embryo adoption situation should be similar to the counseling services offered for traditional adoptions. For example, local area donating families should be provided with counseling services at no charge. Counseling for local adopting families should be included in their program fees. Referrals should be made for families outside of the geographical area serviced by the agency, clinic, or attorney.
How willing are clinics to cooperate with embryo adoption? Most fertility clinics have the best interest of their patients in mind and will guide them through their best options. While some clinics refuse to work with embryos from outside clinics, other clinics will provide the service at their patients' request. Some clinics are open to using an outside service to place their patients' unused embryos but will not refer families to receive embryos.

Adopting Parents

How is embryo adoption different from embryo donation? Embryo adoption, as provided by adoption agencies and/or attorneys, goes beyond the typical donation program by offering the same safeguards and education available as that in a traditional adoption. Specifically:
- A homestudy is conducted for the adopting family and includes screening and education.
- Both the placing and adopting families participate in the selection of each other, as compared to embryo donation, where most often, a doctor in a clinic decides to whom embryos are given.
- An embryo adoption program further recognizes the importance of counseling for all parties involved.
In contrast, in embryo donation cases:
- the adopting family does not have a homestudy prepared,
- the families are usually unknown to one another and have no participation in the selection process,
- there is typically no contact between the families, even through an intermediary.
How is surrogacy different from embryo adoption and donation? In surrogacy, an agreement is made for embryos to be transferred into a woman's uterus, and she then carries the pregnancy for the benefit of the intended parents. The embryos may be genetically related to the intended parents or may be the result of egg and/or sperm donation. Compare that to embryo adoption and donation, where the adopting mother herself carries the child or children. The placing couple relinquishes their rights to any children born from the embryos prior to the implantation of those embryos in the adoptive mother. The child that the adopting mother carries is the child that she and the adopting father will parent.
How is embryo adoption different from traditional adoption on the issue of 'risk'? There are significant differences in age, marital status and maturity between mothers evaluating whether to give up their birth-children for adoption and parents considering whether to place or donate their embryos.
Why would placing parents choose embryo adoption instead of donation? Embryo adoption provides the same safeguards that the traditional adoption process offers. The placing family knows that the family they have chosen to parent their child has been screened for a criminal history and child abuse record, as well as educated about how to parent an adopted child. The placing parents have the peace of mind of having personally selected a family to raise their genetic child. They also have the opportunity to have contact with the adopting family to whatever extent both families are comfortable. The children, full genetic siblings, would also have the opportunity to connect later on if they desired.
Why would adopting parents choose embryo adoption instead of donation? The adopting family has a chance to have a relationship with their child's placing family. Whether they share pictures and letters, have telephone conversations or choose to meet the placing parents, the adopting family will know that they have access to information about their child's history, as well as a possible match for any future medical need, such as an organ donation or blood or bone marrow transplants. The agency is available to facilitate communication between the families. The agency will educate and work with the adoptive family about how to talk to their child(ren) about their unique conception and adoption-related issues.
Why would adopting parents choose embryo adoption instead of traditional adoption of a newborn? The most obvious difference between an embryo adoption and a traditional adoption is the pregnancy experience. Adoptive mothers are able to experience the joys (and burdens!) of pregnancy and labor. They also have the peace of mind of knowing their children received the appropriate prenatal care and were not exposed to alcohol or drugs during pregnancy. There are, of course, certain considerations involved in embryo adoption that are not present in traditional adoption. For instance, because more than one embryo is implanted during the transfer procedure, an adoptive couple might have twins or triplets.
May an adopting family be registered with a traditional adoption program AND work with an agency offering embryo adoption? Each adoption agency and embryo adoption program is different. An adoptive family should check with both the adoption agency and embryo adoption program with which they are working to determine if this is allowed.
What are the basic requirements for an adopting family? The adopting mother must be able to carry a child to term. Her doctor will be asked to provide a letter stating that there are no contraindications to pregnancy. Additional eligibility requirements may be indicated by the placing family. The adopting family must also have completed an adoptive homestudy. This homestudy is the same study used to evaluate and educate adopting parents in traditional domestic adoptions.
Why should an adoptive home assessment or homestudy be performed when embryo donation/ adoption is generally not recognized as a true adopting proceeding in the United States? The importance of the homestudy lies in its purpose to help couples have not only healthy children, but healthy families.
An adoptive homestudy for the recipient couple ensures that the safeguards currently in place for traditional adoption also protect the child, the placing parents and the receiving parents in an embryo adoption situation.
Despite the fact that the adoptive mother gives physical birth to a child from an embryo donation, that child is still an adopted child; he or she shares no genetic relation to the adoptive mother or father. When children are born into a family to whom they are not genetically related, they may have the same types of questions as those of children adopted through traditional means. The homestudy process is 20% screening and 80% education. It provides the adoptive family with an opportunity to learn about and anticipate these types of issues and questions. The homestudy also educates the parents of the best way to addresss and answer these questions with sensitivity to the needs of the child.
The homestudy process benefits donating parents by assuring them that the adopting family:
- was evaluated for any health issues that may affect their ability to care for and raise a child,
- was screened for any criminal and child abuse issues,
- was educated concerning the potential issues of parenting a non-genetically related child
How can an adopting family find a local agency to conduct their homestudy? For most embryo adoption programs, a traditional domestic homestudy is all that is required. It is best to find a private licensed adoption agency to work with because most state agencies or social services departments do not perform pre-placement homestudies, and the ones who do most often will not provide a copy to an outside agency. You can find a list of agencies in your area in the "Service Providers/ Resources" section of this website.
May the homestudy be used for a traditional adoption if an adopting family determines that at some point they no longer wish to adopt embryos? With the completed homestudy, an adopting family is in the position to look at traditional adoption if they determine that they are finished with the embryo adoption program. This determination is different for each family. Set limits and move on to another program when those limits have been reached. Limits can be based on time, a determined number of transfers, money, or a combination of the above. If an adopting family makes several attempts at embryo adoption and is still not able to conceive, they may want to consider domestic or international adoption. An adopting family should discuss this option with their social worker while still in the homestudy process.
How are placing and adopting families matched? The matching process includes the following steps:
Does embryo adoption have to be open? Open adoption encompasses a wide spectrum of contact. There is usually no requirement that families meet, exchange last names or other identifying information, but at a minimum, each family will select each other through the presentation of an introductory letter, biography, and small selection of photographs that they each have personally prepared. All such adoptions are considered open. Whether a family wants more contact (via e-mail, telephone, photographs, and letters, sent either directly or through an adoption agency, attorney, or other intermediary) or less contact, families with similar levels of desired contact are able to be matched with one another.
What type of information will we receive about the donating parents and their embryos? You will receive a medical health history, a family profile including information about the parents of the embryos and possibly pictures. Your doctor will receive the embryology reports, freezing and thawing protocols and all infectious disease screening results.
If the embryos were created with an egg and/ or sperm donor, you will receive as much information as possible on the donor(s).
What is the risk that the donating parents might change their minds? There is no more risk than with any legal contract. The donating family contractually transfers their ownership rights by signing a relinquishment prior to the embryos being shipped to the adopting family's clinic.
Who handles the coordination of an embryo's travel? If you are working with a private embryo adoption provider, the agency or attorney should coordinate travel for the embryos between the two clinics.
What if our clinic doesn't have a dry shipper? The agency or attorney with whom you are working should be able to coordinate the rental of an appropriate shipping container for you.
What does an embryo adoption program fee typically cover? An embryo program's fees typically cover the completion of a homestudy for families who need one, matching of the adopting family with a donating family, maintenance of files, facilitation of communication between donating and adopting families, preparation of contracts, relinquishments and other legal paperwork, counseling for both sides, coordination of communication between clinics and doctors to ensure that requirements are met for the transfer of the embryos between states, and management and direction of shipping of the embryos. Medical and incidental expenses are generally not included.
Does the program fee include medical expenses? This depends on the program you are working with. If medical expenses are included in the fee, generally you will need to work with a specified fertility clinic.
If medical expenses are not included, adopting parents are able to choose their fertility clinic and doctor, and need to pay the clinic to thaw and transfer the embryos as well as any other associated medical costs connected with the transfer.
When choosing a fertility clinic, be sure to compare like services included in various quotes and the costs of subsequent transfers and embryo storage.
What additional out-of-pocket expenses can an adopting family expect? Costs which may not be covered by an embryo adoption program include the rental of a dry shipper for embryo's travel and additional lab tests for a donating family.
Does the adopting family help with any of the storage fees owed by the donating parents? Typically, adopting families do not pick up any costs prior to having been matched with a donating family. Once donating and adopting families have selected one another, the embryos are shipped to the adopting family's clinic, where the adopting family then becomes responsible for storage costs incurred.
What questions should an adopting family ask when looking for a fertility clinic? Ask the clinic how much it would cost for an "FET," or frozen embryo transfer, including necessary prescriptions. Also ask if they are willing to accept embryos from another clinic. It's also important to ask about storage fees and short-term or long-term storage agreements. Adopting families may have to educate a clinic about embryo adoption and/or donation.
A local clinic has agreed to receive frozen storage embryos from other clinics, however, they insist that the donating family follow FDA regulations regarding blood work. What does this mean? Current ASRM/FDA recommended blood tests include: HIV I & II, HTLV I & II, RPR (Syphilis), Hepatitis B Surface Antigen, Hepatitis C Antibody, Blood typing, Rh factor.
The FDA requires that parents who create embryos on or after May 25, 2005 must have their blood screened twice for infectious diseases. The first screen is done at the time of collection/ creation and the second screen must be done at least six months later. This is to ensure that no infectious diseases were contracted during the month or two preceding the collection, which would not have shown up on the first screen.
Parents who created embryos before May 25, 2005 are recommended to have this second screening done, but there is no FDA requirement. However, most clinics who agree to accept embryos from other clinics will require a second screening, even if they embryos were created far before May 25, 2005. If an egg or sperm donor was used in the creation of the embryos before May 25, 2005, the original screening results are sufficient. It is not necessary to locate him or her for additional blood testing.
If the embryos were created prior to May 25, 2005, and the donating parents are not able or willing to complete additional blood testing, a waiver can be signed by the adoptive parents stating that they are aware of the lack of testing and choose to accept any risks.
Fees for the screens are covered by the adopting parents, although donating parents may have to pay initially and then be reimbursed.
How many embryos should an adopting family transfer per cycle? Adopting families should limit the number of embryos transferred to the number that they are willing to carry to term in the event that all the embryos attach. Some embryo adoption programs specifically require their adopting families to agree to implant all thawed and viable embryos and to not selectively reduce the number of embryos that have begun developing. Due to the high-risk nature of a multiple pregnancy, most doctors recommend limiting the number of embryos transferred to no more than three embryos at a time. This is something adopting families should discuss with their doctor prior to their scheduled embryo transfer.
What is the success rate for thawing and viability of embryos? The average overall thaw success rate is approximately 50%. The success rate for frozen embryo transfer varies by clinic. Each clinic reports on their own statistics - adopting families should discuss the numbers with the clinic with which they will be working. Additional research on a clinic's success rates can also be found on the Center for Disease Control's Web site, located at www.cdc.gov.
What is the likelihood of a multiple pregnancy with frozen embryo transfer? Multiple births are less common with frozen embryo cycles than with "fresh" embryo transfers. But this in no way guarantees that an adopting family will not have multiples. Adopting families should consult the Society for Reproductive Technology, ASRM, the Center for Disease Control, and their fertility clinic for statistics.
What are the most significant legal issues associated with embryo adoption? The most significant legal issue associated with embryo donation and adoption relates to, first, the unsettled nature of embryo adoption law, and second, the contractual agreements used to legally bind donor and recipient couples.
What if an adoptive family gets pregnant and there are still embryos remaining? All embryos will be released to the adoptive parents in a relinquishment and they will have an initial period in which to thaw and transfer as many embryos as are needed. If more time is needed, another relinquishment will be requested. If the adopting parents decide that they do not want to keep the embryos for their own use at a later date, the responsibility for the embryos reverts back to the original donating family, who then becomes responsible for storage costs and choosing another family.
What if pregnancy is not achieved after using all of a donating family's embryos? If a match between adopting and placing families does not result in a pregnancy after thawing and/or transferring all of their embryos, another match can usually be facilitated with another donating family. This would normally include a nominal fee to cover counseling for the next couple, new paperwork and embryo travel. However, you should check with the program you are considering, as each embryo adoption program is different.

Medical

How is embryo adoption different from embryo donation? With embryo donation, the adopting family does not have a homestudy prepared, the families are usually unknown to one another and have no participation in the selection process, and there is typically no contact between the families, even through an intermediary. Embryo adoption as provided by adoption agencies and/or attorneys goes beyond the typical donation program by offering the same safeguards and education available as that in a traditional adoption. A homestudy is conducted for the adopting family and includes screening and education. Both the donating and adopting families participate in the selection of each other, as compared to embryo donation, where most often, a doctor in a clinic decides to whom embryos are given. An embryo adoption program further recognizes the importance of counseling for all parties involved.
What are the most significant legal issues associated with embryo adoption? The most significant legal issue associated with embryo donation and adoption relates to, first, the unsettled nature of embryo adoption law, and second, the contractual agreements used to legally bind donor and recipient couples.
First, both the donor and recipient couples should acknowledge that the law of embryo donation and adoption is unsettled. There are no federal or state laws specifically governing the adoption of embryos although some states do have laws generally related to embryo donation and/or assisted reproductive technology.
Second, the embryo donation and adoption process involves adoption agreement and relinquishment forms, which are legal contracts between the donor and recipient couples. These forms formalize the genetic parental relinquishment of their parental rights prior to the embryo being transferred to the receiving mother. Once transferred, the embryos belong to the adopting parents. Parties involved should also note that embryos have a special legal status that is yet to be clearly defined. While many courts are reluctant to classify embryos as property, they also do not characterize them as human beings. As a result, embryo adoption programs may differ in how they define embryos in their legal agreements. Some may refer to embryo donation as a transfer of property while others may incorporate traditional adoption language into their legal documents.
What type of patient medical information will our clinic receive about the donating parents and their embryos? Your clinic will receive:
- Infectious disease screening results (an FDA requirement)
- embryology reports
- embryo freezing and thawing protocols
It is likely that the program your patients are working with will be able to contact the donating parents and their clinic to obtain additional information as necessary.
What are the current FDA requirements for blood tests? The U.S. Food and Drug Administration (FDA) has published regulations regarding human tissue donation that effects embryo donation and adoption. On May 25, 2004, the FDA published final rules addressing donor testing/ screening and good tissue practice. The FDA subsequently issued an interim final rule on May 25, 2005, which amended certain sections of those regulations. For additional information on the rule, see the FDA's web site Question and Answer section at: http://www.fda.gov/cber/rules/hctdnr.htm
Previously, the FDA rules exempted sexually intimate partners engaged in reproductive treatment, from infectious disease testing prior to the creation of their embryos, which were intended for the couple's own use. The interim final rule expanded this exemption, which now permits couples who were not originally screened for infectious disease to donate their cryopreserved embryos to other couples. The regulations do suggest that attempts to test these donor couples should be made before the embryos are transferred to the recipient, but, when testing is not possible, the recipient should at least be advised of the potential communicable disease risk. Given that FDA regulations may change, you should be sure to understand what screening and testing requirements are in effect at the time of your donation.
When issuing the interim final rule, the FDA stated, "We are now adding a new exemption from screening and testing in Sec. 1271.90(a)(4) for cryo preserved embryos that, while originally exempt from the donor eligibility requirement because the donors were sexually intimate partners, are later intended for directed or anonymous donation. When possible, appropriate measures should be taken to screen and test the semen and acolyte donors before transfer of the embryo to a recipient. This change reflects the fact that sexually intimate partners may decide to donate their cryopreserved embryos long after their fertility treatments are completed. Because the embryos were intended for use in a sexually intimate relationship the donors would not have been required to be screened and tested for communicable disease agents at the time that oocytes and semen were recovered. The new provision recommends that appropriate measures be taken to screen and test the semen and oocyte donors before transfer of the embryo to the recipient, when possible.
What counseling should be offered to the donating and adopting families? Counseling is an important component of the services that should be offered in an embryo adoption and, in fact, is specifically included in the ASRM's guidelines for donating embryos. Drawing upon the traditional model of adoption, the type of counseling services made available and offered in an embryo adoption situation should be similar. For example, local area donating families should be provided with counseling services at no charge. Counseling for local adopting families should be included in their program fees. Referrals should be made for families outside of the geographical area serviced by the agency, clinic, or attorney.
Who handles the coordination of the embryos' travel? It is usually the responsibility of the patient's private embryo adoption provider, agency or attorney to coordinate the embryo's travel between the placing and adopting clinics.
What if we don't have a dry shipper? The agency or attorney with whom your patients are working should be able to coordinate the rental of an appropriate shipping container for you.
What are the costs to the donating parents? There are no fees for the donating parents to participate in the program. There may be costs during the process if any additional blood work is required per FDA guidelines, depending on where the embryos are going and what types of tests the donating family has had, but the adopting family may cover these costs.
Does the adopting family help with any of the storage fees owed by the donating parents? Typically, adopting families do not pick up any costs prior to having been matched with a donating family. Once donating and adopting families have selected one another, the embryos are shipped to the adopting family's clinic, where the adopting family then becomes responsible for storage costs incurred.
Is there a limit on the length of time our patients have to use their adopted embryos? Generally, patients have as long as they need to transfer their adopted embryos.
If there are still adopted embryos remaining after our patients are done, what do we do? The original donating parents will resume custody and make a decision about what to do with the remaining embryos.

Legal

Is there legal precedence for the adoption or donation of frozen embryos? Many adoption agencies which offer embryo adoption utilize the same procedures and similar forms to those used in traditional adoption.
What are the most significant legal issues associated with embryo adoption? The most significant legal issue associated with embryo donation and adoption relate to, first, the unsettled nature of embryo adoption law, and second, the contractual agreements used to legally bind donor and recipient couples.
First, both the donor and recipient couples should acknowledge that the law of embryo donation and adoption is unsettled. There are no federal or state laws specifically governing the adoption of embryos although some states do have laws generally related to embryo donation and or assisted reproductive technology.
Second, the embryo donation and adoption process involves adoption and agreement and relinquishment forms, which are legal contracts between the donor and recipient couples. These forms formalize the genetic parental relinquishment of their parental rights prior to the embryo being transferred to the receiving mother. Once transferred, the embryos belong to the adopting parents. Parties involved should also note that embryos have a special legal status that is yet to be clearly defined. While many courts are reluctant to classify embryos as property, they also do not characterize them as human beings. As a result, embryo adoption programs may differ in how they define embryos in their legal agreements. Some may refer to embryo donation as a transfer of property while others may incorporate traditional adoption language into their legal documents.
Which states currently have laws that affect embryo adoption or donation? Note: the following information provided in this section is current only as of April 1, 2006. It is not intended to be a complete or comprehensive statement of the law in this area. It should therefore, in no way, shape, or manner, be construed or interpreted as providing legal advice. You are advised to conduct your own independent research as to the status of law on this subject.
While no states have laws which specifically address embryo adoption or donation there are several states with laws which are related to or directly affect embryo donation and adoption. The following provides examples:
- California: California Health & Safety Code §125315 provides that doctors must inform in-vitro fertilizations (IVF patients) of embryo disposition options, including donating to another couple; written consent is required for any such donation. California Penal Code §367g imposes criminal penalties of up to 5 years imprisonment and/or a $50,000 fine upon anyone who implants embryos in anyone other than the provider of those embryos without the provider's and recipient's written consents.
- Louisiana: Louisiana Revised Statutes §9:123 unequivocally provides that an embryo is a juridical person, and under §9:131, any disputes concerning the embryo must be resolved in the embryo's best interest. Section 9:127 imposes a duty of responsibility for the safekeeping of any embryo on the physician or medical facility causing the fertilization of such embryo, while §9:126 appoints the in vitro fertilization doctor as a temporary guardian of the embryo in certain situations until such time as adoptive implantation can be performed. Section 9:129 prohibits the intentional destruction of any viable embryo. Under §130, adoption occurs only when both parents execute a notarized writing to document the donation of embryos and whenn a live birth occurs. That section also prohibits the donating couple from receiving compensation in exchange for renouncing their parental birth rights.
- Oklahoma: Under §556 of Title 10 of the Oklahoma Statutes, written consent of both donating and recipient couples is required for embryo donation. The doctor who is to perform the transfer must file those consents with a court having adoption jurisdiction in the state. Section 1-730 of Title 63 of the Oklahoma Statutes defines "unborn child" to mean the unborn offspring of human beings from the moment of conception through pregnancy and until live birth and specifically includes "embryo".
- Texas: Under §160.704, the consent of a married woman to an ART procedure must be in record signed by the woman and her husband, with embryo donation being included within the definition of Assisted Reproduction Technology (ART) under §160.102. Clarifying this point further, §160.702 provides that a donor is not considered the parent of a child conceived through assisted reproduction.
- Florida: Florida statute states:
  742.14: The donation of eggs, sperm or preembryos
  742.11: Presumed status of child conceived by means of artificial or in vitro insemination or donated eggs or preembryos
- If a state's laws are silent on the issue of embryo adoption, are there any steps that can be taken to protect the recipient family's parental rights? Most states recognize the birth parents as the legal parents. In embryo adoption/donation, the recipient couple's names are entered on the birth certificate and a court of law would most likely recognize them as the legal parents. Some families have opted to seek an order of parentage from the court while the adoptive mother is pregnant with the child to settle the issue prior to the child's birth.
- What roles may an agency or attorney fulfill in the embryo adoption/donation process?
  - Phase One:The process starts with an initial inquiry from a family either desiring to place their embryos for adoption or to adopt embryos.
  Agency/ Attorney Roles: Staff should be in place who can answer the resulting questions and prepare and mail program information packets and applications. When applications are received, they should be reviewed and approved by an assigned adoption social worker who reads the home assessment (in the case of an adoptive family), interviews the client to discuss matching criteria and address and resolve any issues concerning the placement or adoption of the embryos prior to the family being approved for participation in the program.
  - Phase Two: Both the donating and adopting families establish their criteria for a successful match which will lead to an embryo placement and adoption. A matching process initiates.
  Agency/ Attorney Roles: Once a successful match has been made, each set of parents drafts and signs contracts; embryos are shipped to the adopting family's clinic, and the adopting family is then able to schedule their frozen embryo transfer (FET). Depending on the form and frequency of any on-going contact between the families, an agency or attorney may need to continue to act as intermediary for such contact. There is also the possibility that additional matches and contracts will need to be performed if an adopting family does not use all of the donating family's embryos.
- What average time commitment should an agency or attorney expect to invest with each placement? A typical time investment can range from 100 to 200 hours per family choosing to adopt or place embryos in adoption or donation program. The time spent can be broken down into the following types of activities:
  - processing the application
  - counseling and matching the families
  - preparing the documents for transfer of legal ownership
  - coordinating the medical documentations
  - facilitating shipment of the embryo
  This list is by no means exhaustive and the time required to place embryos may vary greatly depending on the needs and desires of each individual family.
- How many donation/ adoptions occur nationwide each year? There are no national statistics regarding the number of embryo donations/adoptions that occur each year. Each program can vary widely with some programs performing as few as 1 adoption or donation per year, while others may complete as many as 40 placements a year.
- What legal documents are used to transfer the embryos from the donating parents to the adoptive parents? Necessary legal documents include:
  - A document relinquishing the genetic parents' rights and responsibilities to the embryos and any child or children born from those embryos
  - A document allowing the recipients to assume all parental rights and responsibilities for the embryos and any child or children born from them.
- At what point is an embryo adoption considered to be finalized? Although there is little or no precedence on this issue, the language of the written agreement effecting the transfer of ownership in the embryos may specify that the adoption is deemed to have occurred at the point of thawing and implantation of the embryos into the adoptive mother's womb.
- If we wanted to start a program, what is the typical fee schedule? As in any adoption program, the fees charged will vary depending on the type of organization offering the service, the geographical area being serviced, and the motivations of the program founders. Typically, the fees for embryo adoption are less than those for a traditional adoption.
- Are there any tax implications of embryo donation and adoption? There is some support for the application of the adoption tax credit to embryo adoption. Some families have applied for the tax credit with regard to the fees paid to their agency for the adoptive home assessment, educational component, and other adoption agency or attorney expenses directly relating to the adoption of the embryos. These may be families who have participated in an embryo adoption program and who have given birth to a child as a result.
  This information is not intended to be a complete or comprehensive statement of the law in this area. It should therefore, in no way, shape, or manner, be construed or interpreted as providing legal advice. You are advised to conduct your own independent research as to the applicability of the adoption tax credit to embryo adoption or to seek the advice of a tax professional, Certified Public Accountant, or financial adviser.
- Why should an adoptive home assessment or homestudy be performed when embryo donation/adoption is generally not recognized as a true adoption proceeding in the United States? The importance of the homestudy lies in its purpose to help couples have not only healthy children, but healthy families.
  An adoptive homestudy for the recipient couple ensures that the safeguards currently in place for traditional adoption also protect the child, the placing parents and the receiving parents in an embryo adoption situation.
  Despite the fact that the adoptive mother gives physical birth to a child from an embryo donation, that child is still an adopted child; he or she shares no genetic relation to the adoptive mother or father. When children are born into a family to whom they are not genetically related, they will have the same types of questions as those of children adopted through traditional means. The homestudy process is 20% screening and 80% education. It provides the adoptive family with an opportunity, to learn about and anticipate these types of issues and questions. The homestudy also educates the parents in the best way to address and answer these questions with sensitivity to the needs of the child.
  Since the homestudy process provides the donating parents with assurance about their embryos' prospective parents, they are also benefited. This assurance includes:
  - the adopting family has been evaluated for any health issues that may affect their ability to care for and raise a child,
  - has been screened for any criminal and child abuse issues,
  - has been educated concerning the potential issues of parenting a non-genetically related child
- Is there a risk of commercialization of life through the adoption of embryos? There is always the risk of abuse in any process. Therefore, it is imperative that embryos be treated with the respect they deserve and, in order to discourage program participation based on profit incentives, that fees remain low. Embryo adoption programs must be operated with ethical and professional integrity.

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